Although the development of psychiatric residents has been studied extensively, continuing changes in psychiatrists after graduation from training have not. The authors present results of a survey research study of 263 psychiatrists recently graduated from a wide variety of training programs. The psychiatrists reported alarming symptoms of stress during this period, yet they used effective coping mechanisms and perceived themselves as increasing in growth, mastery, and confidence. Their overall contenment with their personal and professional lives effective coping mechanisms were those involving the establishment of support systems with loved ones.

Psychiatrists' transition from training to career: Stress and mastery.

The author reports his findings from interviews with a class of psychiatric residents. He concludes that for the resident, the role that residency training plays in the process of his professional development is very much a function of the types of relationships he is able to form with people in the institute (teachers, supervisors, fellow residents). Where the opportunity exists for an active mutual educational alliance, he experiences professional growth, maturation, and individuation. Where it does not, he is likely to stagnate.

The Making of a Psychiatrist: The Resident's View of the Process of His Professional Development

The author describes the experience of psychiatric residency training as a five-stage crisis in role transition involving role shock, orientation, trial and error, integration-consolidation, and recapitulation. He defines the crisis as a process involving both students and teachers. He hopes his formulation will provide a basis for anticipatory guidance and crisis-oriented interventions, thus maximizing the educational aspects of the training.

Physician to Student: The Crisis of Psychiatric Residency Training

Burnout syndrome is referred to the experience of exhaustion and diminished interest, that is manifested by the professionals usually in the work context. Health care proffesionals are often at high risk of burnout syndrome and job dissatisfaction. Burn-out syndrome consists a serious multidimensional phenomenon, because it can lead the professionals of health to psychosomatic problems, work-associated withdrawal behaviour and a lower

The burn-out syndrome

Today the staff members of hospitals are becoming keenly aware of difficulties in communication among themselves and the effect these difficulties have on patient care Because staffs must continually cope with frustrating communication problems, many undesirable emotional overtones usually arise which in turn intensify the problems In most hospitals there is little or no organizational means by which clarification of such communication problems may take place Many hazards to patient care exist which could be eliminated if the communication difficulties could be reduced qualitatively as well as quantitively What are the obstacles to the type of communication that facilitates organizing for the best kind of clinical care? What are the consequences when the communicative process is not adequate to this end? One does not need to be an expert to observe that the unlimited demands being placed on two of the nation's scarce health resources, physicians and nurses, greatly contribute

Nurse-Physician Communications in the Hospital

FOSTERING professional development of psychiatric residents requires individualizing them in terms of their endowment, past education, professional goals, and progress and rate of achievement. In addition to the general curriculum provided, the teachers have the responsibility to know each resident's specific needs, and to provide appropriate advice and experiences in order to maximize each one's professional development. It is essential, then, to have a systematic concept of professional development, a framework for delineation of the causes of variation in the component functions, and a method for assessing the quality and degree of acquired function. We recognize that the residency is but one phase in the professional development of a psychiatrist; what occurs in the residency is in part a function of what the resident brings to it in the nature of past experience, and his professional identity may not be fully consolidated until some years after the completion of his

Professional development in psychiatric residents. Assessment and facilitation.

Introduction Many aspects of the psychiatric patient's experience in the hospital can have a psychotherapeutic effect, by planned or fortuitous contact. In this paper, we are concerned with the possibilities of planned facilitation of the psychotherapeutic effectiveness of contact with other personnel than the patient's psychiatrist. In recent years, efforts have been made to enhance the therapeutic contribution of the total hospital situation. There has been much interest in the question of the therapeutic milieu with emphasis on social factors which impede or facilitate the treatment process. 1-5 The approach we present is related to "milieu therapy." It can be discussed, better, however, as a systematic stepping back from the socially oriented milieu approach in order to individualize for the patient's particular psychopathology, psychodynamics, therapeutic requirements, and therapeutic course in the hospital. The therapeutic potential of other personnel has been utilized by psychiatrists for many

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=psych&articleId=488349&pdfFileName=archpsyc_9_1_006.pdf

Psychotherapy in Psychiatric Hospitals: A Proposed Model for Psychiatrist-Nurse-Patient Interaction

The present project is an attempt to develop a practical, effective method for improving the existing resources of manpower in remote state hospitals by establishing a close liaison between a professionally isolated state hospital and a private metropolitan psychiatric center. A group of colleagues from the Chicago Institute for Psychoanalysis banded together to form a coordinated team of consultants to the East Moline State Hospital, which is located 175 miles from Chicago, has approximately 1,800 patients, but with the exception of the Superintendent, no psychiatrists. We reasoned that a more effective program of teaching, research, and clinical service could be provided if a group of colleagues who were accustomed to working together would form a coordinated team of consultants, rotating their visits so that the hospital would have at least one consultant regularly for a full day each week. Since the

A coordinated consultant team for remote state hospitals.

A specific educational technique of observation and discussion of a brief diagnostic interview is of special value for the teaching, learning, and assessment of a group of skills central to the professional development of the young psychiatrist. With this method, observational and integrative skills as well as diagnostic activity can be assessed and demonstrated by the teacher in a format that stimulates the "learning alliance" and the resident's development of self-critical functions. Observations of frequent problems in the resident's work are presented, the residents' response to this method is described, and various aspects of the format discussed.

Arthur A. Miller

Papers

Professional development in psychiatric residents. Assessment and facilitation.

Psychotherapy in Psychiatric Hospitals: A Proposed Model for Psychiatrist-Nurse-Patient Interaction

A coordinated consultant team for remote state hospitals.

Teaching and Evaluation of Diagnostic Skills