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Patient Care and Medical Knowledge; Practice-Based Learning and Improvement; Professionalism and Career Development; and Communication Skills and Systems-Based Practice. Patient Care and Medical Knowledge Fellows and supervisors rated all of the elements in this section (psychopharmacology, therapy, case formulation, treatment planning, crisis planning) as very important. While the above findings should be viewed cautiously due to a number of limitations, such as low percentage of programs participating, small sample size, and potential for bias, these data suggest that ongoing efforts may be needed to balance fellow educational goals with institutional service demands in order to ensure that supervision time does not get superseded when services are busy.