Showing papers in "Academic Psychiatry in 2009"

Preventive, lifestyle, and personal health behaviors among physicians.

Abstract: This study examines personal health behaviors and wellness, health-related lifestyles, and prevention screening practices among licensed physicians. An anonymous questionnaire was mailed to a random sample of 1,875 physicians practicing in California. Data from 763 returned questionnaires (41%) were analyzed. Our data show that 7% of this sample were clinically depressed, 13% reported using sedatives or tranquilizers, over 53% reported severe to moderate stress, and only 38% described their level of daily stress as slight. About 4% self-reported recent marijuana use. More than 6% screened positive for alcohol abuse and 5% for gambling problems. Thirty-five percent of participants reported “no” or “occasional” exercise. About 27% self-reported “never” or “occasionally” eating breakfast. In addition, 34% reported 6 or fewer hours of sleep daily, while 21% self-reported working more than 60 hours per week. Physicians’ excessive number of work hours (more than 65 hours per week) was associated with lack of exercise, not eating breakfast, and sleeping fewer than 6 hours per night. California physicians report breast, cervical, colorectal, and prostate cancer screening behaviors that exceeded population estimates in California and Healthy People 2010 national goals. Additional interventions designed to improve physicians’ lifestyles and personal health behaviors should be encouraged. A focus on creating healthy lifestyles will benefit physicians as much as the general population.

Uses and limitations of simulated patients in psychiatric education.

Abstract: Objectives The use of standardized patients (SPs) is becoming prominent as a learning and evaluation tool in both undergraduate and graduate medical education. As increasing attempts are made to extend this tool to psychiatric training and education, it has been suggested that SPs can be useful not only to expose students to the variety of psychopathologic states, but also to teach and assess complex interpersonal processes such as empathic engagement and psychodynamic psychotherapy. The author argues that current enthusiasm for this modality should be tempered with caution about its limitations.

Cultivating Empathy for the Mentally Ill Using Simulated Auditory Hallucinations

Abstract: The authors address the issue of cultivating medical students’ empathy for the mentally ill by examining medical student empathy pre- and postsimulated auditory hallucination experience. At the University of Utah, 150 medical students participated in this study during their 6-week psychiatry rotation. The Jefferson Scale of Physician Empathy, Student Version, was used before and after the experience. The auditory hallucinations were provided as part of the “Hearing Voices That Are Distressing” curriculum created by the National Empowerment Center, which attempted to simulate the experience of hearing auditory hallucinations. While the students were listening to the auditory hallucinations, they underwent a psychiatric interview and simplified cognitive testing and were asked to socially interact in the community. We conducted a paired sample t-test of significance to identify pre- and postsimulated auditory hallucination changes in medical student empathy. Fifty students were randomly selected to serve as a comparison group. The paired sample t-test revealed that after listening to the simulated auditory hallucinations and participating in the simplified neurocognitive testing, the students’ empathy score increased. Students in the comparison group had no significant difference in their empathy scores. These results suggest that empathy may increase when students are given a brief glimpse into the mind of a mentally ill patient by listening to simulated auditory hallucinations. Specific interventions to increase empathy for the mentally ill can lead to a better understanding of how empathy can improve patient care, enhance the doctor-patient relationship, and direct future educational strategies.

Medical Student Mistreatment Results in Symptoms of Posttraumatic Stress.

Abstract: The authors assessed medical student attitudes regarding mistreatment and symptoms of posttraumatic stress in those students who reported exposure to mistreatment. Third- and fourth-year medical students (N=71) responded to questions from a vignette in which a student is mistreated and then described any mistreatment they had witnessed or experienced. They also discussed related symptoms of posttraumatic stress subsequent to the mistreatment. The revised Impact of Event Scale was the primary outcome measure. Ninety percent of respondents reported sympathy for the student in the vignette and supported her discussing the incident with peers, the resident, and administration. Seventy-three percent reported witnessing or experiencing mistreatment, suggesting symptoms of posttraumatic stress, with no differences in scores across the intended field of study, age, or gender. In a supportive environment, medical students will discuss their experiences of mistreatment. Symptoms of posttraumatic stress can occur from mistreatment.

Burnout, perceived stress, and depression among cardiology residents in Argentina.

Abstract: Because medical residency is a stressful time for training physicians, placing residents at increased risk for psychological distress, the authors studied the prevalence of burnout, perceived stress, and depression in cardiology residents in Argentina and examined the association between sociodemographic characteristics and these syndromes. The authors conducted a cross-sectional observational study of 106 cardiology residents in Argentina and a comparison group of 104 age- and gender-matched nonmedical professionals. The main outcome measures included the prevalence of burnout with the Maslach Burnout Inventory, distress with the Perceived Stress Scale, and depression with the Beck Depression Inventory. One hundred six residents completed the survey. Of these, 31.3% were women, the mean age was 29.1 years old, and half were married. Respondents worked an average of 64 hours per week, and 60% of the residents needed a second job. High emotional exhaustion and depersonalization was found in the majority of respondents. Significant depressive symptoms were found in less than half of residents, and stress was on average 21.7 points on the Perceived Stress Scale. Residents who had a second job showed high levels of depersonalization. No other association was found with sociodemographic characteristics. There were no differences in sociodemographic characteristics of residents compared with nonmedical professionals, but non-medical professionals worked less hours per week, had a lower percentage of second jobs, and higher salary. Burnout, depressive symptoms, and perceived stress were significantly lower in the reference group. Cardiology residents in Argentina exhibit high levels of burnout, perceived stress, and depressive symptoms, which warrants greater attention to the psychological needs of residents.

What Do We Teach Psychiatric Residents About Suicide? A National Survey of Chief Residents

Abstract: Objective Because of the clinical significance of patient suicide for trainees and current limited information on this essential educational subject, the authors sought to determine what topics involving the care of suicidal patients were taught to residents in psychiatry training programs.

When residents need health care: stigma of the patient role.

Abstract: Whether and under what circumstances medical residents seek personal health care is a growing concern that has important implications for medical education and patient welfare, but has not been thoroughly investigated. Barriers to obtaining care have been previously documented, but very little empirical work has focused on trainees who seek health care at their home institution. A self-report survey on special issues in personal health care of residents was created and distributed at the University of New Mexico School of Medicine in 2001. The authors report findings regarding stigma, fear of jeopardy to training status, and attitudes toward seeking self-care for residents in dual roles as patients and trainees. Residents (N = 155) rated their concerns regarding stigma and jeopardy to training status and the likelihood of seeking care at their training institution for six vignettes. The vignettes were paired to make comparisons between attending or supervisor as treating physician and between clinical scenarios. Alcohol abuse, nausea and diarrhea, panic attacks, and pregnancy were the most highly stigmatizing to residents; diabetes and hypertension were the least. Differences were also found for gender and specialty. Residents’ perceived stigma for clinical situations was an influential factor, strongly affecting concern about jeopardizing training status and likelihood of avoiding care at their home institution.

Students' Views on Factors Affecting Empathy in Medical Education.

Abstract: Empathy is a prominent goal of medical education that is too often underachieved. Using concept mapping, the authors constructed a student-generated conceptual model of factors viewed as affecting empathy during medical education. During the 2005–2006 academic year, 293 medical students and interns answered a brainstorming survey asking respondents to list factors affecting empathy, and 34 participants then sorted the factors into categories and rated each factor’s relative importance. Factors and ratings were examined using multidimensional scaling and cluster analyses, Pearson’s r, and Student’s t test. This process, known as “concept mapping,” was conducted using Concept Systems. One hundred sixty perceived empathy factors were identified and sorted into four clusters: personal experiences, connections and beliefs; negative feelings and attitudes toward patients; mentoring and clinical experiences that promote professional growth (rated most important); and school and work experiences that undermine development of empathy (rated least important). All students rated factors in a similar hierarchical fashion across all four clusters with no differences among groups. Listening was the most highly rated factor. Students consider experiences that promote personal and professional growth to be the most important factors affecting empathy in medical education. Though less important to students, negative feelings and attitudes toward patients, as well as negative school and work experiences, affect empathy at all stages of education.

Professionalism and ethics education on relationships and boundaries: psychiatric residents' training preferences.

Abstract: Awareness of the privileges and limits of one’s role as physician, as well as recognition and respect for the patient as a human being, are central to ethical medical practice. The authors were particularly interested in examining the attitudes and perceived needs of psychiatric residents toward education on professional boundaries and relationships given the heightened current focus on professionalism and ethics. Residents from six psychiatric residencies provided views on professionalism and ethics education on a survey encompassing 10 domains of professionalism. The authors focus on residents’ perceived need for education on boundaries in the psychiatrist-patient relationship and in peer-peer and supervisor-trainee interactions. Respondents (N = 134) felt that nine relationship and boundary issues arising during training should receive more education: being asked to work with inadequate supervision, resolving conflicts between attendings and trainees, resident health care, adequately caring for patients while adhering to work-hour guidelines, performing work beyond one’s competence, mistreatment of residents, sexual/romantic relationships between faculty and trainees, mistreatment of medical students, and sexual/romantic relationships between residents and medical students (p>0.05 in all cases). In addition, 15 relationship and boundary issues arising during clinical practice were felt to warrant more education: responding to impaired colleagues, coping with mistakes in clinical care, reporting mistakes, balancing personal and professional life, resolving conflicts, writing prescriptions for friends or family, allocation of health care resources, providing medical advice to friends and family, physicians’ social responsibilities, interacting with families, medicine as a profession, gender bias, being asked to falsify clinical information, accepting gifts from patients, and personal relationships with patients (p>0.05 in all cases). The authors found a perceived need for more education for psychiatric residents for the majority of topics pertaining to boundaries and relationships. Residents who reported encountering ethical dilemmas more frequently wanted more education on these topics.

Bullying of Trainee Psychiatrists in Pakistan: A Cross-Sectional Questionnaire Survey

Abstract: Bullying is widely prevalent in health care organizations and medical institutions. It leads to stress, anxiety, depression, sickness absences, and intention to leave the job. This issue has not been studied widely and thoroughly in most developing countries. The authors surveyed all postgraduate psychiatry trainees in the College of Physicians and Surgeons, Pakistan, with a cross-sectional questionnaire. In addition to sociodemographic data, the questionnaire included a bullying scale that asked whether the respondents had experienced in the preceding 12 months any of the 21 bullying behaviors listed and who had perpetrated the bullying. Out of 84 psychiatry trainees registered with the College of Physicians and Surgeons in May 2007, 60 participated in the survey. Eighty percent of participating trainees reported experiencing at least one bullying behavior in the preceding 12 months. There was no significant association between likelihood of experiencing bullying and any of the sociodemographic variables. However, in view of the small number of psychiatry trainees in Pakistan, this finding needs to be interpreted cautiously. Consultants were the most likely perpetrators of bullying. Most postgraduate psychiatry trainees in Pakistan have experienced bullying. Measures need to be taken to increase awareness of what constitutes bullying and how it affects its victims. It may be necessary to introduce antibullying policies at least at the organizational level.

Speaking out for Mental Health: Collaboration of Future Journalists and Psychiatrists.

Abstract: Objectives The authors assess the effects of an educational intervention on the attitudes and understanding of psychiatric residents and journalism students, review how collaboration between these disciplines affects these attitudes, and propose the development of similar programs within residency to enhance systems-based learning.

Attitudes toward psychiatry among final-year medical students in kumasi, ghana.

Abstract: Most sub-Saharan African countries have fewer psychiatrists than one per one million people. One possible reason could be that medical students have a negative attitude toward the specialty. The authors evaluated the attitudes toward a career in psychiatry of final-year medical students in Kumasi, Ghana, and compare these with attitudes of medical students in Spain and the United States. Medical students were given a 28-item questionnaire on attitudes toward psychiatry, which was used in previous studies in Spain and the United States. Ghanaian students (N = 94) had a fairly positive view of psychiatry, similar to those in Spain, although less positive than U.S. students. About 15% were considering psychiatry as a career option. There was evidence of significant stigmatization of patients with mental illness and psychiatrists and concern about the use of coercive detention of patients. The difficulty recruiting physicians into psychiatry in Ghana, and perhaps other African countries, is unlikely to be due to negative attitudes and may be due to a lack of opportunity to train in psychiatry.

Ensuring Research Competency in Psychiatric Residency Training

Abstract: Objective This article discusses the importance of research training in psychiatric residency programs and makes recommendations for enhancement.

Balint-style case discussion groups in psychiatric training: an evaluation.

Abstract: The authors aim to identify any benefits or limitations of psychiatric residents attending a Balint-style case discussion group, to explore those experiences, to study the process of the learning experience, and to identify potential educational implications. Seventeen psychiatric residents and counselors completing two parallel case discussion groups at a U.K. psychotherapy service were given in-depth interviews about their experiences of this training. Interview transcripts were analyzed using qualitative methodology. The groups were anxiety provoking; most participants were able to progressively accommodate to and benefit from the psychological learning process, but some struggled to adapt. Basic psychological competency and the awareness of the self in relation to the patient can be fostered through attendance at a case discussion group. With some limitations, Balint groups continue to be a useful way of introducing young psychiatrists to psychological processes.

Computer simulation and virtual reality in the diagnosis and treatment of psychiatric disorders.

Abstract: Patient: Well, my boyfriend made me come here Computer: YOUR BOYFRIEND MADE YOU COME HERE Patient: He says I’m depressed much of the time Computer: I AM SORRY TO HEAR YOU ARE DEPRESSED Patient: It is true. I am unhappy Computer: DO YOU THINK COMING HERE WILL HELP YOU NOT TO BE UNHAPPY? Patient: I need some help, that much seems certain Computer: WHAT WOULD IT MEAN TO YOU IF YOU GOT SOME HELP? Patient: Perhaps I could learn to get along with my mother

The Effect of Psychiatric Third-Year Rotation Setting on Academic Performance, Student Attitudes, and Specialty Choice

Abstract: Objective Few studies have directly compared the effects of third-year clerkship rotation type on measures of academic performance, student attitudes about psychiatry and psychiatric patients, and level of interest in psychiatry as a career. The goal of this study was to assess the extent to which rotation type influenced these outcome variables among third-year medical students.

Developing a Modern Standard to Define and Assess Professionalism in Trainees

Abstract: Assessing professionalism in medical education poses many challenges. The authors discuss common themes and principles in managing professionalism in medical education. The authors review the development of standards of professionalism in medical education. They define educational goals for professionalism and also discuss the practical problems with assessing professionalism and addressing it with the trainees. Strategies for remediation of unprofessional conduct are outlined. Given the importance of role models in the development of professional behavior, maintaining an environment that fosters professionalism is an implicit feature of teaching professionalism. Professionalism should be a part of the objectives for each course and clinical rotation, using clearly defined goals and objectives. Assessment of professionalism should begin early and be conducted frequently, giving trainees the opportunity to change. A formal mentoring system can be an effective mechanism to develop role models and teach professionalism. Teaching professionalism through formal curricula is paramount in helping develop new generations of compassionate and responsible physicians. Additional strategies such as consistent role modeling of professional behaviors are also needed to encourage the development of professional physicians.

Medical students' affirmation of ethics education.

Abstract: Objective Despite the acknowledged importance of ethics education in medical school, little empirical work has been done to assess the needs and preferences of medical students regarding ethics curricula.

End-of-Life Care Education for Psychiatric Residents: Attitudes, Preparedness, and Conceptualizations of Dignity

Abstract: The authors examined psychiatric residents’ attitudes, perceived preparedness, experiences, and needs in end-of-life care education. They also examined how residents conceptualized good end-of-life care and dignity. The authors conducted an electronic survey of 116 psychiatric residents at the University of Toronto. The survey had a mix of qualitative and quantitative questions. Eighty-two of116 invited psychiatric residents participated for a response rate of 71%. With favorable attitudes, residents felt least prepared in existential, spiritual, cultural, and some psychological aspects of caring for dying patients. Trainees conceptualized dignity at the end of life in a way very similar to that of patients, including concerns of the mind, body, soul, relationships, and autonomy. Residents desired more longitudinal, contextualized training, particularly in the psychosocial, existential, and spiritual aspects of care. This is the first study to examine the end-of-life educational experience of psychiatric residents. Despite conceptualizing quality care and the construct of dignity similarly to dying patients, psychiatric residents feel poorly prepared to deliver such care, particularly the nonphysical aspects of caring for the dying. These results will inform curriculum development in end-of-life care for psychiatric residents, a complex area now considered a core competency.

The perceptions and habits of alcohol consumption and smoking among Canadian medical students.

Abstract: The authors aim to quantify the extent, and to assess student perception, of alcohol and tobacco use among medical students at the University of Calgary, and the relationship of these attitudes to problem drinking (according to the CAGE questionnaire). A questionnaire was distributed to first-, second-, and third-year medical students attending the University of Calgary medical school. Of the 327 students enrolled, 175 of students responded to the questionnaire. Six percent of the students currently smoke while 24% of students reported cigarette smoking at some point in their life. Eighty-six percent of students currently drink, with a majority drinking fewer than 11 drinks per week. Fifteen percent of students were at an increased risk for problem drinking according to the CAGE questionnaire. An increased risk for problem drinking was significantly related to believing more strongly that getting drunk is acceptable on occasion and less strongly that increased alcohol has many negative health consequences, as well as feeling less in control of alcohol consumption. Medical students at the University of Calgary consume less alcohol and cigarettes than a comparable population. However, a high proportion of students are at risk for alcohol abuse according to the CAGE questionnaire. The results of this study suggest that although the quantity of alcohol consumed is not a substantial concern at this time, students might be at risk for future alcohol abuse.

Relationship Between Resident-In-Training Examination in Psychiatry and Subsequent Certification Examination Performances

Abstract: This study analyzed the relationship between performance on The American College of Psychiatrists’ Psychiatry Resident-In-Training Examination (PRITE) and the ABPN Part 1 examination. Pearson correlation coefficients were used to examine the relationship between performance on the 2002 PRITE and the 2003 Part 1 examination for 297 examinees. The correlation between the PRITE global psychiatry and the Part 1 psychiatry scores was 0.59, and the correlation between the PRITE global neurology and the Part 1 neurology scores was 0.39. Although the PRITE and the Part 1 examination have different purposes and are developed independently, the significant correlations between scores on the two tests support the use of PRITE results to guide preparation for the Part 1 examination. Guidelines for PRITE scores associated with poor performance on the Part 1 examination are provided.

Mistreatment of trainees: verbal abuse and other bullying behaviors.

Abstract: Medical school and residency training programs are intended to provide positive educational and mentorship experiences and to inculcate a culture of professionalism and collegiality. Academic psychiatrists often contribute greatly to these positive efforts, given the emphasis in their work on psychotherapeutic and interpersonal skills and their attentiveness to conflict prevention and resolution. It is very reasonable to expect, therefore, that occasions of verbal abuse or bullying of trainees would be very low in prevalence in psychiatric settings. Is this a realistic expectation or merely a statement of what we would like to believe about our profession? In their cross-sectional survey study of 71% of all trainees in psychiatry registered with the College of Physicians and Surgeons in Pakistan, Ahmer and colleagues (1) demonstrated that disrespectful interactions may be the rule rather than the exception in psychiatric residents’ educational experience. Fully 80% of the psychiatry trainees in this study (60 respondents, response rate 71%) had been the victim of at least one bullying behavior in the preceding 12 months. The most commonly encountered behaviors were persistent attempts to belittle and undermine the work of the trainee or to humiliate the trainee in front of colleagues. The greatest source of mistreatment was from consultants (74%), as well as peers (36%), managers (22%), and nurses (13%). Interestingly, patients (16%) also were identified as engaging in verbal abuse and bullying behaviors toward psychiatric trainees. To what degree are the findings of Ahmer et al. (1) likely similar or dissimilar to other educational settings in psychiatry and beyond? One of our goals for this editorial is to try to answer this question. We also intend to place this information on the verbal abuses or bullying of psychiatry trainees into context with relevant findings from medical students, residents in other specialties, and nurses. Finally, we will make recommendations for future research in this area. As Ahmer et al. (1) noted, the possible consequences of any attempts to belittle or undermine and humiliate residents are serious and warrant attention. Verbal aggression, abuse, or bullying incorporates a wide range of behaviors including threats, intimidation, humiliation, excessive criticism, covert innuendo, exclusion or denial of access to opportunity, undue additions to work requirements, and shifting of responsibilities without appropriate notice (2, 3). Such occasions, especially when repeated, could take the form of psychological harassment, creating distress and dissatisfaction in the training environment. Indeed, mistreatment in professional settings unfortunately comes in many forms. These are widely varying behaviors that are not easily defined or validated as abuse or bullying; therefore, in capturing relevant information on mistreatment in psychiatry training, a key challenge was to find all the relevant articles pertaining to the verbal abuse or bullying of psychiatry residents. We used a combination of search teams including “abuse,” “bullying,” “harassment,” “intimidation,” “discrimination,” “horizontal violence,” “aggression,” and “interpersonal conflict” and “psychiatry residents.” We searched databases including PubMed, Embase, and PsycINFO. The reference lists of relevant articles were also searched for additional references. Furthermore, because articles published in Academic Psychiatry prior to 2001 were not readily located through PubMed, we searched the indexes of Academic Psychiatry for additional information. We Received April 7, 2009; accepted April 8, 2009. Dr. Coverdale is affiliated with the Department of Psychiatry and Behavioral Sciences at Baylor College of Medicine in Houston; Dr. Balon is affiliated with Wayne State University, Detroit; Dr. Roberts is affiliated with the Department of Psychiatry and Behavioral Medicine at the Medical College of Wisconsin in Milwaukee. Address correspondence to John H. Coverdale, M.D., Baylor College of Medicine, Department of Psychiatry and Behavioral Sciences, One Baylor Plaza BCM 350, Houston, TX 77030; jhc@bcm.tmc.edu (e-mail). Copyright © 2009 Academic Psychiatry

Teaching the Physician-Manager Role to Psychiatric Residents: Development and Implementation of a Pilot Curriculum

Abstract: Objective The authors describe a pilot physician-manager curriculum designed to address the learning needs of psychiatric residents in administrative psychiatry and health systems.

A 4-Year Curriculum on Substance Use Disorders for Psychiatry Residents

Abstract: The authors describe an addiction psychiatry curriculum integrated in a general psychiatry training program to demonstrate comprehensive and practical approaches to educating general psychiatric residents on the recognition and treatment of substance use disorders. The Massachusetts General Hospital/McLean Hospital adult psychiatric residency training program provides training in addiction psychiatry in multiple treatment settings during the 4 years of residency. Addiction specialists, nonspecialty psychiatrists, and residents and fellows provide training. Adult psychiatric residencies can provide comprehensive addiction psychiatry training that spans multiple treatment settings and postgraduate years by training general staff psychiatrists, senior residents, and fellows to assist core addiction faculty in providing addiction psychiatry education. Substance use disorders are common among patients presenting to general psychiatry treatment settings, and thus it is important that all psychiatric residents be well trained in the screening, diagnosis, and treatment of outpatients with these problems.

Mentoring in psychiatric residency programs: a survey of chief residents.

Abstract: Mentorship is an important component of graduate education. This study assessed the perceptions of general psychiatry chief residents regarding the adequacy of mentorship provided during training. The authors surveyed 229 chief residents participating in the APA National Chief Residents Leadership Program in 2004 and 2005. The survey assessed domains such as work hours, didactics, home and family life, and mentorship. Of the chief psychiatric residents surveyed, 49% reported that they did not have a clearly defined career development mentor, and 39% reported that they did not feel adequately mentored. Gender, race/ethnicity, marital status, moonlighting, medical school (American versus international), and type of residency program (academic versus community based) did not show significant association with either “having a clearly defined mentor” or “feeling adequately mentored,” based on chisquared tests for independence. Chief residents who had authored peer-reviewed publications were significantly more likely to report having a clearly defined mentor and to feel adequately mentored than those who did not author publications. Logistic regression analysis showed that having a clearly defined mentor was associated with twice the odds for feeling well prepared to practice psychiatry upon graduation compared with those who did not have a clearly defined mentor, even after controlling for gender, race, medical school, and residency program type. Half of the psychiatric chief residents surveyed reported the lack of a clearly defined career development mentor. In addition, a chief resident’s response of lacking a clear mentor was associated with the perception of being less prepared to practice psychiatry upon graduation. Psychiatric residency training programs may benefit from further clarification and implementation of effective mentorship programs.

The Effect of Clinical Clerkship on Students’ Attitudes Toward Psychiatry in Karachi, Pakistan

Abstract: Attitudes of medical students toward a specialty is strongly related to their future choice of specialty. In developing countries like Pakistan, where there is a shortage of psychiatrists, there is a need to assess the effect of exposure to psychiatry on medical students. The authors conducted a survey of fourth-year medical students at Aga Khan University in Karachi, Pakistan. Psychiatry clerkship had an overall positive attitude toward psychiatric illness, patients, and psychiatrists, but no effect on students’ choice of psychiatry as a career. Psychiatry teaching needs to be made more relevant to the rest of the medical curricula. This may improve students’ interest and their future choice of psychiatry as an area of specialization.

What Do Psychiatric Residents Think of Addiction Psychiatry as a Career

Abstract: Objective The authors attempt to better understand the recent decline in the number of applicants to addiction psychiatry training.

Using standardized patients' marks in scoring postgraduate psychiatry OSCEs.

Abstract: Standardized patients (SPs) do not contribute scores in postgraduate psychiatry objective structured clinical examinations (OSCEs) in the United Kingdom. However, this may change in the near future. The primary aim of this study was to measure the degree of agreement between scores given by examiners and those given by SPs in an OSCE. The authors measured the degree of agreement in two consecutive postgraduate OSCEs for psychiatric residents on a London training scheme. Fifty-five candidates participated in the two OSCEs. There was a moderate degree of agreement between examiner and SP scores for communication and for the overall mark. However, there was a stronger relationship between the examiner score for communication and the candidates’ overall mark. Examiners and SPs scored candidates differently. Therefore, the decision to include SP scores in the marking scheme for postgraduate OSCEs would be a significant development.

The Career Development Institute for Psychiatry: An Innovative, Longitudinal Program for Physician-Scientists

Abstract: Objectives The Research Career Development Institute for Psychiatry is a collaboration between the University of Pittsburgh and Stanford University to recruit and train a broad-based group of promising junior physicians by providing the necessary skills and support for successful research careers in academic psychiatry.