New Accreditation Council for Graduate Medical Education requirements expect residents to demonstrate competency in working with families and residency programs to identify the knowledge, attitude, and skill level to reach competency. This article defines a knowledge base as understanding how family functioning influences psychiatric illness and recovery patterns and the ability to integrate this understanding into a biopsychosocial formulation and treatment plan. Knowledge of how a family functions, family research findings, and other specific issues are also essential. An attitude of respect, compassion, and willingness to listen promotes a collaborative working alliance with patient and family. To be effective with families, the inpatient psychiatrist should be competent in helping family members understand and cope with their relative's illness; be able to manage family interactions, especially highly emotionally charged interactions; and be able to assess families and provide intervention for simple problems. These skills can be taught and assessed during the resident's general psychiatry inpatient rotations in the 2nd year of training.