ArticleHealth policy OPEN2026
National trends and territorial disparities in psychiatry residency fill rates in France: a longitudinal panel study, 2016-2026.
Article in Health policy OPEN, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
5 authors.
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Abstract
Background: Mental health needs are increasing across Europe, while psychiatric workforce planning in France is challenged by workforce ageing and territorial inequalities. Objective: To assess national trends in psychiatry residency fill rates in France and examine the territorial distribution of unfilled positions from 2016-2017 to 2025-2026. Methods: We conducted a nationwide retrospective longitudinal panel study including all 28 French residency subdivisions over 10 academic years. Opened and filled positions were extracted from decrees published in the French Official Journal. Fill rates were modelled using a beta-binomial generalised linear mixed model. Heterogeneity was quantified using the median odds ratio, and concentration using the Gini coefficient and top-share estimates. Results: The panel included 280 subdivision-year observations, corresponding to 5282 opened, 4719 filled, and 563 unfilled positions. Observed national fill rates declined from near-complete levels before 2019 to 82.49% in 2019-2020 and remained below pre-2019 levels thereafter. The model-based national fill rate decreased from 98.10% in the early period to 82.74% in the late period, an absolute change of -15.4 percentage points. Between-subdivision heterogeneity was substantial. Unfilled positions were territorially concentrated and the top 25% of subdivisions accounted for 61.3% of all unfilled positions. Conclusions: Psychiatry residency underfilling in France has become a sustained, territorially uneven workforce planning issue. In centralised rank-based allocation systems, workforce planning should monitor not only the number of training positions opened, but also their conversion into filled positions and the territorial accumulation of vacancies.
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