After four years of medical school, a student wishing to specialize in psychiatry enters our residency. My faculty and I then have four more years (five, if the trainee elects child psychiatry) to turn the physician into a psychiatrist.
Our goal is to produce clinicians who will be knowledgeable and compassionate with patients, to be doctors we’d refer our family members to. Above all, they should be safe practitioners. What do we hope the residents will learn in four years?
The mental status examination and standard observation and description are relatively static over time. Diagnostic categories evolve slowly. Psychotherapies evolve, also relatively gradually. But neurobiology progresses rapidly, and pharmacology and other biological interventions change constantly.
I am acutely aware that many practical pointers I give my residents (how many milligrams of that drug to prescribe) will be obsolete before they graduate. So, what do I really want them to carry away from their four postgraduate years at a university?
Lifelong learning: it’s not an abstraction but a vital requirement for all doctors. (I don’t want to see an internist whose knowledge is out of date.) I try to imbue my residents with that as a core value. And I hope to model for them an approach—to patients and to the application of constantly updated knowledge to their care. I try to demonstrate incisive but compassionate interviewing, thoughtful formulation, and up-to-date bio-psycho-social therapeutic interventions.
It isn’t easy. If it were, it wouldn’t be fun. And it is.