Bridging the gap in transcranial magnetic stimulation training: Considerations for enhancing resident education in TMS

Background Transcranial magnetic stimulation (TMS) has emerged as a powerful tool in psychiatric treatment. The expanding clinical indications for TMS and its ability to improve patient outcomes with minimal side effects underscore the need to integrate TMS education into psychiatric residency programs. The Accreditation Council for Graduate Medical Education (ACGME) mandates psychiatry resident education in neuromodulation therapies, including TMS. The American Psychiatric Association (APA) formally recognized the need for increased TMS education given its clinical utility; further, the Brain Stimulation Subspecialty Summit (BraSSS) recently reached a consensus that brain stimulation modalities, including TMS, have adequately developed to warrant subspecialty recognition. However, the rapid expansion of TMS indications may exceed the capacity of postgraduate programs to meet this educational requirement. Methods Literature searches and consultations with TMS educators and experts were conducted. Methods included PubMed and Google searches using terms such as "Interventional psychiatry," "neuromodulation," "TMS," "psychiatry," "fellowship," and "residency" to identify psychiatry residency programs and fellowships offering TMS education as of December 2024 with targeted follow up in 2025. Results We identified nine non-ACGME-accredited fellowships in Interventional Psychiatry or neuromodulation and six residency programs with specialized interventional psychiatry tracks, and four intensive TMS courses for clinicians and residents. Conclusion Considering its manifest clinical utility, it is ripe time for psychiatric residencies to develop TMS curriculums. In this article, we offer foundational curriculum considerations, covering core knowledge, basic clinical skills, and advanced skills while highlighting financial and logistic considerations that need to be addressed across institutions.