Psychiatric residency training faces an uncertain future related both to ongoing changes in the health care delivery system and to the current state of knowledge within psychiatry itself. The author discusses issues concerned with financing, models of training, clinical settings, generalist versus subspecialist training, psychotherapy training, caring for the chronically mentally ill, selection, assessment of quality, and enhancement of the quality of training. He concludes that, whatever form health care takes, psychiatric educators must maintain a commitment to acquiring and communicating new knowledge as the essential basis for a high-quality education.