1. Place in the library#

Psychiatry is EmbeddedKnowledge's second book and its first postgraduate, clinically adjacent curriculum. It is a modern academic syllabus, not a universal residency prescription. It synthesizes durable common ground across current United States, United Kingdom, Canadian, Australian and Aotearoa New Zealand, European, and global frameworks while keeping jurisdiction-specific law, certification, service organization, and scope of practice visible.

The design is intentionally broader than a diagnostic manual or board-review outline. Neuroscience, medicine, phenomenology, formulation, psychotherapy, pharmacotherapy, recovery, public mental health, human rights, culture, evidence, and systems practice remain co-equal strands. Classification is taught as one useful tool inside a larger clinical argument, not as the definition of psychiatry.

The syllabus has a public knowledge graph and focused production-lesson intake. Its lesson set, assessment bank, optional area-of-depth graph, and clinical-host standard grow only through separate reviewed pull requests. Graph availability does not create clinical authority.

2. Audience and routes#

The common academic curriculum supports three routes without pretending they are equivalent:

People with lived and living experience are not treated as teaching objects. They may participate as learners, paid educators, authors, reviewers, or governance partners under explicit role, consent, accessibility, attribution, compensation, withdrawal, and support agreements.

3. Entry and on-ramp#

3.1 Expected entry capabilities#

The normal physician-learner entry point is a medical degree or the biomedical, behavioural, and research-methods knowledge expected at graduation from medical school. Open scholars may enter without a medical degree, but should be able to:

• explain introductory neuroanatomy, physiology, pharmacology, genetics, and general pathology;
• take apart a research paper's question, population, design, main estimate, uncertainty, and limitations;
• reason with probability, diagnostic-test performance, risk, and absolute as well as relative effects;
• communicate about distress, disability, identity, and disagreement without stigmatizing language;
• distinguish education, simulation, supervision, and licensed clinical practice;
• protect personal and health information in notes, discussion, collaboration, and tool use.

3.2 Diagnostic and bridge PSY-ONR-000 (0–120 hours, as needed)#

The untimed diagnostic samples six prerequisite domains. It produces a concept-level study prescription, never a clinical judgment about the learner or another person.

Bridge completion is support, not admission or evidence of medical training.

4. Curriculum commitments#

1. The person exceeds the diagnosis. Symptoms, strengths, goals, development, relationships, body, culture, spirituality, material conditions, and power belong in the formulation.
2. Lived experience changes the curriculum. Paid contributors with lived and living experience help set outcomes, author cases, teach, review language, and evaluate shared decision-making. Consultation after decisions are made is not co-production.
3. Medicine and meaning stay connected. Biological mechanisms and medical mimics are taught alongside phenomenology, narrative, psychology, and social context; no single level is treated as a complete explanation.
4. Uncertainty is an assessed capability. Learners calibrate confidence, compare alternatives, state missing evidence, update formulations, and name when a classification or intervention may harm.
5. Safety includes rights. Immediate protection, therapeutic alliance, supported decision-making, least-restrictive care, safeguarding, staff safety, disclosure, and learning after harm are taught together.
6. Treatment is collaborative and longitudinal. Benefits, burdens, alternatives, interactions, monitoring, withdrawal, access, preference, and recovery goals accompany every intervention.
7. Psychotherapy is core clinical science. Relationship, formulation, common factors, model-specific methods, supervision, process, outcome, and adverse effects recur throughout the course.
8. Culture is not a module-sized add-on. Language, racism, migration, Indigeneity, gender, sexuality, disability, poverty, housing, religion, family, and local knowledge shape every clinical question.
9. Assessment samples performance. Retrieval supports learning, but progression depends on observed reasoning, communication, transfer, feedback uptake, and work across cases and contexts.
10. Open does not mean unsupervised. The book can teach knowledge and simulation. Real-patient assessment, prescribing, psychotherapy, compulsory care, and procedures require an authorized host.
11. Sources and rights outrank convenience. Every production lesson must support material claims, track version and jurisdiction, and clear text, instrument, case, image, and data rights.
12. The curriculum remains corrigible. Diagnostic categories, treatment evidence, law, technology, and preferred language change. Dated audits and reversible versioning are part of the design.

5. Graduate capabilities#

By academic completion, a learner can:

Person-centred assessment and reasoning#

1. PSY-PLO-01 Establish a respectful, boundaried, trauma-aware conversation with a standardized person and adapt it for language, disability, development, culture, and setting.
2. PSY-PLO-02 Elicit and organize a psychiatric, medical, neurologic, developmental, medication, substance, family, social, cultural, spiritual, and functional history using fictional or consented simulation material.
3. PSY-PLO-03 Describe a mental-status examination as time-bound observation, distinguish observation from inference, and communicate uncertainty without dehumanizing shorthand.
4. PSY-PLO-04 Produce and revise a concise formulation that integrates predisposing, precipitating, perpetuating, protective, biological, psychological, relational, cultural, and structural factors.
5. PSY-PLO-05 Construct a prioritized differential that includes medical, neurologic, substance-, medication-, sleep-, developmental-, and context-related explanations and states what evidence would change it.
6. PSY-PLO-06 Use dimensional measures and classification systems critically, respecting intended use, validity, copyright, version, culture, and the difference between a code and a person.

Safety, ethics, and partnership#

7. PSY-PLO-07 Reason through fictional urgent presentations involving self-harm, suicide, violence, abuse, exploitation, intoxication, withdrawal, delirium, catatonia, agitation, or severe medication effects and identify when emergency escalation is required.
8. PSY-PLO-08 Explain capacity, consent, confidentiality, safeguarding, supported decision-making, advance planning, and least-restrictive practice while labelling jurisdiction-specific law.
9. PSY-PLO-09 Build a collaborative safety and recovery plan in simulation that includes the person's priorities, strengths, supporters, access barriers, warning signs, and local crisis pathways.
10. PSY-PLO-10 Recognize diagnostic overshadowing, coercion, discrimination, epistemic injustice, conflicts of interest, and iatrogenic harm and propose accountable repair.

Treatment and longitudinal care#

11. PSY-PLO-11 Compare reasonable intervention options by indication, mechanism, expected benefit, uncertainty, burden, contraindication, interaction, monitoring, access, preference, and stopping plan.
12. PSY-PLO-12 Explain the principles and evidence of psychopharmacology, deprescribing, psychotherapy, social interventions, peer support, rehabilitation, physical-health care, and interventional treatments without issuing personal treatment advice.
13. PSY-PLO-13 Build a measurement-informed longitudinal plan that tracks symptoms, function, quality of life, physical health, adverse effects, alliance, preference, equity, and recovery rather than a symptom score alone.
14. PSY-PLO-14 Explain psychotherapy formulation and common factors; compare supportive, cognitive-behavioural, psychodynamic, interpersonal, dialectical-behavioural, family, group, and motivational approaches at a level appropriate to academic study.
15. PSY-PLO-15 Coordinate a fictional care pathway across primary care, emergency, inpatient, outpatient, community, rehabilitation, housing, education, employment, peer, and specialist services.

Scholarship, systems, and professional formation#

16. PSY-PLO-16 Appraise diagnostic, prognostic, therapeutic, qualitative, implementation, and harms evidence; detect spin, selective outcome reporting, confounding, and clinically trivial effects.
17. PSY-PLO-17 Design an ethical quality-improvement or service-evaluation proposal with stakeholder governance, balancing measures, equity analysis, privacy, and an explicit plan to stop ineffective practice.
18. PSY-PLO-18 Evaluate telepsychiatry, clinical software, generative AI, predictive models, and digital phenotyping for validity, bias, explainability, privacy, security, workflow effects, and failure modes.
19. PSY-PLO-19 Communicate with patients, families, interpreters, peers, multidisciplinary teams, services, and public audiences; disclose uncertainty, conflicts, errors, evidence limits, and tool use.
20. PSY-PLO-20 Teach, supervise in simulation, seek help, use feedback, maintain boundaries, respond to impairment or mistreatment, and construct a sustainable plan for continued learning.
21. PSY-PLO-21 Compare mental-health systems across resource settings and explain how financing, workforce, law, housing, inequality, colonization, climate, conflict, and policy shape access and outcomes.
22. PSY-PLO-22 Integrate the curriculum in an independently authored capstone and defend its decisions before academic, clinical, and lived-experience perspectives.

6. Architecture and workload#

The common curriculum contains 1,440 nominal academic hours. Hours include guided study, tutorials, standardized-person simulation, deliberate practice, assessment, and reflection. They exclude real patient care, on-call work, clinical-service delivery, and the protected supervision an accredited residency must provide.

Recommended sequence:

PSY-101 -> PSY-110 || PSY-120 || PSY-140
  -> PSY-130
  -> PSY-210 || PSY-220
  -> PSY-230
  -> PSY-240 || PSY-250 || PSY-260 || PSY-270 || PSY-280
  -> PSY-310 || PSY-320
  -> PSY-330
  -> PSY-340 || PSY-350 || PSY-360 || PSY-370
  -> PSY-410 || PSY-420 || PSY-430 || PSY-440 || PSY-450
  -> one AREA OF DEPTH -> PSY-460

The order is spiral rather than strictly linear. The longitudinal strands in section 7 must appear in every stage. Learners revisit common presentations with increasing complexity instead of completing one disorder and treating it as closed.

7. Longitudinal strands#

Every module must visibly map to at least four strands; every assessment cycle samples all ten.

8. Detailed modules#

Stage I — Person, mind, brain, and method (320 hours)#

PSY-101 What psychiatry is — 40 hours#

Scope. Competing histories and models of mental distress; the medical specialty and its limits; phenomenology; disability, neurodiversity, recovery, survivor and service-user movements; institutional power; racism, colonialism, gender and sexuality in diagnosis and care; rights; stigma; professional roles; the uses and harms of classification.

Evidence. A source-traced position paper compares three explanatory models, includes a lived-experience critique, states where they conflict, and proposes safeguards against overreach.

PSY-110 Clinical neuroscience and mind–brain models — 80 hours#

Scope. Functional neuroanatomy; neural development; signalling, networks, plasticity, stress systems, sleep and circadian biology; genetics and epigenetics; immune, endocrine, metabolic and gut–brain claims; neuropsychology; lesion and stimulation evidence; imaging; computational models; inference from association; replication and translation limits.

Evidence. An unfamiliar multi-method study is reconstructed from molecule to circuit to behaviour, with causal claims downgraded where the design cannot support them.

PSY-120 Development, relationships, and the life course — 60 hours#

Scope. Prenatal development through older age; attachment and caregiving; temperament; cognition, language, identity and moral development; family and peer systems; adversity and resilience; education and work; migration; reproductive transitions; ageing; developmental psychopathology; cohort and intergenerational evidence.

Evidence. A fictional longitudinal case is reformulated at four ages without treating childhood experience as destiny.

PSY-130 Interview, observation, alliance, and communication — 80 hours#

Scope. Preparing the setting; introductions and role clarity; open and focused inquiry; narrative and chronology; symptoms, strengths, goals and function; collateral sources; mental-status examination; interpreters and communication access; trauma-aware practice; tele-interviewing; boundaries; documentation; uncertainty; feedback; difficult conversations.

Evidence. Three standardized-person encounters across different communication needs, followed by transcript annotation, observer feedback, self-calibration, and repair.

PSY-140 Epidemiology, evidence, and measurement — 60 hours#

Scope. Incidence, prevalence, burden and service use; sampling; measurement validity and invariance; diagnostic accuracy; prognosis; trials; observational and qualitative designs; systematic reviews; heterogeneity; causal diagrams; missing data; effect size; minimal important change; harms; conflicts; open science; measurement-based care; instrument rights.

Evidence. A multi-study evidence brief answers a bounded question and reports absolute effects, uncertainty, applicability, harms, funding, and what remains unknown.

Stage II — Formulation, safety, and presentations (480 hours)#

PSY-210 Formulation, classification, and diagnostic reasoning — 60 hours#

Scope. Problem lists; syndromic, dimensional and narrative descriptions; ICD-11 literacy; DSM literacy without reproducing proprietary criteria; differential diagnosis; base rates; thresholds; comorbidity; heterogeneity; cultural formulation; functional analysis; causal and maintenance hypotheses; protective factors; Bayesian updating; diagnostic error; communicating a working formulation.

Evidence. A timed case conference compares at least four alternatives, explicitly tests medical and contextual explanations, and revises the formulation after new data.

PSY-220 Medicine, neurology, investigations, and physical health — 60 hours#

Scope. Delirium; seizures; movement, autoimmune, endocrine, infectious, nutritional, toxic, medication-related and sleep-related presentations; neurologic and physical examination reasoning; laboratory, toxicology, ECG, EEG, imaging and cognitive testing; pregnancy; multimorbidity; pain; health promotion; diagnostic overshadowing; physical-health inequity.

Evidence. A medical-mimic objective structured simulation requires escalation, investigation choices, interpretation, and a plain-language explanation of uncertainty.

PSY-230 Urgency, safety, and crisis care — 60 hours#

Scope. Suicide and self-harm; violence and victimization; abuse, neglect and exploitation; intoxication and withdrawal; agitation; catatonia; delirium; severe adverse effects; crisis communication; de-escalation; safety planning; means safety; safeguarding; handover; observation; emergency pathways; post-incident care; restraint and seclusion alternatives; limits of prediction.

Evidence. A circuit of fictional emergencies scored on recognition, immediate priorities, help-seeking, rights, communication, and avoidance of false numerical certainty. Any missed emergency action is non-compensable.

PSY-240 Psychosis and unusual experiences — 60 hours#

Scope. Hallucinations, delusions, disorganization, negative symptoms, catatonia and cognitive change; trauma, culture and spirituality; first episode; affective, substance-, medication-, neurologic and medical alternatives; early intervention; family work; antipsychotic evidence and burden; physical health; rehabilitation; hearing-voices and recovery perspectives; refractory illness.

Evidence. A first-episode transfer case integrates urgency, differential, meaning, shared decisions, family context, monitoring, and a five-year recovery horizon.

PSY-250 Depression, bipolarity, and mood variation — 60 hours#

Scope. Depressive and manic presentations; mixed features; grief; trauma; perinatal and seasonal contexts; bipolar differential; medical and medication-related causes; suicide; longitudinal course; psychosocial, pharmacologic and interventional options; activation, withdrawal and relapse; function and recovery.

Evidence. A longitudinal case requires phase-specific treatment comparisons and revision after an adverse effect and a change in the person's goals.

PSY-260 Anxiety, obsessive-compulsive, trauma-related, and dissociative presentations — 60 hours#

Scope. Fear and avoidance; panic; generalized anxiety; obsessions and compulsions; traumatic stress; dissociation; somatic arousal; developmental and cultural expression; medical and substance alternatives; exposure principles; cognitive, behavioural, pharmacologic and social interventions; stabilization and the risks of premature trauma processing.

Evidence. A mechanism map links learning processes to a graded plan while preserving consent, pacing, comorbidity, and alternative explanations.

PSY-270 Substance use and behavioural addictions — 60 hours#

Scope. Intoxication, withdrawal, overdose and interactions; alcohol, sedatives, opioids, stimulants, cannabis, nicotine and emerging substances; pain; gambling and debated behavioural addictions; harm reduction; motivational communication; pharmacotherapy; recovery communities; trauma; housing and criminalization; family effects; dual diagnosis.

Evidence. A non-judgmental care plan handles acute risk, readiness, harm reduction, medication options, social needs, recurrence, and local service constraints.

PSY-280 Relational, behavioural, and bodily presentations — 60 hours#

Scope. Personality functioning and enduring patterns; self-injury; eating and feeding disorders; somatic symptom and functional presentations; sleep disorders; sexual function and concerns; gender-related care without pathologizing identity; impulse-control presentations; factitious illness; overlap, stigma, medical risk, therapeutic stance, and iatrogenic harm.

Evidence. Comparative cases test medical risk, formulation, language, boundaries, team dynamics, and selection of specialist care without stereotype-based shortcuts.

Stage III — Treatment, lifespan, and continuity (400 hours)#

PSY-310 Psychopharmacology and deprescribing — 70 hours#

Scope. Decision thresholds; placebo and expectancy; pharmacokinetics, pharmacodynamics, interactions and pharmacogenomic limits; antidepressant, antipsychotic, mood-stabilizing, anxiolytic, stimulant, cognitive and addiction pharmacotherapies; age, pregnancy, organ function and comorbidity; monitoring; adherence; polypharmacy; shortages and access; adverse effects; withdrawal; deprescribing; regulatory evidence and conflicts.

Evidence. An oral medication conference compares options with absolute benefit and harm, monitoring and stopping plans, interaction checks, person preferences, cost, and uncertainty. It is not a prescribing authorization exercise.

PSY-320 Psychotherapy science and core models — 70 hours#

Scope. Alliance, empathy, boundaries, common and contextual factors; case formulation; goals and contracting; supportive, cognitive-behavioural, psychodynamic, interpersonal, dialectical-behavioural, motivational, family, couples and group approaches; trauma-informed care; process and outcome research; cultural adaptation; rupture and repair; ending; adverse effects; supervision and therapist development.

Evidence. Standardized-person micro-skills, model comparisons, session formulation, observed role-play, outcome interpretation, and supervision response. Reading or role-play never counts as delivering psychotherapy to patients.

PSY-330 Recovery, rehabilitation, social and interventional treatments — 50 hours#

Scope. Shared decision-making; peer support; family intervention; supported education, employment and housing; occupational and social recovery; physical activity, sleep and nutrition; ECT, TMS and other neuromodulation; ketamine and emerging interventions; service eligibility; evidence, consent, anaesthetic and medical considerations; maintenance; access and hype.

Evidence. A recovery portfolio contrasts a social, psychological, pharmacologic, and interventional option against goals chosen by a fictional person.

PSY-340 Child, adolescent, and family psychiatry — 55 hours#

Scope. Developmental assessment; family and school systems; neurodevelopmental presentations; mood, anxiety, psychosis, eating, trauma and substance use in young people; safeguarding; consent and assent; transition; medicine and psychotherapy evidence; caregiver partnership; online environments; anti-pathologizing and neurodiversity-affirming care.

Evidence. A multi-informant case reconciles disagreement among a young person, family, school, and clinician while centring safety, development, autonomy, and context.

PSY-350 Older-adult, neurocognitive, and neuropsychiatric care — 45 hours#

Scope. Normal ageing; delirium; mild and major neurocognitive disorders; depression, psychosis and anxiety in later life; neurologic disease; cognition; sensory and communication access; polypharmacy; capacity; carers; abuse; loneliness; palliative goals; services and transitions.

Evidence. A fluctuating-cognition case distinguishes delirium, dementia and depression and includes carers without erasing the older person's voice.

PSY-360 Consultation-liaison and integrated care — 55 hours#

Scope. Psychiatric questions in medical, surgical, obstetric, neurologic, pain, oncology, transplant, intensive, palliative and primary-care settings; reproductive and perinatal mental health; functional symptoms; capacity; treatment refusal; medication interactions; collaborative care; communication between teams.

Evidence. A consultation note answers the referrer's question, reframes it when necessary, integrates medicine and context, and provides prioritized, feasible recommendations.

PSY-370 Community, public, rural, and global mental health — 55 hours#

Scope. Prevention; population need; severe and persistent illness; crisis/home treatment; assertive and early-intervention models; primary care; homelessness; migration and displacement; correctional interfaces; rural and remote services; task-sharing; peer-led services; financing; workforce; policy; disaster and climate; implementation across resource settings.

Evidence. A service map and redesign proposal is co-evaluated for access, continuity, rights, equity, feasibility, outcomes, and unintended consequences.

Stage IV — Rights, systems, and independent scholarship (240 hours)#

PSY-410 Ethics, law, forensic questions, and human rights — 40 hours#

Scope. Ethical reasoning; professional duties; confidentiality; capacity; consent; advance planning; supported decision-making; safeguarding; compulsory assessment and treatment; criminal and civil interfaces; fitness and disability; expert evidence; correctional psychiatry; dual loyalty; coercion alternatives; international human-rights principles. All legal rules are jurisdiction- and date-labelled.

Evidence. A comparative legal-ethical analysis separates universal principles, contested claims, and local law and proposes the least-restrictive defensible action.

PSY-420 Culture, identity, spirituality, and structural competence — 40 hours#

Scope. Cultural humility; explanatory models; interpreters; racism and colonial history; Indigenous and First Nations mental health as locally governed learning; migration and asylum; gender and sexuality; disability; poverty, housing and work; religion and spirituality; community knowledge; structural formulation; advocacy and epistemic justice.

Evidence. A community-reviewed formulation audit identifies where a standard case changes when power, language, history, and access are made visible.

PSY-430 Quality, safety, implementation, and service design — 40 hours#

Scope. Human factors; just culture; incident analysis; handovers; medication safety; diagnostic safety; restraint reduction; measurement systems; QI methods; implementation and de-implementation; economics; stakeholder governance; equity; learning health systems; adverse-event disclosure.

Evidence. A preregistered service-improvement simulation includes theory of change, process and outcome measures, balancing measures, equity stratification, governance, and stop rules.

PSY-440 Digital psychiatry, telehealth, AI, and data ethics — 30 hours#

Scope. Telepsychiatry; accessibility; digital therapeutics; electronic records; patient portals; sensors and digital phenotyping; social media; clinical decision support; generative and agentic AI; automation bias; model validity and drift; privacy, security and consent; data provenance; documentation; environmental and labour costs; procurement and incident response.

Evidence. A red-team evaluation of a fictional product identifies unsupported claims, subgroup harms, privacy and workflow failures, human-oversight requirements, and conditions for refusal or withdrawal.

PSY-450 Leadership, teaching, supervision, and professional sustainability — 40 hours#

Scope. Team roles; conflict; inclusive meetings; resource stewardship; management and financing; teaching design; feedback; assessment validity; supervision; remediation; whistleblowing; boundaries; moral injury; burnout; impairment; bullying and harassment; help-seeking; career transition and continuing development.

Evidence. Learners lead a simulated case conference, teach one difficult concept, respond to a professionalism dilemma, and revise a personal development plan from multisource feedback.

PSY-460 Integration and capstone — 50 hours#

Scope. Independent synthesis of a consequential problem in psychiatric knowledge, education, service, or policy. Acceptable forms include a systematic evidence map, reproducible analysis, rights-based service design, open teaching unit, implementation proposal, or research protocol. A personal clinical case report is not accepted.

Evidence. Proposal, source and rights audit, preregistered questions, public artifact, limitations statement, oral defence, stakeholder feedback, correction log, and an accessible nontechnical explanation. The defence panel should include academic/clinical, educational-method, and lived-experience perspectives; panel participation does not convert the course into clinical credentialing.

9. Repeating learning grammar#

Every presentation and treatment lesson follows the same sequence so that diagnosis cannot crowd out the rest of care:

1. person's question, language, goals, strengths, and setting;
2. phenomenology, chronology, function, development, culture, and context;
3. urgency, safeguarding, medical and neurologic alternatives;
4. differential, dimensional description, classification, and uncertainty;
5. multi-level formulation and explicit maintenance/protective hypotheses;
6. shared option comparison: benefits, harms, burdens, access, preferences, and no-treatment alternative;
7. acute, longitudinal, recovery, family, community, and physical-health plan;
8. outcomes that matter, monitoring, review, stopping, and repair after harm;
9. evidence quality, conflicts, rights, and unanswered questions;
10. transfer to a new age, identity, comorbidity, service, or resource setting.

Cases must vary across age, disability, language, race and ethnicity, Indigeneity where locally governed, gender, sexuality, family form, religion, socioeconomic position, housing, migration history, geography, and service access. Variation must change the reasoning rather than decorate it.

10. Mastery and assessment#

10.1 Academic mastery states#

These states describe course evidence only. They are not clinical entrustment decisions.

10.2 Assessment program#

The assessment program samples knowledge, reasoning, communication, uncertainty, rights, and feedback uptake through:

• low-stakes retrieval and confidence calibration;
• key-feature and script-concordance-style fictional cases;
• oral formulations and differential updates;
• standardized-person interviews and difficult-conversation simulations;
• observed psychotherapy micro-skills, never represented as patient treatment;
• evidence appraisals, medication conferences, and measurement critiques;
• simulated emergency, handover, disclosure, and team exercises;
• service maps, quality-improvement work, teaching, and capstone defence;
• multisource feedback, including appropriately supported lived-experience educators;
• a longitudinal portfolio with corrections, reflections, rights decisions, and tool-use disclosure.

No single examination can compensate for a missed critical action. Safety- and rights-critical gates include recognizing medical emergencies, seeking help, preserving privacy, avoiding discriminatory or coercive shortcuts, responding to safeguarding concerns, and not presenting a simulation result as clinical authority.

10.3 Progress decisions#

Academic progression requires multiple observations, different cases, more than one assessor, retained performance, and response to feedback. A competence committee model is recommended for host institutions, but EmbeddedKnowledge does not constitute such a committee. Appeals, accessibility adjustments, remediation, and reassessment must be documented and separate from punitive conduct processes.

11. Supervised-practice crosswalk#

Residency frameworks require real clinical experience that an open book cannot provide. A recognized clinical host may map this academic curriculum to its own standards, but must independently supply and verify:

• supervised responsibility across inpatient, outpatient, emergency, community, consultation-liaison, child and adolescent, older-adult, addiction, forensic, medical/neurologic, and other locally required settings;
• longitudinal care and follow-up rather than isolated encounters;
• observed assessment, formulation, treatment planning, handover, teamwork, and documentation with real patients;
• protected individual and group supervision, including psychotherapy supervision;
• progressive responsibility based on demonstrated performance and patient acuity;
• workplace-based assessment from multiple observers and settings, service-user feedback where ethical, a clinical portfolio, remediation, and an appeal route;
• local training in prescribing, procedures, mental-health law, safeguarding, emergency response, privacy, infection control, and occupational safety;
• identity, medical registration, background, health, duty-hour, employment, indemnity, and site-accreditation requirements.

Simulation can prepare for rare or dangerous situations. It cannot replace required patient contact, supervised psychotherapy cases, procedure experience, or a regulator's decision. EmbeddedKnowledge will not record a learner as clinically entrusted merely because a host links to this syllabus.

12. Areas of depth (120–240 hours)#

One area of depth is required for the course's academic completion notation. It signals extended study, not subspecialist status.

An individually designed pathway requires a question, outcomes, supervision plan, source and rights audit, 120-hour minimum, and capstone approved before work begins. Production instrumentation for all pathways is future work.

13. Source, classification, and rights policy#

13.1 Evidence hierarchy#

Production lessons should triangulate:

1. current official safety, regulatory, public-health, and classification sources;
2. high-quality guidelines and systematic reviews with explicit population, date, jurisdiction, and conflicts;
3. pivotal and corrective primary research;
4. qualitative, community, implementation, and lived-experience evidence;
5. clearly licensed educational material used within its level and scope.

Guidelines do not become truth by authority, and randomized trials do not answer every question. Material claims must distinguish consensus, evidence-supported inference, plausible hypothesis, contested judgment, and local rule.

13.2 Classification and instruments#

ICD-11 is the global classification reference. Its text and codes retain WHO's licence and may not be rewritten into a derivative classification. DSM literacy is required for jurisdictions and literature that use it, but proprietary criteria, tables, and wording must not be reproduced. Screening tools, rating scales, interview schedules, cognitive tests, and psychotherapy worksheets require instrument-level rights checks; being common or free to read is not permission to republish.

13.3 Reuse#

EmbeddedKnowledge curriculum and original lessons are CC BY 4.0. A source carrying NonCommercial, ShareAlike, or NoDerivatives terms may be cited as evidence but is not copied, closely adapted, or embedded into this differently licensed corpus. U.S. federal material still requires item-level checks for contractor, image, logo, instrument, and jurisdictional exceptions. Every source and asset records author, title, version/date, URL, access date, licence, reuse decision, and changes.

OpenStax books are excluded from model-assisted authoring under their stated AI-use restriction. Patient stories, forums, charts, and clinical media are never scraped for cases.

14. Cases, privacy, accessibility, and learner welfare#

14.1 Case standard#

Production cases are fictional composites written from public knowledge or are purpose-commissioned with documented consent and rights. They contain no identifiable patient data and no disguised one-to-one clinical narrative. A case has a provenance note, uncertainty, non-stigmatizing language, relevant strengths, and review for stereotype and diagnostic leakage.

Lived-experience narratives require informed consent for the exact use, a negotiated CC BY 4.0 licence, attribution preference, compensation, accessibility, withdrawal terms before publication, support, and protection against pressure to disclose. Consent to care, research, or a public interview is not consent to create an open derivative lesson.

14.2 Accessibility and potentially distressing material#

All material must work with keyboard and assistive technology, reflow without horizontal scrolling, avoid colour-only meaning, provide transcripts/captions and text equivalents, and use plain-language summaries for dense sections. Learners may use accessible standardized-person alternatives where an activity depends on speech, vision, hearing, movement, or synchronous participation; the same construct must be assessed.

Modules involving suicide, self-harm, violence, abuse, trauma, eating disorders, coercion, or discrimination provide a specific preview, the pedagogical reason for inclusion, an equivalent route where feasible, pause/return controls, and non-punitive support guidance. The course does not monitor learners or provide crisis care. Public pages direct immediate concerns to current local emergency and crisis resources rather than assuming one country's service.

15. Digital and AI safeguards#

Learners and contributors may use declared tools for brainstorming, translation, accessibility, coding, or critique only when the assignment permits it. They remain accountable for every claim, citation, calculation, right, and disclosure.

The following are prohibited in this curriculum:

• entering identifiable patient, learner, staff, or service data into an unapproved tool;
• asking a model to diagnose, predict suicide or violence, recommend detention, prescribe, or replace supervision;
• presenting synthetic empathy, a chatbot, or a score as a therapeutic relationship;
• using generated citations without checking the primary source;
• training or evaluating a tool on copyrighted or consent-restricted material without permission;
• deploying a clinical model because it performs well in a classroom simulation;
• concealing model assistance in assessed or published work.

AI-related lessons must include a no-tool route, subgroup performance, uncertainty, human factors, workflow, privacy, security, drift, red-team cases, incident reporting, and a defensible condition under which the system should not be used.

16. Completion, records, and boundaries#

Academic completion requires:

• every required program outcome at M or above, with retained evidence for all safety- and rights-critical outcomes;
• completion of every stage and one area of depth;
• a portfolio containing at least six observed simulations, six evidence appraisals, four longitudinal case revisions, one quality or service-design project, a teaching performance, and a rights/licensing audit;
• an accepted capstone and oral defence with all material corrections resolved;
• final calibration showing that confidence tracks performance and that the learner seeks help when a problem exceeds the evidence or their role.

The record names the curriculum version, assessment modality, accommodations, completed pathway, and whether any evidence came from an external host. It does not convert external clinical activity into an EmbeddedKnowledge claim of competence.

The following statements are never permitted:

• “completed psychiatry residency” or “psychiatrist” on the basis of this course;
• “board eligible,” “licensed,” “credentialed,” or “competent to practise”;
• “qualified to diagnose, prescribe, provide psychotherapy, conduct capacity evaluations, detain, restrain, or perform a procedure”;
• “equivalent to” a named national training program without that authority's formal determination.

17. Quality governance and revision#

Before the candidate can become version 1.0, the project should obtain documented review from:

• practising psychiatrists from more than one training jurisdiction and service setting;
• residents or recent graduates;
• people with lived and living experience, including perspectives critical of psychiatric systems;
• peer specialists and family/carer representatives;
• child/adolescent, older-adult, addiction, psychotherapy, consultation-liaison, community/public, forensic, neuroscience, and primary-care expertise;
• nursing, psychology, social work, occupational therapy, pharmacy, and other multidisciplinary partners;
• experts in education, assessment, statistics, human rights, culture, accessibility, privacy, and content licensing.

Conflicts, compensation, jurisdiction, and role are disclosed. Review findings and dispositions are public; private clinical detail is not. High-impact safety claims receive primary-source re-verification and subject-matter review. Classification, major guideline, medication-safety, law, rights, crisis-resource, and AI-regulation sources are audited at least annually and whenever a material update is reported.

Versioning uses semantic curriculum labels:

• patch: clarification or correction without changing outcomes or completion;
• minor: additive or reorganized content with a migration note;
• major: changed graduate capabilities, safety gate, workload, or completion contract.

18. Research basis and known gaps#

The source audit behind this candidate is published in research/PSYCHIATRY-SOURCE-CATALOG.md. The design was synthesized from current official training requirements, competency frameworks, residency curricula, public-health and human-rights guidance, and an item-level open-source and licensing audit. Three role-separated research runs examined United States training, international training, and reusable knowledge sources; their conclusions were checked and reconciled by the authoring run. This is research provenance, not formal review quorum.

Known gaps before a production curriculum can open include:

• jurisdiction-specific law and culturally governed Indigenous/First Nations learning;
• rights-cleared diagnostic instruments, psychotherapy materials, clinical media, and specialist-depth OER;
• commissioned, compensated lived-experience cases and governance;
• a machine-readable knowledge graph, lesson boundaries, misconception map, and assessment blueprint;
• external expert review of workload, sequence, omissions, safety gates, and global applicability;
• a clinical-host crosswalk that regulators and accredited programs can inspect without confusing academic and workplace evidence.

Until those gaps are resolved through separate reviewed contributions, this remains an evolving academic curriculum and not a residency or clinical credential.

Appendix A — Clinical-framework crosswalk#

This is a directional design audit, not a claim of formal equivalence.

Appendix B — Minimum lesson evidence#

Every future production lesson must include:

1. an explicit learner model, prerequisite check, outcomes, and boundary;
2. a case or problem that makes the knowledge consequential without soliciting personal disclosure;
3. a coherent explanatory model plus its limits and at least one alternative;
4. worked reasoning, retrieval, misconception repair, varied practice, feedback, and transfer;
5. same-scene learner-visible source notes for material claims;
6. current safety and jurisdiction labels where applicable;
7. a source, instrument, asset, case, and AI-use rights record;
8. accessible equivalents and a content preview for potentially distressing material;
9. a non-stigmatizing and stereotype audit, including lived-experience review where relevant;
10. a clear statement of what the lesson does not authorize.

Appendix C — Candidate decision log#