Richness and creativity in medical student education in psychiatry.

The cornucopia of articles in this issue of Academic Psychiatry illustrates the richness and creativity of medical student education in psychiatry. This collection, which arose through spontaneous submissions to our journal from dedicated teachers and scholars throughout the world, also demonstrates that educational innovation in psychiatry is flourishing in several countries. Because psychiatric disorders have been identified as a critical cause of premature death and disability in every country, and the psychiatric workforce globally is tragically small, these exceptional efforts in medical schools to advance the field of psychiatry are vital, perhaps essential, to the future. Different venues for clinical experience and learning in psychiatry, students’ satisfaction with these venues, and their possible effect on recruitment to psychiatry are themes explored in several articles. Students clearly liked spending part of their medical school clerkship on an inpatient psychosomatic medicine service (1). Bourgeois et al. felt that this clerkship possibly contributed to the high rates of students matching into psychiatry at their institution, which, over a 5-year period, was a truly remarkable 12%. According to the authors, the comments from students and residents also suggested a uniquely useful role for psychosomatic medicine in countering the notion that students will be “giving up medicine” when choosing psychiatry. This rotation may also address the need to give all medical students a “dose” of psychiatry that will be applicable to their specialty choice outside of psychiatry. Interestingly, child and adolescent psychiatry was highly regarded as a career choice at several Germanmedical schools. In the study by Lempp et al. (2), 25% of medical student respondents considered seriously the choice of child and adolescent psychiatry. The opportunity to work with mentally ill children during their clinical course was one of the best parameters correlating with child and adolescent psychiatry as a possible career choice. It should be noted that almost no U.S. medical school offers core child psychiatry experience during medical school and that U.S. students have to take child and adolescent psychiatry as an elective to appreciate thisfield. Perhaps this report should alert us to the importance of including child and adolescent psychiatrywithin a core psychiatric clerkship experience. In contrast, a single home-visit to a home-bound senior citizen (3) did not change students’ attitudes about geriatric patients in a small study also reported in this issue, although students still found the experience to be useful.We suggest that changing attitudes with one visitwas probably toohigh or unrealistic a goal for an educational intervention. Given psychiatric educators’ enthusiasm for studying different ways of enriching medical students’ experiencewithin ourfield,with the hopes of increasing recruitment to it, it would be interesting to see whether other specialties with equally low matching rates develop similar strategies and whether they are more or less successful. Two studies examined the effect of a student-run clinic on student attitudes (4, 5). Almost all students who answered a questionnaire after participating in one small study of a large, urban-area clinic felt that their experience at the clinic was a valuable supplement to their psychiatric education (4). Most of them agreed that their work at the clinic taught them a skill or attitude that their formal curriculum could not provide. It is interesting that, frequently, medical students need to make their career choices on the basis of in-hospital training, with about 85% high acuity and lack of Received February 15, 2012; accepted March 5, 2012. From the Depts. of Psychiatry and Behavioral Neurosciences and Anesthesiology, Wayne State University School of Medicine, Detroit, MI (RB); Dept. of Psychiatry and Behavioral Sciences and Center for Ethics, Baylor College of Medicine, Houston, TX (JHC); Dept. of Psychiatry, Harvard Medical School, and Massachusetts General Hospital, Boston, MA (EB); Dept. of Psychiatry, UCSF, San Francisco, CA (AKL); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA (LWR). Address all correspondence to: RichardBalon,M.D., UPC-Jefferson, 2751E. Jefferson #200, Detroit, MI; e-mail: [email protected] Copyright © 2012 Academic Psychiatry