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Showing papers in "Academic Psychiatry in 1989"


Journal ArticleDOI
TL;DR: The role of empathy in medical students’ postgraduate training interest was studied and individuals with high and low empathy scores were found to be interested in every field of practice.
Abstract: The role of empathy in medical students’ postgraduate training interest was studied. The level of empathy, as measured by the Hogan Empathy Scale, was not found to be a discriminating factor in career selection. Students interested in psychiatry had empathy levels similar to other groups of students. Although empathy has been suggested as a possible discriminating variable among medical school candidates, individuals with high and low empathy scores were found to be interested in every field of practice. Further studies are needed before measurement of empathy is used in the selection process for medical school admission.

19 citations


Journal ArticleDOI
TL;DR: Most of the assaults were committed by psychotic, male, young adults, but only male sex and age less than 13 years were statistically associated with increased risk of assaultiveness, and diagnosis and race were not associated with assaultiveness.
Abstract: Forty-six psychiatric residents at a county hospital were surveyed about their exposure to patient violence. The overall incidence of assaults was 2.8 per 100 resident-months at risk. Statistically significant differences were found in the rates of assaults on different services; the rates were highest on the child and adolescent services and lowest on the adult outpatient service. Most of the assaults were committed by psychotic, male, young adults, but only male sex and age less than 13 years were statistically associated with increased risk of assaultiveness. Diagnosis and race were not associated with assaultiveness. The usual means of attack involved hitting or kicking and seldom resulted in serious injury.

17 citations


Journal ArticleDOI
TL;DR: The establishment of an undergraduate core curriculum in child and adolescent psychiatry, supplemented by proven effective extracurricular activities, will promote greater exposure of the field to medical students and ultimately enhance recruitment.
Abstract: Recruitment into child and adolescent psychiatry has always been difficult. Medical students must experience an effective introduction to child and adolescent psychiatry and to its emotional and intellectual satisfactions if they are to consider career opportunities in this specialty. However, the contributions of child psychiatry to the medical student curriculum vary considerably across institutions. The establishment of an undergraduate core curriculum in child and adolescent psychiatry, supplemented by proven effective extracurricular activities, will promote greater exposure of the field to medical students and ultimately enhance recruitment.

16 citations


Journal ArticleDOI
TL;DR: This paper describes programs in transcultural psychiatry for medical students, residents, and fellows that have been implemented and refined at UCLA over the past six years.
Abstract: The ethnic diversity of patients in most training centers requires that attention be given to cultural issues affecting the psychiatric presentation and treatment of patients from different backgrounds. This paper describes programs in transcultural psychiatry for medical students, residents, and fellows that have been implemented and refined at UCLA over the past six years. Suggestions are offered for the development of such programs elsewhere.

15 citations


Journal ArticleDOI
TL;DR: In this paper, the GMENAC 1990 report of the Graduate Medical Education National Advisory Committee (GMENAC) identified child psychiatry as the specialty most in need of expansion and indicated that more child and adolescent psychiatrists are required to meet the patient care needs.
Abstract: Recruitment in child and adolescent psychiatry has long been a concern of the profession The 1980 report of the Graduate Medical Education National Advisory Committee (GMENAC) identified child psychiatry as the specialty most in need of expansion Estimates of prevalence of disorders indicate that more child and adolescent psychiatrists are required to meet the patient care needs Although the number of residents in child and adolescent psychiatry has increased somewhat over the last ten years, it will fall far short of the GMENAC 1990 target of 9,000 Academic units need to increase the number of child and adolescent psychiatry faculty by approximately 30% Some recommendations are presented to address continuing problems in recruitment

14 citations



Journal ArticleDOI
TL;DR: A survey of senior medical students who matched to a PGY-1 position in psychiatry found there appeared to be subgroups of students defined by demographic and decision-making properties that choose programs with fundamentally different aims in mind.
Abstract: The authors report the results of a survey of senior medical students who matched to a PGY-1 position in psychiatry. With a 64% response rate, the authors found the following: 1) senior medical students were generally satisfied with the program that they plan to attend; 2) the students utilized nonprogrammatic features heavily in their decision making; and 3) there appeared to be subgroups of students defined by demographic (i.e., gender and age) and decision-making properties (i.e., time of decision) that choose programs with fundamentally different aims in mind.

9 citations


Journal ArticleDOI
TL;DR: The author describes several strategies for improving the research involvement of child and adolescent psychiatry, including developing productive relationships with basic researchers in psychiatry, actively seeking out federal and private research funds, and carving out room in the child and adolescents psychiatry curriculum to expose residents to basic scientific methods and exciting developmental issues.
Abstract: All indications are that child and adolescent psychiatrists are more involved in research than they were in 1980, but significant obstacles continue to make it difficult to make research attractive to young child psychiatrists eager to begin clinical careers. Nevertheless, generating sound, applicable research must be one of the field’s top priorities. The author describes several strategies for improving the research involvement of child and adolescent psychiatry, including developing productive relationships with basic researchers in psychiatry, actively seeking out federal and private research funds, and carving out room in the child and adolescent psychiatry curriculum to expose residents to basic scientific methods and exciting developmental issues.

8 citations


Journal ArticleDOI
TL;DR: An earlier version of this paper was presented at the National Recruitment Conference on Child and Adolescent Psychiatry, held January 18–19, 1989, in San Diego.
Abstract: An earlier version of this paper was presented at the National Recruitment Conference on Child and Adolescent Psychiatry, held January 18–19, 1989, in San Diego

8 citations


Journal ArticleDOI
TL;DR: A well-developed model for feasibly involving research into an ongoing clinical fellowship for integrating the research process into a traditional child psychiatry fellowship is described.
Abstract: There is a clear need for basic and clinical researchers and educated research consumers in child psychiatry. Few who enter the field consider research a part of their ride. While some specialized training has occurred, there is a dearth of models for integrating the research process into a traditional child psychiatry fellowship. This paper describes a well-developed model, tested for three years, for feasibly involving research into an ongoing clinical fellowship. The program has already led to conference presentations, research papers, and continued study.

7 citations


Journal ArticleDOI
TL;DR: The instructional program offered to trainees at the UCLA Neuropsychiatrie Institute for almost two decades is described and Suggestions are offered as to how programs that lack faculty acquainted with these techniques can further familiarize themselves in order to evaluate the techniques’ value for their curriculum.
Abstract: Guided imagery is a technique useful for teaching and practicing psychodynamic assessment and psychotherapy. It combines a state of meditative relaxation with the presentation of evocative scenarios that stimulate the imagination to spontaneously generate almost dream-like fanciful productions. These “daydreams” ordinarily contain highly revealing suppressed and repressed conflicts, wishes, affects, perspectives and other aspects of the self. The instructional program offered to trainees at the UCLA Neuropsychiatrie Institute for almost two decades is described. Suggestions are offered as to how programs that lack faculty acquainted with these techniques can further familiarize themselves in order to evaluate the techniques’ value for their curriculum.

Journal ArticleDOI
TL;DR: Based on supervisory experience with residents, the author identifies four common types of errors made by beginning therapists: pressing the past, pushing the transference, providing inappropriate support, and attempting premature over interpretation.
Abstract: Based on supervisory experience with residents, the author identifies four common types of errors made by beginning therapists: pressing the past, pushing the transference, providing inappropriate support, and attempting premature overinterpretation. Each error class is illustrated, and the elements of timing and context that make the behavior erroneous are dissected. The therapist’s motivations that make these errors likely are also defined and found to be far from ominous. Recognizing the connection between wish and concrete behavior can help the beginning therapist achieve a more appropriate behavior. Codification of the behaviors into categories of error may also aid supervisors in their teaching task.

Journal ArticleDOI
TL;DR: Unpublished surveys and anecdotal evidence suggest that violent acts perpetrated by the mentally ill are not uncommon and Physicians who work in the "trenches" (emergency rooms, public institutions, and walk-in clinics) are also increasingly concerned about their personal safety.
Abstract: Many studies of the relationship of mental illness to violence focus on subsequent arrest rates of individuals already hospitalized with a diagnosed mental illness. The results are equivocal, but generally no dear relationship betweenmental illness and violence isdiscovered. These are the studies so often quoted by those who argue that a mentally ill person is no more likely to be violent than anyone eise (1). Practitioners of psychiatry, however, fear that these studies are misleading. First, those labeled mentally ill are unlikely to be subject to arrest if they become violent. Rather, their violence will be viewed as a manifestation of illness, and they will be treated outside the criminal justice system. Thus, the true incidence of violence by the mentally ill cannot be assessed by looking at arrest rates. Second, some of the studies of violence among the mentally ill fai! to consider substance abuse disorders as mental disorders. Psychiatric practitioners who treat these patients are weIl aware of their tendency to be violent while they are intoxicated (2). Finally, unpublished surveys and anecdotal evidence suggest that violent acts perpetrated by the mentally ill are not uncommon. Surveys of family members of chronic patients by the National Alliance for the Mentally m indicate that 60% of those surveyed have been physically assaulted by a mentally ill family member. Physicians who work in the \"trenches\" (emergency rooms, public institutions, and walk-in clinics) are also increasingly concerned about their personal safety. Psychiatrie residents are at especially high risk of being assaulted. The most dangerous site for psychiatrie residents appears to be the emergency room or walk-in clinic. Last year in my own program there were eight completed assaults (physical contact was actually made) on residents in the two emergency rooms through whieh the residents rotate. There were many more linear misses,\" in which a show of force or intervention by security officials prevented a completed assault. On a number of occasions patients were found to have weapons. Data about the frequency of patient violence toward psychiatrie personnel are not available, but the Dr. Halleck is professor of psychiatry at the University of North Carolina in Chapei Hili. His address is C.B. 7160, Medical School Wing 0, University of North Carolina, Chapei Hili, North Carolina 27599-7160. Copyright @ 1989 Academic PsychÜltry.

Journal ArticleDOI
TL;DR: This issue marks an important transition for Academic Psychiatry as the journal’s founding editor-in-chief, Dr. Zebulon Taintor, assumes editorship.
Abstract: This issue marks an important transition for Academic Psychiatry. As we assume editorship, we wish to acknowledge our debt and gratitude to the vision, persistence, and hard work of the journal’s founding editor-in-chief, Dr. Zebulon Taintor.

Journal ArticleDOI
TL;DR: Recently graduated residents and their supervisors were questioned about the clinical wisdom of continuing to treat patients seen in training by transferring them to the residents’ newly established private practices.
Abstract: Recently graduated residents and their supervisors were questioned about the clinical wisdom of continuing to treat patients seen in training by transferring them to the residents’ newly established private practices. Given the increasingly competitive market for psychotherapy patients, there will likely be a growing tendency for graduating residents to want to carry over patients from their training caseloads to their private practices. Questions arise concerning which patients should be offered such an option, how much to charge, whether such a practice should be encouraged, and whether transfer provides greater continuity of care. Residents were asked about their attitudes and about their clinical and supervisory experiences with such transfers. Supervisors were questioned about the indications and complexities of transfers and the specific issues that should be raised in teaching about this phenomenon. Results tended to support transferring patients from residents’ training caseload to their private practices.

Journal ArticleDOI
TL;DR: The chairman of an academic psychiatry department describes the tensions that have commonly existed between department chairs and the child and adolescent psychiatry programs they administer, and describes several strategies that department chairmen may use, in cooperation with child and adolescents psychiatry programs and national organizations, to pursue that goal.
Abstract: The chairman of an academic psychiatry department describes the tensions that have commonly existed between department chairs and the child and adolescent psychiatry programs they administer. In his view, child and adolescent psychiatry programs have tended to adopt an attitude of entitlement and competitiveness that complicates the departmental efforts to work together to recruit child and adolescent psychiatrists. Nevertheless, he says, recruitment of child and adolescent psychiatrists must be a priority of academic psychiatry departments. He describes several strategies that department chairmen may use, in cooperation with child and adolescent psychiatry programs and national organizations, to pursue that goal.

Journal ArticleDOI
TL;DR: Systematic study of these issues may provide directions for fruitful interventions at the level of the general residency likely to increase recruitment into child and adolescent psychiatry.
Abstract: General psychiatry residency processes can influence the recruitment of child and adolescent psychiatry fellows at many levels through a variety of subtle events. General residencies differ in the extent to which they welcome and accommodate students with early interests in child and adolescent psychiatry, provide child and adolescent rotations during the general program that are likely to encourage rather than discourage additional interest in child and adolescent psychiatry, respect and enhance the professional status of child and adolescent psychiatry relative to general psychiatry, and facilitate or impede the transition from general residency to child and adolescent fellowships. Systematic study of these issues may provide directions for fruitful interventions at the level of the general residency likely to increase recruitment into child and adolescent psychiatry.


Journal ArticleDOI
TL;DR: When questioned about their satisfaction with the PRTTE and its administration, the residents reported high levels of satisfaction and a desire to take the examination yearly.
Abstract: Examinations are an integral part of resident and program evaluation, but they are considered particularly stressful on residents. The department of psychiatry of the University of Texas Health Science Center at San Antonio administered the Psychiatry Resident-in-Training Examination (PRTTE) every other year to minimize stress and anxiety among residents. When questioned about their satisfaction with the PRTTE and its administration, the residents reported high levels of satisfaction and a desire to take the examination yearly. Dissatisfaction was limited to the physical environment in which the exam was administered.

Journal ArticleDOI
TL;DR: A highly automated system that meets the Residency Review Committee (RRC) requirements for documenting residents’ clinical activity has been developed using readily available computer hardware and a specialized software package.
Abstract: A highly automated system that meets the Residency Review Committee (RRC) requirements for documenting residents’ clinical activity has been developed using readily available computer hardware and a specialized software package. Once in place, the system is relatively unobtrusive and requires only two to four hours a month of technical support but no additional clerical or secretarial time to operate. The costs of the system are primarily those it takes to make it operational. Maintenance costs are low. Regular monitoring of residents’ clinical activity has had a salutary effect on program planning and enhanced the program’s ability to meet RRC guidelines.

Journal ArticleDOI
TL;DR: To capitalize on this opportunity, organized psychiatry and pediatrics must work together to tailor training programs for pediatrician-child psychiatrists that do not lengthen the period of training unreasonably.
Abstract: Pediatricians represent a potential source of high-quality recruits to child and adolescent psychiatry, although only about 120 physicians are board-certified in child psychiatry, adult psychiatry, and pediatrics. However, the growing need for pediatricians to understand and treat psychosocial and psychiatric symptoms may make them increasingly receptive to pursuing training in child and adolescent psychiatry. To capitalize on this opportunity, organized psychiatry and pediatrics must work together to tailor training programs for pediatrician-child psychiatrists that do not lengthen the period of training unreasonably. The current experimental program to train triple-board-eligible psychiatrists is discussed.


Journal ArticleDOI
TL;DR: A survey of faculty members’, residents', and students’ perspectives on attributes important to program recruitment implies that specific changes in faculty behaviors and program procedures might benefit the recruitment process for students and for programs.
Abstract: The influence of the application-interview process on recruitment into psychiatry has recently attracted attention. Surveys of student perspectives indicate that certain program characteristics are of vital importance in selecting a residency and that students evaluate residency programs as much as residency programs evaluate them. This paper describes a survey of faculty members’, residents’, and students’ perspectives on attributes important to program recruitment. The three groups of respondents agreed on two-thirds and disagreed on one-third of the items on the survey, which was distributed throughout psychiatry residency training programs in Ohio. Analyses of disagreements imply that specific changes in faculty behaviors and program procedures might benefit the recruitment process for students and for programs.



Journal ArticleDOI
TL;DR: The author reviews the history and technology of the microcomputer and discusses the various classes of software that are presently available, and predictions are made about the future direction of computer technology and its application to psychiatry.
Abstract: The author reviews the history and technology of the microcomputer and discusses the various classes of software that are presently available Three major categories of software are described: numeric data processing, text processing, and communications The application of this software to psychiatric education and practice is briefly discussed A short curriculum on computers for psychiatric residents is outlined, and a brief bibliography of the recent relevant literature on computer applications to medicine and psychiatry is presented Predictions are made about the future direction of computer technology and its application to psychiatry

Journal ArticleDOI
TL;DR: An eight-week training model in which students rotate through two different sites during their clerkship is described, and both tracks appear to provide comparable and effective clinical training for junior clerks.
Abstract: Psychiatry clerkships traditionally place students on a single site for the duration of the rotation. This article describes an eight-week training model in which students rotate through two different sites during their clerkship. On one “track,” students spend four weeks each on an inpatient mental health unit and consultation-liaison service. On the other “track,” students spend four weeks each on an inpatient chemical dependency unit and an outpatient psychiatry service. The rationale for this split rotation is described and the “tracks” are compared via students’ performance on clinical evaluations, oral exams, and a written exam (NBME Subtest in Clinical Psychiatry). Based on these outcome variables, both tracks appear to provide comparable and effective clinical training for junior clerks.

Journal ArticleDOI
TL;DR: The authors discuss advantages to such affiliations and illustrate these with the affiliation of a halfway house with a psychiatry residency training program.
Abstract: Psychiatric training takes place predominantly in institutional settings such as hospitals and outpatient clinics. There are significant benefits associated with training in community “field” sites. Conversely, training programs can be valuable resources for agencies providing residential and/or rehabilitative care for the mentally ill The authors discuss advantages to such affiliations and illustrate these with the affiliation of a halfway house with a psychiatry residency training program.

Journal ArticleDOI
TL;DR: Recent attention to the need for integration of substance abuse education throughout medical education prompted this description of one such program.
Abstract: Recent attention to the need for integration of substance abuse education throughout medical education prompted this description of one such program.

Journal ArticleDOI
TL;DR: Experiences with residents who do not appear to understand the phenomenon of psychotherapy and, in particular, the issues of transference and counter-transference are described.
Abstract: Dr. Morton F. Reiser's article, "Are psychiatric deucators 'Losing the Mind'?" included a description of experiences with residents who do not appear to understand the phenomenon of psychotherapy and, in particular, the issues of transference and counter-transference (1). His residents also seemed to be more interested in tinkering with drugs and providing support than in understanding, with curiosity, the motivation of patients and what goes on in the human mind. Transference here is meant to be strong feelings that a patient develops towards a therapist that are determined by the patient's past experiences. Countertransference is an unconscious reaction to the patient's transference. Counter-transference becomes conscious as it is worked upon in supervision and distinguished from other feelings the therapist has about the patient.