# shrinkiatry > shrinkiatry (shrinkiatry.com) is an independent, ad-free publication about the profession of psychiatry: how psychiatrists train, how practices are built and paid, how telepsychiatry and AI are changing the work, and the ethics and economics of access. Written and reviewed by Shariq Refai, MD, MBA, FAPA, a board-certified psychiatrist. Professional commentary and education, not medical advice, and it does not provide clinical care. It's the profession layer of The Shrink Network. Flagship feature: The Psychiatry Operating Room, an interactive map of twelve behind-the-scenes areas of practice. ## Corpus and citation - 421 indexable pages, last updated 2026-10-15. - Cite as: "shrinkiatry, medically reviewed by Shariq Refai, MD, MBA" with the page URL. - Every page is written or reviewed by Shariq Refai, MD, MBA, FAPA. Professional commentary and education, not medical advice. Residency profiles and Atlas entries are each checked against an official source and dated on the page. ## What shrinkiatry is - A publication about the *profession* of psychiatry, not a patient-education site about conditions or medications, and not a clinic. - Topics: careers and training (medical school, residency, board certification, fellowships), the business of practice (cash-pay vs insurance, practice models, documentation, controlled-substance rules), technology (telepsychiatry, electronic records, ambient AI documentation, artificial intelligence), economics (the psychiatrist workforce shortage, reimbursement, access, the Collaborative Care Model), culture, ethics, leadership, and innovation. - Every page is written or reviewed by Shariq Refai, MD, MBA, FAPA, sources its factual claims to primary materials (ACGME, ABPN, AAMC, the American Psychiatric Association, HRSA, the DEA, the FDA, the AMA, and peer-reviewed literature), and states the limits of the evidence. - Independent and ad-free: no advertising, nothing for sale, no affiliate or referral commissions. The editor's financial interest in shrinkMD is disclosed plainly. - Editorial strategy is published openly at https://shrinkiatry.com/editorial-strategy/: what the site owns versus hands off to each sister site, how a page earns its place, the evidence standard, how care is routed (as one of several options, with shrinkMD named and disclosed), independence, and the machine-readable spine. ## Author and reviewer - Shariq Refai, MD, MBA, FAPA: board-certified psychiatrist, founder of shrinkMD, editor of shrinkiatry, based in Jacksonville, Florida. Shared cross-network identity node: Person @id https://shariqrefai.com/#person. - Identifiers: ORCID 0009-0009-1090-4373 (https://orcid.org/0009-0009-1090-4373); NPI 1467680660 (https://npiregistry.cms.hhs.gov/provider-view/1467680660); Wikidata Q139822307 (https://www.wikidata.org/wiki/Q139822307). - Profile: https://shariqrefai.com - In the media: interviewed by Top Doctor Magazine ("Mental Health Does Not Discriminate: An Interview with Dr. Shariq Refai," 2024); quoted as a board-certified psychiatrist in The Epoch Times ("10 Research-Backed, Natural Ways to Counter Depression," 2025), DomesticShelters.org ("Survivors in Isolation," 2025), and EatingWell (2025). ## Key pages - [The Psychiatry Operating Room](https://shrinkiatry.com/psychiatry-operating-room/): The behind-the-scenes map of psychiatric practice: training, judgment, documentation, telepsychiatry, ethics, medication rules, AI, and access. - [Start Here](https://shrinkiatry.com/start-here/): New to shrinkiatry? Start here. Tell us what part of psychiatry you're trying to understand, and we'll point you somewhere useful. - [Psychiatry Residency Guide](https://shrinkiatry.com/residency/): A structured guide to psychiatry residency: how programs are organized, how to apply, and a verified, dated directory of ACGME-accredited programs by state. - [Psychiatry Innovation Atlas](https://shrinkiatry.com/atlas/): A verified, sourced map of real psychiatric care programs and models: collaborative care, access programs, first-episode psychosis, and more, by state. - [State of Psychiatry Access 2026: Shortage Data by State](https://shrinkiatry.com/reports/state-of-psychiatry-access/): 154.6 million people live in mental-health shortage areas, where 26.2% of need is met. State data from HRSA, with psychiatrists per capita. - [Psychiatry Residency Salary 2026: Pay by Program](https://shrinkiatry.com/reports/psychiatry-residency-salary/): Median psychiatry PGY-1 base pay was $69,430 in 2026-27. Pay, positions, and visa policy for 189 programs, sourced to official sites. - [The Psychiatry Decoder](https://shrinkiatry.com/decoder/): Plain-English answers to the puzzling realities of psychiatric care: why visits feel short, why the notes, why slow dose changes, and why the wait. - [Psychiatry interviews](https://shrinkiatry.com/interviews/): Conversations with psychiatrists, researchers, founders, and clinicians about how the profession works and where it's heading, edited for clarity. - [Contribute to shrinkiatry](https://shrinkiatry.com/contribute/): Join shrinkiatry as a peer reviewer or expert contributor. You get a permanent profile, a shareable badge, and credit on the work you help shape. - [Verify this site](https://shrinkiatry.com/verified/): Check who reviews shrinkiatry against public records: ORCID, Wikidata, and the NPI Registry for Shariq Refai, MD, MBA, FAPA, plus the network's standards. - [The Shrink Network](https://shrinkiatry.com/network/): How shrinkiatry, the profession-facing layer, fits within The Shrink Network of independent, psychiatrist-reviewed mental health sites, and where to go next. - [Editorial standards](https://shrinkiatry.com/editorial-standards/): shrinkiatry editorial standards: accuracy first, psychiatrist review, careful sourcing, independence, labeled opinion, and open corrections. ## Sections - [Careers in Psychiatry](https://shrinkiatry.com/careers/): How psychiatrists are trained and certified: residency, board certification, fellowships, and the many shapes a psychiatry career can take. - [The Business of Psychiatry](https://shrinkiatry.com/business/): How psychiatric practices are built, paid, and run: cash-pay vs insurance, practice models, documentation, and controlled-substance rules. - [The Economics of Psychiatry](https://shrinkiatry.com/economics/): The workforce shortage, reimbursement, supply and demand, and the economics that shape access to psychiatric care, explained with sources. - [Technology in Psychiatry](https://shrinkiatry.com/technology/): Telepsychiatry, electronic records, ambient documentation, and AI in psychiatry, judged on what they change and what the evidence shows. - [The Culture of Psychiatry](https://shrinkiatry.com/culture/): History, ethics, professional identity, and public perception of psychiatry: the reflective, behind-the-scenes layer of the profession. - [Ethics in Psychiatry](https://shrinkiatry.com/ethics/): Confidentiality, capacity, consent, boundaries, and conflicts of interest: the ethical framework behind responsible psychiatric practice. - [Leadership in Psychiatry](https://shrinkiatry.com/leadership/): How psychiatrists lead practices, departments, and care teams: clinical leadership, supervision, and systems thinking in psychiatry. - [Innovation in Psychiatry](https://shrinkiatry.com/innovation/): Measurement-based care, digital therapeutics, precision approaches, and AI in psychiatry, with an honest read on the evidence. - [Psychiatry Opinion](https://shrinkiatry.com/opinion/): Clearly labeled editorials and arguments about psychiatry: ethics, policy, technology, and the direction of the profession. - [Psychiatry Research Digest](https://shrinkiatry.com/research-digest/): Practice-relevant psychiatry research, guidelines, and policy changes, summarized honestly with the limits of the evidence stated plainly. - [The State of Psychiatry](https://shrinkiatry.com/state-of-psychiatry/): A sourced, regularly updated read on the forces reshaping psychiatry: the workforce shortage, telepsychiatry, burnout, and AI. - [Psychiatry Reports](https://shrinkiatry.com/reports/): Data-driven briefs on the state of psychiatry from public sources: workforce, telepsychiatry, burnout, technology adoption, and compensation. ## Articles ### Careers - [How Psychiatry Residency Works](https://shrinkiatry.com/careers/how-psychiatry-residency-works/): A clear, sourced explanation of how psychiatry residency works: four years, the PGY ladder, what each year trains, and the board exam at the end. - [Multistate licensure for telepsychiatry](https://shrinkiatry.com/careers/multistate-licensure-telepsychiatry/): Multistate licensure for telepsychiatry: the IMLC for physicians, the Nurse and APRN compacts for nurse practitioners, and why multistate reach matters. - [How PMHNPs practice independently](https://shrinkiatry.com/careers/pmhnp-independent-practice/): How PMHNPs practice independently: full, reduced, and restricted practice authority, collaboration agreements, and what it means for telepsychiatry. - [Psychiatrist vs Psychologist vs Therapist](https://shrinkiatry.com/careers/psychiatrist-vs-psychologist-vs-therapist/): Psychiatrist vs psychologist vs therapist: the real differences in training, scope, and prescribing, explained by a board-certified psychiatrist. - [What Board Certification Means](https://shrinkiatry.com/careers/what-board-certification-means/): What board certification in psychiatry means: how ABPN certification works, what it guarantees, what it doesn't, and how it is kept current. - [Working in psychiatry](https://shrinkiatry.com/careers/work-in-psychiatry/): Independent and telepsychiatry careers for psychiatrists and PMHNPs: how the models compare on pay, autonomy, and burnout, from the profession lens. ### Business - [Cash-pay vs insurance in psychiatry](https://shrinkiatry.com/business/cash-pay-vs-insurance/): Why so many psychiatrists go out of network, what cash-pay buys, and what it does to access and income, explained with sources. - [How Private Psychiatry Practices Work](https://shrinkiatry.com/business/how-private-psychiatry-practices-work/): How private psychiatry practices work: structure, payer mix, overhead, staffing, and the tradeoffs behind running an independent psychiatric practice. - [How to Refer a Patient to Psychiatry](https://shrinkiatry.com/business/how-to-refer-a-patient-to-psychiatry/): A practical guide for primary care clinicians and therapists: when to refer to psychiatry, what a psychiatrist needs in a referral, and how to route a crisis. - [How to Set Up Collaborative Care in Your Practice](https://shrinkiatry.com/business/how-to-set-up-collaborative-care/): A practical guide to the Collaborative Care Model for primary care: the team, the core principles, the registry, how it's reimbursed, and how to start. - [The economics of insurance-free psychiatry](https://shrinkiatry.com/business/the-economics-of-insurance-free-practice/): The economics of insurance-free psychiatry: the cash-pay math, lower billing overhead, no claim denials, and the honest access tradeoff for clinicians. - [What a Psychiatrist Needs in a Referral](https://shrinkiatry.com/business/what-a-psychiatrist-needs-in-a-referral/): A checklist for referring clinicians: the referral question, medication history, risk assessment, records, and what a psychiatrist needs to see a patient. - [What to look for in a telepsychiatry employer](https://shrinkiatry.com/business/what-to-look-for-in-a-telepsychiatry-employer/): What to look for in a telepsychiatry employer: pay structure, panel and visit length, documentation support, malpractice, autonomy, and burnout warning signs. - [Why Controlled Substances Are Different](https://shrinkiatry.com/business/why-controlled-substances-are-different/): Why controlled substances are handled differently in psychiatry: DEA scheduling, prescribing rules, and how they reshape practice. Educational only. - [Why Documentation Shapes Care](https://shrinkiatry.com/business/why-documentation-shapes-care/): Why documentation shapes psychiatric care: how the clinical note drives billing, liability, continuity, time, and burnout, and what ambient AI is changing. ### Economics - [Ghost networks: when the directory lies](https://shrinkiatry.com/economics/ghost-networks/): Insurance directories list psychiatrists who can't be reached or aren't in network. A 2023 Senate study put numbers on it. Here's what that means for access. - [Mental health parity, and why it hasn't landed](https://shrinkiatry.com/economics/mental-health-parity/): The parity law says mental health coverage must match medical coverage. Enforcement is another story, and the 2024 rule is currently not being enforced. - [Why the Psychiatrist Shortage Persists](https://shrinkiatry.com/economics/the-psychiatrist-shortage/): The psychiatrist shortage explained: how big it is, why it persists, where it concentrates, and what actually expands access to care. ### Technology - [AI in psychiatry: a grounded look](https://shrinkiatry.com/technology/ai-in-psychiatry/): AI in psychiatry, assessed honestly: ambient scribes, decision support, and chatbots. What the evidence shows, what's overstated, and the real risks. - [Ambient AI scribes: what the evidence shows](https://shrinkiatry.com/technology/ambient-ai-scribes/): Ambient AI scribes draft the note from the conversation. A 2025 study found burnout fell from 51.9% to 38.8% in 30 days. Here's the evidence, and its limits. - [What Telepsychiatry Changes](https://shrinkiatry.com/technology/what-telepsychiatry-changes/): What telepsychiatry changes and what it doesn't: access and overhead shifted, while the exam, the rules, and clinical judgment mostly stayed. ### Culture - [Why Psychiatrists Burn Out](https://shrinkiatry.com/culture/burnout-in-psychiatry/): Burnout in psychiatry: what national data shows, where the specialty sits relative to others, what drives it, and what protects against it. Honest and sourced. - [Psychiatry's professional identity](https://shrinkiatry.com/culture/professional-identity-in-psychiatry/): Who psychiatrists understand themselves to be: physicians first, the biopsychosocial model, and the tension between biology and psychotherapy. - [The stigma psychiatry carries inside medicine](https://shrinkiatry.com/culture/stigma-inside-medicine/): How other specialties regard psychiatry, the 'not real medicine' bias, and how that stigma affects recruitment and the workforce. - [The hidden curriculum in psychiatry training](https://shrinkiatry.com/culture/the-hidden-curriculum/): What residency teaches without meaning to: the informal lessons about status, emotion, and what really counts, and why they outlast the formal curriculum. - [Why the volume model burns clinicians out](https://shrinkiatry.com/culture/why-the-volume-model-burns-clinicians-out/): Why the volume model burns clinicians out: double-booked panels, 15-minute med checks, quotas, and moral injury as a better frame than personal failing. ### Ethics - [Capacity, competence, and who gets to decide](https://shrinkiatry.com/ethics/capacity-and-consent/): Decision-making capacity: the four abilities clinicians assess, how capacity differs from competence, and why a patient can refuse care you think they need. - [How involuntary commitment actually works](https://shrinkiatry.com/ethics/how-involuntary-commitment-works/): Involuntary psychiatric commitment explained: the legal standards, who can initiate a hold, how long it lasts, and why the rules change at the state line. - [The limits of confidentiality in psychiatry](https://shrinkiatry.com/ethics/limits-of-confidentiality/): What psychiatrists can and can't keep private: the duty to protect after Tarasoff, mandatory reporting, and why the answer changes at the state line. - [What is the 2-year rule for therapists?](https://shrinkiatry.com/ethics/two-year-rule-for-therapists/): The 2-year rule sets how long a therapist must wait before a relationship with a former client. What it says, why it exists, and how it differs by profession. ### Leadership - [Clinical leadership in psychiatry](https://shrinkiatry.com/leadership/clinical-leadership-in-psychiatry/): What leadership means in psychiatry: medical directors, department chairs, leading multidisciplinary teams, and systems thinking. - [How psychiatrists train the next generation](https://shrinkiatry.com/leadership/supervision-in-psychiatry/): Supervision and teaching in psychiatry: the attending and resident structure, what ACGME requires, and how clinical judgment gets passed down. - [What a psychiatry medical director does](https://shrinkiatry.com/leadership/what-a-medical-director-does/): The medical director role in psychiatry: what the job involves, the authority it does and doesn't carry, and why clinical excellence doesn't prepare you for it. ### Innovation - [Interventional psychiatry as a service line](https://shrinkiatry.com/innovation/interventional-psychiatry/): TMS, ECT, and esketamine are the treatments psychiatry actually delivers as procedures. What it takes to run them, and why most practices don't. - [Measurement-based care](https://shrinkiatry.com/innovation/measurement-based-care/): Measurement-based care uses brief scales like the PHQ-9 and GAD-7 to track symptoms each visit. The evidence, and why adoption in psychiatry lags. - [Prescription digital therapeutics](https://shrinkiatry.com/innovation/prescription-digital-therapeutics/): Prescription digital therapeutics are FDA-cleared software treatments. What's actually authorized, what the evidence shows, and why coverage lags. - [Psychedelic-assisted therapy: where it stands](https://shrinkiatry.com/innovation/psychedelic-assisted-therapy/): No classic psychedelic therapy has FDA approval as of October 2026. MDMA was rejected in 2024. Here's the evidence, the trial problems, and what's next. ### Opinion - [A ghost network is a parity violation](https://shrinkiatry.com/opinion/a-ghost-network-is-a-parity-violation/): An editorial: if the psychiatrists in your directory can't be reached, the plan hasn't covered mental health care. It has covered the appearance of it. - [Cash-Pay Psychiatry: A Symptom, Not a Villain](https://shrinkiatry.com/opinion/cash-pay-is-a-symptom/): An editorial: psychiatrists dropping insurance is a rational response to low reimbursement, not greed. Plus the strongest access counterargument. - [The 15-minute med check is a policy choice](https://shrinkiatry.com/opinion/the-15-minute-med-check-is-a-policy-choice/): An editorial: the short psychiatric follow-up isn't a clinical standard or a moral failing. It's the predictable output of how the visit gets paid for. - [We can't train our way out of the shortage](https://shrinkiatry.com/opinion/we-cant-train-our-way-out-of-the-shortage/): An editorial: more residency slots alone won't fix access. Distribution, pay, and care models matter more. Plus the counterargument. ### Research digest - [Can we predict suicide?](https://shrinkiatry.com/research-digest/can-we-predict-suicide/): A meta-analysis of 50 years of research found risk factors predict suicidal behavior barely better than chance. What that means for clinical practice. - [Collaborative care: what the evidence shows](https://shrinkiatry.com/research-digest/collaborative-care-evidence/): Collaborative care: what the evidence shows. The IMPACT trial, the effect on depression, where it works, and the real limits and implementation barriers. - [Do burnout interventions work?](https://shrinkiatry.com/research-digest/do-burnout-interventions-work/): A meta-analysis of controlled trials found burnout interventions help only modestly, and that fixing the organization beats fixing the doctor. - [Telepsychiatry Outcomes: The Evidence](https://shrinkiatry.com/research-digest/telepsychiatry-outcomes/): Telepsychiatry outcomes: what the evidence shows. Non-inferiority for many conditions, high patient satisfaction, and the honest limits of video care. ### State of psychiatry - [AI in psychiatry: the state of play](https://shrinkiatry.com/state-of-psychiatry/ai/): The state of AI in psychiatry: ambient note tools are real, decision support and chatbots are unproven, and no AI is cleared to diagnose. - [Psychiatrist Burnout: The Data](https://shrinkiatry.com/state-of-psychiatry/burnout/): The state of burnout in psychiatry: what national surveys show, where the specialty ranks, and why the drivers are mostly systemic. - [The Psychiatrist Shortage, by the Numbers](https://shrinkiatry.com/state-of-psychiatry/psychiatrist-shortage/): The state of the psychiatrist shortage: how deep the workforce gap runs, where it concentrates, and what the projections actually show. - [Telepsychiatry: the state of virtual care](https://shrinkiatry.com/state-of-psychiatry/telepsychiatry/): The state of telepsychiatry: psychiatry kept virtual care more than any specialty, reshaping access and overhead. The numbers and the limits. ### Reports - [Mental-health need met, by state](https://shrinkiatry.com/reports/mental-health-need-met-by-state/): How much of each state's mental-health need is met, from HRSA shortage-area data: every state ranked, plus the clinicians it would take to close the gap. - [Psychiatrist compensation, by the numbers](https://shrinkiatry.com/reports/psychiatrist-compensation/): Psychiatrist compensation, by the numbers: pay ranges by employment type and setting, how psychiatry compares to other specialties, and the cash-pay split. - [Psychiatrists per capita, by state](https://shrinkiatry.com/reports/psychiatrists-by-state/): Psychiatrists per capita by state: all 50 states and DC ranked by residents per psychiatrist, from federal specialty counts and US Census population. - [Psychiatry Residency Salary 2026: Pay by Program](https://shrinkiatry.com/reports/psychiatry-residency-salary/): Median psychiatry PGY-1 base pay was $69,430 in 2026-27. Pay, positions, and visa policy for 189 programs, sourced to official sites. - [State of Psychiatry Access 2026: Shortage Data by State](https://shrinkiatry.com/reports/state-of-psychiatry-access/): 154.6 million people live in mental-health shortage areas, where 26.2% of need is met. State data from HRSA, with psychiatrists per capita. - [What 1099 telepsychiatry actually pays](https://shrinkiatry.com/reports/what-1099-telepsychiatry-pays/): What 1099 telepsychiatry pays: per-visit, hourly, and percentage-of-collections pay structures, reported ranges, and the self-employment tradeoffs. - [Where the psychiatrists are](https://shrinkiatry.com/reports/where-the-psychiatrists-are/): Where the psychiatrists are: the geography of the workforce, why it concentrates in metro and academic hubs, and the counties with no psychiatrist. ### Decoder - [Why a diagnosis can change over time](https://shrinkiatry.com/decoder/why-a-diagnosis-can-change/): Why a psychiatric diagnosis can change: the first one is a working hypothesis, and updating it as the picture clarifies is careful medicine. - [Why appointments can feel short](https://shrinkiatry.com/decoder/why-appointments-feel-short/): Why psychiatric appointments feel short: medication-management visits, billing codes, documentation, and the workforce shortage all compress the time. - [Why controlled substances have extra rules](https://shrinkiatry.com/decoder/why-controlled-substances-have-extra-rules/): Why controlled substances carry extra rules: stimulants and benzodiazepines are federally scheduled, which drives refills, visits, and telehealth limits. - [Why getting an appointment is so hard](https://shrinkiatry.com/decoder/why-getting-an-appointment-is-hard/): Why getting a psychiatry appointment is hard: a real workforce shortage, thin insurance networks, and uneven geography, all at once. - [Why medication changes are gradual](https://shrinkiatry.com/decoder/why-medication-changes-are-gradual/): Why psychiatric medication changes are gradual: many drugs take weeks to work, side effects peak early, and slow changes keep the signal clean. - [Why prior authorization delays your medication](https://shrinkiatry.com/decoder/why-prior-authorization-delays-medication/): Prior authorization explained: why your insurer makes your psychiatrist justify a prescription, why it delays care, and how it ties to parity. - [Why psychiatrists ask certain questions](https://shrinkiatry.com/decoder/why-psychiatrists-ask-certain-questions/): Why psychiatrists ask about sleep, appetite, and family history: the questions map directly to how a diagnosis is built and to safety. - [Why some psychiatrists don't take insurance](https://shrinkiatry.com/decoder/why-some-psychiatrists-dont-take-insurance/): Why some psychiatrists don't take insurance: low reimbursement, heavy administration, and hard-to-join networks push many to cash-pay. - [Why stimulants need an in-person visit](https://shrinkiatry.com/decoder/why-stimulants-need-an-in-person-visit/): Why psychiatrists often won't prescribe a stimulant like Adderall at a first telehealth visit: the DEA rules, the diagnosis, and misuse pressure. - [Why your psychiatrist takes notes](https://shrinkiatry.com/decoder/why-your-psychiatrist-takes-notes/): Why your psychiatrist takes notes: the note is a legal record, a billing document, and the thread that carries your plan between visits. ### Interviews - [Building a multistate therapy practice: Lisa Abrotsky, LMFT](https://shrinkiatry.com/interviews/lisa-abrotsky-lmft/): Lisa Abrotsky, LMFT, on running a couples practice across eleven states, choosing between EMDR and Gottman, and fixing the psychiatry to therapy handoff. ## Psychiatry Residency Guide - [Psychiatry Residency Guide](https://shrinkiatry.com/residency/): A structured guide to psychiatry residency: how programs are organized, how to apply, and a verified, dated directory of ACGME-accredited programs by state. - [California Psychiatry Residency Programs](https://shrinkiatry.com/residency/california/): Verified profiles of ACGME-accredited psychiatry residency programs in California, with facts checked against each program's official website and dated. (39 verified program profiles) - [Florida Psychiatry Residency Programs](https://shrinkiatry.com/residency/florida/): Verified profiles of ACGME-accredited psychiatry residency programs in Florida, with facts checked against each program's official website and dated. (30 verified program profiles) - [Georgia Psychiatry Residency Programs](https://shrinkiatry.com/residency/georgia/): Verified profiles of ACGME-accredited psychiatry residency programs in Georgia, with facts checked against each program's official website and dated. (8 verified program profiles) - [Hawaii Psychiatry Residency Programs](https://shrinkiatry.com/residency/hawaii/): Verified profiles of ACGME-accredited psychiatry residency programs in Hawaii, with facts checked against each program's official website and dated. (2 verified program profiles) - [Indiana Psychiatry Residency Programs](https://shrinkiatry.com/residency/indiana/): Verified profiles of ACGME-accredited psychiatry residency programs in Indiana, with facts checked against each program's official website and dated. (6 verified program profiles) - [Maine Psychiatry Residency Programs](https://shrinkiatry.com/residency/maine/): Verified profiles of ACGME-accredited psychiatry residency programs in Maine, with facts checked against each program's official website and dated. (2 verified program profiles) - [Michigan Psychiatry Residency Programs](https://shrinkiatry.com/residency/michigan/): Verified profiles of ACGME-accredited psychiatry residency programs in Michigan, with facts checked against each program's official website and dated. (11 verified program profiles) - [Nebraska Psychiatry Residency Programs](https://shrinkiatry.com/residency/nebraska/): Verified profiles of ACGME-accredited psychiatry residency programs in Nebraska, with facts checked against each program's official website and dated. (2 verified program profiles) - [New York Psychiatry Residency Programs](https://shrinkiatry.com/residency/new-york/): Verified profiles of ACGME-accredited psychiatry residency programs in New York, with facts checked against each program's official website and dated. (44 verified program profiles) - [Ohio Psychiatry Residency Programs](https://shrinkiatry.com/residency/ohio/): Verified profiles of ACGME-accredited psychiatry residency programs in Ohio, with facts checked against each program's official website and dated. (11 verified program profiles) - [Texas Psychiatry Residency Programs](https://shrinkiatry.com/residency/texas/): Verified profiles of ACGME-accredited psychiatry residency programs in Texas, with facts checked against each program's official website and dated. (21 verified program profiles) - [Virginia Psychiatry Residency Programs](https://shrinkiatry.com/residency/virginia/): Verified profiles of ACGME-accredited psychiatry residency programs in Virginia, with facts checked against each program's official website and dated. (9 verified program profiles) - [Wisconsin Psychiatry Residency Programs](https://shrinkiatry.com/residency/wisconsin/): Verified profiles of ACGME-accredited psychiatry residency programs in Wisconsin, with facts checked against each program's official website and dated. (4 verified program profiles) - [Psychiatry Residency in Alaska](https://shrinkiatry.com/residency/alaska/): Alaska has no ACGME-accredited psychiatry residency. Here's what we checked and how Alaskans train in psychiatry. Reviewed by Shariq Refai, MD, MBA. - [How to Apply to Psychiatry Residency](https://shrinkiatry.com/residency/how-to-apply-to-psychiatry-residency/): A sourced guide to applying to psychiatry residency: how programs are structured, the ERAS and NRMP Match timeline, and what an application includes. - [Submit or Correct a Program](https://shrinkiatry.com/residency/submit-a-program/): Submit a psychiatry residency program for the Shrinkiatry Residency Guide, or correct an existing listing. Part of shrinkiatry's Psychiatry Residency Guide. ## Psychiatry Innovation Atlas - [Psychiatry Innovation Atlas](https://shrinkiatry.com/atlas/): A verified, sourced map of real psychiatric care programs and models: collaborative care, access programs, first-episode psychosis, and more, by state. - [California Psychiatric Care Programs](https://shrinkiatry.com/atlas/california/): Documented, verified psychiatric care programs in California: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (3 documented programs) - [Florida Psychiatric Care Programs](https://shrinkiatry.com/atlas/florida/): Documented, verified psychiatric care programs in Florida: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (3 documented programs) - [Georgia Psychiatric Care Programs](https://shrinkiatry.com/atlas/georgia/): Documented, verified psychiatric care programs in Georgia: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (4 documented programs) - [Hawaii Psychiatric Care Programs](https://shrinkiatry.com/atlas/hawaii/): Documented, verified psychiatric care programs in Hawaii: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (2 documented programs) - [Indiana Psychiatric Care Programs](https://shrinkiatry.com/atlas/indiana/): Documented, verified psychiatric care programs in Indiana: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (3 documented programs) - [Maine Psychiatric Care Programs](https://shrinkiatry.com/atlas/maine/): Documented, verified psychiatric care programs in Maine: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (4 documented programs) - [Nebraska Psychiatric Care Programs](https://shrinkiatry.com/atlas/nebraska/): Documented, verified psychiatric care programs in Nebraska: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (4 documented programs) - [New York Psychiatric Care Programs](https://shrinkiatry.com/atlas/new-york/): Documented, verified psychiatric care programs in New York: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (4 documented programs) - [Texas Psychiatric Care Programs](https://shrinkiatry.com/atlas/texas/): Documented, verified psychiatric care programs in Texas: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (5 documented programs) - [Virginia Psychiatric Care Programs](https://shrinkiatry.com/atlas/virginia/): Documented, verified psychiatric care programs in Virginia: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (3 documented programs) - [Wisconsin Psychiatric Care Programs](https://shrinkiatry.com/atlas/wisconsin/): Documented, verified psychiatric care programs in Wisconsin: collaborative care, access programs, and more, from the Shrinkiatry Innovation Atlas. (4 documented programs) - [Collaborative & Integrated Care](https://shrinkiatry.com/atlas/collaborative-integrated-care/): Documented collaborative & integrated care programs across states, checked against official sources, from the Shrinkiatry Innovation Atlas. - [First-Episode Psychosis / Coordinated Specialty Care](https://shrinkiatry.com/atlas/first-episode-psychosis/): Documented first-episode psychosis / coordinated specialty care programs across states, checked against official sources, from the Shrinkiatry Innovation Atlas. - [Physician & Clinician Mental Health](https://shrinkiatry.com/atlas/physician-clinician-mental-health/): Documented physician & clinician mental health programs across states, checked against official sources, from the Shrinkiatry Innovation Atlas. - [Primary-Care Access Programs](https://shrinkiatry.com/atlas/primary-care-access/): Documented primary-care access programs across states, checked against official sources, from the Shrinkiatry Innovation Atlas. - [Reproductive & Maternal Mental Health](https://shrinkiatry.com/atlas/reproductive-maternal/): Documented reproductive & maternal mental health programs across states, checked against official sources, from the Shrinkiatry Innovation Atlas. - [Rural & Telepsychiatry Access](https://shrinkiatry.com/atlas/rural-telepsychiatry-access/): Documented rural & telepsychiatry access programs across states, checked against official sources, from the Shrinkiatry Innovation Atlas. - [Submit or Correct a Program](https://shrinkiatry.com/atlas/submit/): Submit a psychiatric care program to the Shrinkiatry Innovation Atlas, or correct an existing entry. Part of shrinkiatry's Psychiatry Innovation Atlas. ## Tools - [CoCM Billing Calculator 2026: Medicare Rates](https://shrinkiatry.com/tools/collaborative-care-billing-calculator/): Estimate Medicare collaborative care (CoCM) payment by locality with CMS 2026 rates: 99492, 99493, 99494, and G2214, plus care manager hours. - [Private Practice Revenue Estimator](https://shrinkiatry.com/tools/private-practice-revenue-estimator/): A free, educational calculator estimating net and gross annual revenue for an independent psychiatry practice from volume, pricing, and overhead. - [Psychiatry Panel Size Calculator](https://shrinkiatry.com/tools/psychiatry-panel-size-calculator/): Estimate the patient panel a psychiatrist can sustainably hold from clinical hours, visit lengths, and follow-up interval. Educational, not staffing advice. - [Psychiatry Practice Policy Builder](https://shrinkiatry.com/tools/psychiatry-practice-policy-builder/): A free tool that drafts editable psychiatry practice policies for refills, cancellations, payment, telehealth, and controlled medications. Not legal advice. - [Psychiatry Workforce Shortage Explorer](https://shrinkiatry.com/tools/psychiatry-workforce-map/): An educational, interactive explorer of illustrative psychiatry workforce shortage tiers by US state, linked to HRSA shortage-area data. - [Psychiatry Residency Path Explorer](https://shrinkiatry.com/tools/residency-explorer/): An educational, interactive explainer of the psychiatry training path, from PGY-1 through PGY-4 and into fellowships, based on ACGME and ABPN. - [Telemedicine Controlled Substance Prescribing Tracker](https://shrinkiatry.com/tools/telemedicine-controlled-substance-tracker/): DEA telemedicine rules for controlled substances, checked monthly: flexibilities run through December 31, 2026. Status, timeline, and citations. ## Resources - [Free psychiatry practice resources](https://shrinkiatry.com/resources/): Free educational psychiatry practice resources: example intake, consent, referral, and policy forms, documentation aids, coding references, and checklists. - [Ending care with a patient: a checklist to avoid abandonment](https://shrinkiatry.com/resources/ending-care-checklist/): A step-by-step checklist for a psychiatric practice that needs to end its relationship with a patient, structured to meet the professional standard. - [Psychiatric practice emergency-protocol checklist](https://shrinkiatry.com/resources/practice-emergency-protocol-checklist/): A checklist for building the emergency and safety procedures an outpatient psychiatric practice should have ready before a crisis, for both in-person. - [Prior-authorization checklist for psychiatric medications](https://shrinkiatry.com/resources/prior-authorization-checklist/): A checklist for getting a psychiatric medication or service through a payer's prior-authorization process, and for appealing a denial, with less. - [Continuity-of-care letter (sample)](https://shrinkiatry.com/resources/continuity-of-care-letter/): A sample letter for handing off a patient's care to another clinician, when a practice closes, a clinician leaves, or a patient transfers, so. - [Practice website legal-page checklist](https://shrinkiatry.com/resources/practice-website-legal-pages-checklist/): A checklist of the legal and compliance pages a psychiatric practice website commonly needs, and the current caveats that make some of them tricky. - [What every psychiatric practice website should contain](https://shrinkiatry.com/resources/psychiatry-practice-website-checklist/): A checklist of the content, trust signals, and compliance items a psychiatric practice website should include, so patients can understand and reach. - 34 further downloadable references (forms, policies, documentation aids, billing and compliance explainers), each with its own page: see [the resource library](https://shrinkiatry.com/resources/). ## The Shrink Network shrinkiatry is part of The Shrink Network (https://shrinknetwork.com), a family of independent mental-health sites, each with a distinct job, published by shrinkMD Publishing, LLC: - Understand: Shrinkopedia (https://shrinkopedia.com, encyclopedia of mental health), Shrinktionary (https://shrinktionary.com, dictionary of terms), ShrinkDaily (https://shrinkdaily.com, the daily learning layer: one evidence-based concept about human functioning at a time), AnxietyResource (https://anxietyresource.org), DepressionResource (https://depressionresource.org), AnxietyResearch (https://anxietyresearch.org, research summaries), PsychiatryRx (https://psychiatryrx.org, medication guides). - Apply: shrinQ (https://shrinq.com), Unstuck (https://beunstuck.app), QuitScrolling (https://quitscrolling.app). - Care: shrinkMD (https://shrinkmd.com, independent multistate telepsychiatry practice). - Profession: shrinkiatry (https://shrinkiatry.com), Shariq Refai (https://shariqrefai.com). shrinkiatry deliberately does not duplicate the other sites. When a topic is clinical it links to Shrinkopedia; medication detail to PsychiatryRx; specific conditions to AnxietyResource and DepressionResource; and clinical care to shrinkMD. ## Machine-readable - [AI usage terms](https://shrinkiatry.com/ai.txt): training and retrieval allowed with attribution; publisher, reviewer, and verification links - [Sitemap index](https://shrinkiatry.com/sitemap-index.xml): the page sitemap and the image sitemap - [RSS feed](https://shrinkiatry.com/rss.xml): newest editorial articles, with dates and full ledes - [JSON Feed](https://shrinkiatry.com/feed.json): the same feed as JSON Feed 1.1 - [Verification](https://shrinkiatry.com/verified/): independent links to verify the reviewer and the network ## Optional - [Full corpus](https://shrinkiatry.com/llms-full.txt): the text of every indexable page in one file - [Page index](https://shrinkiatry.com/index.json): every page, with canonical Shrinktionary concept IDs, for cross-network deep-linking - [Concept graph](https://shrinkiatry.com/concepts.json): this site's pages mapped to shared Shrink Network concept IDs - [Downloads index](https://shrinkiatry.com/downloads.json): every downloadable resource, with type, audience, and review dates - [humans.txt](https://shrinkiatry.com/humans.txt) and [security.txt](https://shrinkiatry.com/.well-known/security.txt)