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The mission of medical educators in all fields is to perfect the science and the art of training competent physicians and the next generation of leaders. To do this, outcomes research regarding effective training and supervision techniques and curricula, the optimal educational environment, assessment, and remediation of competency is needed. It is incumbent upon training directors to continue to provide the primary leadership for the field of training. The areas that are ripe for research and development include effective curricula, effective evaluation and remediation of competency, and leadership skill development. As medicine becomes more complex, so does the task of training physicians. Joint monitoring and outcomes research of the training enterprise are the scholarly and academic missions of the present and the future.

In this article we propose developmentally informed remedies to the challenges that face research training. The initiatives described in it have been implemented to various degrees at our institution, and several are already being replicated or expanded through strategic partnerships across the country. We are fortunate to work in an environment in which child and adolescent psychiatry is visible and well represented, but we are aware than many of the settings in which education and recruitment needs are most pressing may not have the range of our resources. We view our different programs as seamlessly interconnected with one another but present them as separate entities to facilitate the incorporation of different components into local realities.

Research concerning ADHD and cost-effective and efficacious treatments of the core deficits and concomitant functional impairments is burgeoning. Substantial gains have been made in elucidating effective treatment modalities for the complex neuropsychiatric disorder of ADHD. Much remains to be investigated in order to gain a more thorough understanding of the differential contributions of psychosocial and medication treatments to the long-term outcome of this complex disorder.

There have been "modern" descriptions of ADHD in the medical literature since 1902. Despite the burgeoning growth of information about the cause, pathophysiology, and effective treatments of the disorder, ADHD has been particularly steeped in controversy, especially regarding the use of medication (safety, efficacy, use or overuse, and concerns about medication treatment of preschool children). Changing diagnostic criteria, evolving conceptualizations of the disorder, and international differences in diagnosis, have enhanced and complicated ongoing research and understanding of the disorder. The recent Multimodal Treatment Study of Children with ADHD, a large, multisite study comparing efficacy of behavioral, medication, and combined treatments, and a recent NIH Consensus Conference on ADHD, represent true advances in the scientific understanding of the disorder and its treatment.