Enhancing Psychiatry Residents’ Knowledge and Comfort With Clozapine Prescribing Through Educational Interventions

Introduction: Clozapine is the most effective antipsychotic for treatment-resistant schizophrenia but remains underutilized due to safety concerns and monitoring complexity. Recent discontinuation of the Clozapine Risk Evaluation and Mitigation Strategy (REMS) program reduced regulatory barriers but shifted responsibility for monitoring to clinicians. Psychiatry residents may lack adequate training and confidence to prescribe clozapine safely in this new context. The goal of this study is to evaluate the impact of a structured educational intervention on psychiatry residents’ knowledge of clozapine prescribing and management. Methods: This study was a single-institution quality improvement study using a pre-post design. Participants were psychiatry residents from PGY-1 to PGY-4. Participants underwent a one-hour structured educational session covering clozapine pharmacology, indications, monitoring, adverse effects, and post-REMS management. Outcomes assessed include knowledge assessment scores both before and after the educational session. A paired t-test comparing pre- and post-intervention scores was used to analyze the data. Results: Ten residents completed both assessments. Mean knowledge scores increased from 69.4% to 82.8% (mean increase 13.4 percentage points (19.3% relative increase); p < 0.05). Conclusions: A brief, targeted educational intervention was associated with improved psychiatry residents’ knowledge regarding clozapine prescribing and management. Focused resident education may help mitigate barriers to clozapine use, particularly following REMS discontinuation. Incorporating structured clozapine training into residency curricula may promote safer and more appropriate use of clozapine in clinical practice.