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Hiring, Training, and Supervision

These are only examples of how some psychiatrists approach the essential elements of working in collaboration and are not meant to serve as official recommendations of NCPA.

One of the most important and confusing things for physicians related to supervision is how much is enough?  As outlined in the section on Medical and Nursing Board Requirements, North Carolina has mandatory minimum guidelines for supervision.  But remember, these are the minimal standards.  In some cases, the minimum may be adequate; in others, more direct supervision, co-signing, and frequent meetings are required. Please read carefully the NCMB Forum Article

The most important thing for a psychiatrist or any physician who works closely with NP/PAs is the physician’s comfort level with the competence of the colleague. There will be times when you need to insist on a higher level of supervision. Or, the NP/PA will ask for more support and supervision.

As the supervising physician, you should feel empowered to set the standard for the training, oversight, and supervision experience in your practice. This may depend on the practice setting (inpatient or outpatient), patient population (child, adult, geriatric), geographic area of the state (an urban area may have a larger, more experienced workforce), and certainly the experience and clinical training of the practitioner! You should not feel obligated to accept the minimum standards for any professional you are asked to supervise, even if you are employed in an agency or hospital and feel pressure to spend as little time as possible. Ultimately, your medical license is on the line with the NP/PAs who work under your supervision.


Here are some real-life examples from practicing psychiatrists in various settings:

Staff Psychiatrist at Major Urban Health System

Child and Adolescent Psychiatrist in a Rural Community

Psychiatrist in a Community Hospital

The following resources are available to assist you with training and supervision:

Checklist for Supervision

Psychiatric Continuing Education

Monitoring Quality of Care


Requirements for Professional Licensure >>

Medical and Nursing Board Requirements >>

Requirements of Supervisory Practice Agreements >>

Liability Implications of Supervision >>

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