Teaching Personality Disorders: An Essential Component of Psychiatry Residency Training

Personality disorders are common across psychiatric settings yet may receive insufficient attention in residency training.This may contribute to diagnostic error, inappropriate polypharmacy, and failure to recognize clinically meaningful interpersonal patterns and countertransference reactions.We argue that competence in personality pathology should be considered a fundamental component of psychiatric training rather than a subspecialty interest.We propose a tiered educational model in which all residents learn to assess personality organization, understand major evidence-based treatments, and develop generalist competence in the management of personality disorders, while more specialized psychotherapy training remains elective.Psychotherapy education provides an especially valuable setting for learning to recognize defenses, disturbances of identity, recurrent interpersonal patterns, and enduring personality pathology over time.Even as fewer psychiatrists provide formal psychotherapy, training in personality disorders remains important for accurate diagnosis, comprehensive formulation, appropriate treatment selection, and effective referral across psychiatric practice.