Medical residency in psychiatry and its subspecialties: demographic analysis in Brazil

Abstract

ABSTRACT Introduction: The training of psychiatrists through medical residency plays a fundamental role in strengthening mental health in Brazil. Given the increase in mental health problems, it is essential to understand how psychiatry residency programs and their subspecialties are organized across the country. Objective: To analyze the geographical distribution of positions and psychiatry residency programs and their subspecialties in Brazil in 2025. Method: Observational and descriptive study, with an ecological approach, using public data from the National Medical Residency Commission, collected in July 2025. Variables analyzed included location, number of authorized and filled positions, occupancy rate, program size, and financial investments, as well as the ratio of psychiatry residents per 100,000 inhabitants, supported by descriptive thematic cartography. Result: A total of 174 psychiatry residency programs were identified, distributed across 90 municipalities, with an occupancy rate of 80.1% of the 2,431 authorized positions. The majority of these positions are in state capitals (47.1%) and municipalities with over 300,000 inhabitants (77%). The national ratio is 0.91 psychiatry residents per 100,000 inhabitants, ranging from 0.18 in Pará to 2.3 in the Federal District; three states in the North region have no residents. Regarding subspecialties, 55 programs and 182 positions were identified, of which 121 (66.5%) were occupied, with the highest proportion in the Southeast (57.1%) and absence in 18 states. Conclusion: Despite the expansion of psychiatry residency programs, there remains a concentration in the South and Southeast regions and in state capitals, which compromises the retention of professionals in certain areas. Public policies should align the creation of positions and programs with the health needs of the population, encouraging decentralization, strengthening subspecialties, and promoting regional retention of psychiatrists.