Perceptions of treatment value, therapeutic orientation, and actual experience of psychiatric residents.

A LTHOUGH A FAIRLY EXTENSIVE literature exists on how psychiatrists develop professionally,‘-g three important areas remain inadequately documented. First, doubts remain about the ideologic orientation of residents toward psychiatry. Second, how psychiatry residents perceive the value of various treatment modalities used in psychiatry is essentially undetermined. Third, the actual experience that residents accumulate in using various treatment modalities requires considerable elaboration. These deficiences of information are striking since a psychiatrist’s professional identity is clearly related to what he believes valuable and what experiences he incorporates in his practice.‘O The investigators that have evaluated these three topics have concentrated on the attitudes toward treatment approaches mainly of practicing psychiatrists,“-I5 although the work by Stone and his colleagues is a major exception.16 In this era of concern about the question “what is a psychiatrist?” (as shown by the existence of an American Psychiatric Association Committee to study this subject), renewed attention must be given to the possible danger of premature theoretic closure among psychiatry residents. If ideologic closure occurs early in residency, the acquisition of new knowledge will clearly be impaired. The present study evolved from our observations that residents in several residency programs in the Washington, D.C./Baltimore, Md. vicinity seemed to share the same opinions about the worth of various therapies regardless of level of training and orientation of their programs. Most residents also seemed to be firmly set in their opinions at an early stage. To provide some data for these subjective impressions, we decided to survey a relatively large population of psychiatry residents. Several main questions were formulated: