Acad Psychiatry (2015) 39:242–245 DOI 10.1007/s40596-015-0339-4
IN DEPTH ARTICLE: COMMENTARY
Medical Student Education in Psychiatry: Opportunities and Challenges Brenda J. B. Roman 1
Received: 10 March 2015 / Accepted: 17 March 2015 / Published online: 18 April 2015 # Academic Psychiatry 2015
This issue of Academic Psychiatry relates to various aspects of medical student education. Most impressive to me is that the faculty members who wrote these papers are demonstrating their commitment to educate students, mentor students for careers in psychiatry, and share their ideas with the educational community. As found in the recent survey of Association of Directors of Medical Student Education in Psychiatry (ADMSEP) members [1], psychiatric educators are committed to scholarship, and it is refreshing to see so many papers in this issue of Academic Psychiatry on topics related to medical student education. From these papers, three general themes emerge: (1) innovations in medical student education, (2) recruitment of medical students into the field of psychiatry, and (3) the prevalence of psychiatric disorders in medical students. The overarching issue of stigma toward psychiatry emerges in some way in many of these papers, reminding us of this enduring challenge.
Innovations in Medical Student Education With the increasing emphasis on reflection in both the practice and teaching of medicine, Schatte and colleagues [2] give us a glimpse of what students may be really feeling about their experiences on a psychiatry clerkship. Many of the student reflections show increased awareness of the complexities of psychiatric illnesses and the impact of trauma and addiction on the lives of our patients—showing that, indeed, our
* Brenda J. B. Roman [email protected] 1
Wright State University, Dayton, OH, USA
students are still very empathic. We hope that they will carry these insights forward into their practice as future physicians. In addition, their reflections offer curricular opportunities to discuss student observations of the “frustrations” of the system—and perhaps encourage some to become advocates for better systems of care. Because some of the comments centered on the importance of multidisciplinary teamwork, perhaps clerkship directors can deliberately focus on this interprofessional educational opportunity. Schatte et al. [2] sought the expertise of a medical humanities scholar to help provide better feedback to the students in the area of professional identity formation. Perhaps this technique could decrease future burnout in medical school and within the profession of medicine at large—something that would be interesting to study long-term. The qualitative analysis by Brown et al. [3] on a brief narrative exercise in the second year of medical school is another way to focus on the “patient’s voice” and infuse professional identity formation into the curriculum through active learning without being time-intensive. In light of the work of Schatte et al. [2], it would be interesting to see if such a brief narrative exercise in the psychiatry clerkship yields similar themes. Along similar paths, the pilot study by Alexander et al. [4] to increase interpersonal skills in medical students through teaching an experiential mind-body method known as innerrelationship focusing, combining empathic listening and mind-body awareness, is quite thought-provoking. Seeing the comments of students who participated in this course, one is left wondering if such courses were included in the medical curriculum, would there be a decrease in future physician burnout? Having medical students participate in chaplain rounds, as described by Frazier et al. [5], is a unique interprofessional education activity that takes only 3 h. Using the grounded theory method of analyzing the reflections provides insights
Acad Psychiatry (2015) 39:242–245
that focus on the humanistic aspect of medical care that often is disregarded in working with physicians, especially the importance of spirituality. Like the other reflective exercises described in this issue [2–4], the importance of compassion and personal introspection were evident in the student reflections [5]. While the above studies focused on educating students in areas other than factual knowledge, the teaching of core clinical and basic science knowledge remains vitally important. McKean and Palmer [6] found that resident-led tutorials helped improve shelf exam scores. This finding reinforces the fact that students crave good teaching, and they respond when people spend time with them. Tsao [7] reminds educators that most aspects of medical education are better with a specific process to follow; her description of “learning through discussion” gives us a straightforward approach that academic psychiatrists can use as part of their teaching in small group settings. Two student-driven educational opportunities—sex workers as medical student educators by Robitz et al. [8] and students conducting depression screenings at a studentrun free clinic by Soltani et al. [9]—show the industrious nature of medical students and the desire to truly make a difference in the lives of people, even as students. Other schools can easily adopt these programs; what is so wonderful is that students are performing a valuable service in addition to learning. Balon et al. [10] provide a further, in-depth discussion of issues raised by Robitz et al. [8] in the editorial for this issue of the journal. Lehmann et al. [11] highlight an area where we can do better as educators, specifically in the area of geriatric psychiatry, as 21 % of schools lacked any geriatric components, despite the aging population of the USA. Even more concerning, given the risk of suicide in the elderly population [12], is that when geriatric content was included, it was more likely to be on the topic of cognitive impairment than on geriatric depression. We must do better if we are going to equip future physicians with the skills to recognize and treat people with psychiatric disorders—in this case, to prevent the morbidity that comes along with missing late-life depression and teach how to manage the disorder. With curriculum reform occurring across the nation, psychiatric educators need to advocate for the inclusion of a curriculum that includes the important elements of taking care of our geriatric population.
Recruitment of Medical Students into the Field of Psychiatry Leung and colleagues [13] examine the qualitative studies that are available regarding factors that might impact recruitment of students into psychiatry. This article included students from Australia, the USA, the UK, Canada, and Ghana—reflecting
243
the global challenge of recruiting students into this field. Not surprising, having committed psychiatrists as role models was an important factor for students to consider a career in psychiatry. Conversely, the stigma about the profession of psychiatry continues to be a challenge, as noted by Leung et al. [13] and the comparison study between Australian and Ghana medical students by Lyons and colleagues [14]. Ighodaro et al. [15] examined medical students and physicians in Nigeria (a nation with strongly held beliefs about mental illness), finding that clinical experience results in more positive attitudes toward people with mental illness, which is not surprising. But the question remains, how does this translate to overall long-term attitudes toward psychiatry as a field? Likewise, are we doing all that we can as educators to assure students who are considering a career in psychiatry that we will not have biases should they disclose their own mental health history? One of my own mentees, planning a career in psychiatry, asked how sharing a personal story might impact residency applications. Sadly, I could not confidently assure the student that the revelation would be looked at positively. Studies are needed in this area, not only for students planning to enter psychiatry, but other medical specialties—why should sharing about depression be any different than sharing about the impact of cancer on personal decisions? Even more specific was the article by Currant and colleagues [16] about medical students’ perspectives regarding an academic career in psychiatry. Once again, in the qualitative portion of this study, a facilitating factor was having a positive experience with research and a mentor, whereas lack of knowledge about academic careers and lack of exposure to geriatric populations were some of the barriers. The study by the Canadian Organization of Undergraduate Psychiatric Educators [17] found that the duration of preclerkship exposure predicted the number of students selecting psychiatry as their first choice as a discipline, not the number of clerkship weeks. This finding should propel psychiatric educators to become as involved in the preclinical curriculum as possible. With the move toward greater integration of clinical sciences earlier into the curriculum, psychiatric faculty should become involved in the interview skills curriculum, motivational interviewing, and interprofessional education opportunities. Offering early shadowing opportunities for medical students can also increase preclinical exposure to the field of psychiatry, especially if tailored to specific interests, like child psychiatry. With the finding (albeit a small number at this time) that students participating in longitudinal integrated clerkships (LICs) were less likely to select psychiatry as a career raises several issues, as the authors noted, it can be an opportunity for greater interdisciplinary collaboration. The study examining communication skills and specialty choice [18] by Tsao and colleagues found no significant difference in mean communication scores for medical students who entered person-oriented versus technique-oriented
244
specialties, which is different from what we might have expected. Although the study had several limitations, it does elucidate areas for further research, perhaps to further subcategorize what kinds of communication skills may or may not predict interest in psychiatry. Medfest, as described by Ahmed and colleagues [19], is an innovative idea at UK medical schools. Using short films about psychiatry with panelist-led discussions had a remarkable impact in the positive direction on views of psychiatry and psychiatrists, and 46 % of those who attended indicated that they were more likely to consider a career in psychiatry. This event has grown to 31 sites in the UK, Ireland, Latvia, and Australia; the next logical research step is to determine whether the students who attended and indicated a greater likelihood of selecting psychiatry as a career actually do so! Even more important research would be to determine if the positive attitudes toward psychiatry persisted regardless of the area of medicine ultimately selected.
Prevalence of Psychiatric Disorders in Medical Students The review article by Bacchi and Licinio [20] challenges the literature’s general consensus about medical students having a higher prevalence of depression than various comparative groups. Even so, the rates are still concerning, and as the authors state, we need to do further research in the area, especially in the form of longitudinal studies. We also need to better assess and treat medical students who are depressed. Perhaps identifying and treating students during medical school can save future physicians from the despair of depression and the consequences of suicide [21]. Tsimtsiou and colleagues’ survey of Internet addiction among Greek medical students [22] has implications for educators, as we generally begin to think about the possibility of substance use disorders or depression when students struggle. Most surprising in this study is the finding that using e-mail is negatively associated with addictive behaviors.
Acad Psychiatry (2015) 39:242–245
psychiatry, but poor as a career choice, and thus called for more innovative teaching strategies in the psychiatric curriculum. Only time will tell if the innovations and ideas described in some of this papers will have an impact—but in the meantime, we need to continue to do more research on specific factors as to the kind of students who gravitate toward psychiatry, while keeping in mind that we need to provide excellent educational opportunities for all of our students so they may be prepared to meet the demands of caring for patients with psychiatric disorders. Implications for Educators • Reflective exercise as part of the curriculum provides a unique opportunity for educators to better understand student perspectives of psychiatry and can be used to facilitate professional identity formation. • Stigma regarding attitudes toward a psychiatric illness and psychiatry as a career continues to be a challenge and should propel educators to become as involved in all aspects of the curriculum as possible. • Geriatric psychiatry content needs to be included in the curriculum for our students to be prepared to take care of the needs of our elderly population. • Depression among medical students continues to be a concern, with more longitudinal studies needed and attention given to preventing professional burnout as well as better identifying and treating students with depression.
Acknowledgments The author would like to thank Greg Briscoe for his helpful comments in preparing this commentary. Disclosures The author has no conflicts of interest.
References 1.
2.
3.
Conclusion All these articles, plus a medical student perspective on her experiences in participation in the Summer Institute for Medical Student program at the Betty Ford Center [23], showcase the innovative educational opportunities, highlight the challenges in recruiting students to the field of psychiatry, and remind us of the potential for burnout in the educational process. What is proving to be elusive is translating educational experiences and reducing stigma into improved recruitment into the field of psychiatry. A 20-year systematic review in 2013 [24] found overall attitudes to be positive toward
4.
5.
6.
Roman B, Briscoe G, Gay TL. Medical student psychiatric educators’ perceptions of supports, resources and rewards. Acad Psychiatry. 2014;38:316–9. Schattte DJ, Piemonte N, Clark M. “I started to feel like a ‘real doctor’”: medical students’ reflections on their psychiatry clerkship. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0276-7. Brown R, Griggs M, Cummins J, Nittler J, Gordy-Panhorst K, Hoffman KG. What can a brief narrative exercise reveal about medical students as patient-centered physicians and their attitudes toward patients with mental illness? Acad Psychiatry. 2015. doi:10. 1007/s40596-015-0291-3. Alexander C, Sheeler RD, Rasmussen NH, Hayden L. Teaching an experiential mind–body method to medical students to increase interpersonal skills: a pilot study. Acad Psychiatry. 2015. doi:10. 1007/s40596-014-0159-y. Frazier M, Schnell K, Baillie S, Stuber ML. Chaplain rounds: a chance for medical students to reflect on spirituality in patientcentered care. Acad Psychiatry. 2015. doi:10.1007/s40596-0150292-2. McKean AJS, Palmer BA. Psychiatry resident-led tutorials increase medical student knowledge and improve National Board of Medical Examiners shelf exam scores. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0277-6.
Acad Psychiatry (2015) 39:242–245 7. 8.
9.
10.
11.
12.
13.
14.
15.
Tsao CIP. Using learning through discussion in medical education settings. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0156-1. Robitz R, Morrison L, Ventura A, Melton MC, Bennett A. Sex workers as medical student educators. Acad Psychiatry. 2015. doi: 10.1007/s40596-014-0214-8. Soltani M, Smith S, Beck E, Johnson M. Universal depression screening, diagnosis, management, and outcomes at a student-run free clinic. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0257-x. Balon R, Tait GR, Beresin EV, Coverdale JH, Louie AK, Roberts LW. Stigma and empathy: sex workers as educators of medical students. Acad Psychiatry 2015. Lehmann SW, Blazek MC, Popeo DM. Geriatric psychiatry in the psychiatry clerkship: a survey of current education practices. Acad Psychiatry. 2015. doi:10.1007/s40596-015-0316-y. Centers for Disease Control and Prevention. Injury Prevention & Control: Division of Violence Prevention. National Suicide Statistics at a Glance. Trends in Suicide Rates* Among Both Sexes, by Age Group, United States, 1991–2009. Available at http://www.cdc.gov/violenceprevention/suicide/statistics/trends02. html. Last accessed 23 Feb 2015. Leung K, Awani A, Chima C, Udo I. What can qualitative studies reveal about recruitment into psychiatry? Acad Psychiatry. 2015. doi:10.1007/s40596-015-0290-4. Lyons Z, Laugharne J, Laugharne R, Appiah-Poku J. Stigma towards mental illness among medical students in Australia and Ghana. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0147-2. Ighordaro A, Stefanovics E, Makanjuola V, Rosenheck R. An assessment of attitudes towards people with mental illness among medical students and physicians in Ibadan. Niger Acad Psychiatry. 2015. doi:10.1007/s40596-014-0169-9.
245 16.
17.
18.
19.
20.
21. 22.
23. 24.
Curran MA, Black M, Depp CA, Iglewicz A, Reichstadt J, Palinkas L. Perceived barriers and facilitators for an academic career in geriatrics: medical students’ perspectives. Acad Psychiatry. 2015. doi: 10.1007/s40596-014-0208-6. Lau T, Zamani D, Lee EK, Asli KD, Gill J, Brager N, et al. Factors affecting recruitment into psychiatry: a Canadian experience. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0269-6. Tsao CP, Simpson D, Treat R. Medical student communication skills and specialty choice. Acad Psychiatry. 2015. doi:10.1007/ s40596-014-0165-0. Ahmed K, Bennett DM, Halder N, Byrne P. Medfest: the effect of a national medical film festival on attendees’ attitudes to psychiatry and psychiatrists and medical students’ attitudes to a career in psychiatry. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0184-x. Bacchi S, Licinio J. Qualitative literature review of the prevalence of depression in medical students compared to students in nonmedical degrees. Acad Psychiatry. 2015. doi:10.1007/s40596014-0241-5. Bright RP, Krahn L. Depression and suicide among physicians. Curr Psychiatr. 2011;10:16–30. Tsimtsiou Z, Haidich AB, Spachos D, Kokkali S, Bamidis P, Dardavesis T, et al. Internet addiction in Greek medical students: an online survey. Acad Psychiatry. 2015. doi:10.1007/s40596-0140273-x. Palma N. A medical student’s education in addiction. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0246-0. Lyons Z. Attitudes of medical students toward psychiatry and psychiatry as a career: a systematic review. Acad Psychiatry. 2013;37: 150–7.
IN DEPTH ARTICLE: COMMENTARY
Medical Student Education in Psychiatry: Opportunities and Challenges Brenda J. B. Roman 1
Received: 10 March 2015 / Accepted: 17 March 2015 / Published online: 18 April 2015 # Academic Psychiatry 2015
This issue of Academic Psychiatry relates to various aspects of medical student education. Most impressive to me is that the faculty members who wrote these papers are demonstrating their commitment to educate students, mentor students for careers in psychiatry, and share their ideas with the educational community. As found in the recent survey of Association of Directors of Medical Student Education in Psychiatry (ADMSEP) members [1], psychiatric educators are committed to scholarship, and it is refreshing to see so many papers in this issue of Academic Psychiatry on topics related to medical student education. From these papers, three general themes emerge: (1) innovations in medical student education, (2) recruitment of medical students into the field of psychiatry, and (3) the prevalence of psychiatric disorders in medical students. The overarching issue of stigma toward psychiatry emerges in some way in many of these papers, reminding us of this enduring challenge.
Innovations in Medical Student Education With the increasing emphasis on reflection in both the practice and teaching of medicine, Schatte and colleagues [2] give us a glimpse of what students may be really feeling about their experiences on a psychiatry clerkship. Many of the student reflections show increased awareness of the complexities of psychiatric illnesses and the impact of trauma and addiction on the lives of our patients—showing that, indeed, our
* Brenda J. B. Roman [email protected] 1
Wright State University, Dayton, OH, USA
students are still very empathic. We hope that they will carry these insights forward into their practice as future physicians. In addition, their reflections offer curricular opportunities to discuss student observations of the “frustrations” of the system—and perhaps encourage some to become advocates for better systems of care. Because some of the comments centered on the importance of multidisciplinary teamwork, perhaps clerkship directors can deliberately focus on this interprofessional educational opportunity. Schatte et al. [2] sought the expertise of a medical humanities scholar to help provide better feedback to the students in the area of professional identity formation. Perhaps this technique could decrease future burnout in medical school and within the profession of medicine at large—something that would be interesting to study long-term. The qualitative analysis by Brown et al. [3] on a brief narrative exercise in the second year of medical school is another way to focus on the “patient’s voice” and infuse professional identity formation into the curriculum through active learning without being time-intensive. In light of the work of Schatte et al. [2], it would be interesting to see if such a brief narrative exercise in the psychiatry clerkship yields similar themes. Along similar paths, the pilot study by Alexander et al. [4] to increase interpersonal skills in medical students through teaching an experiential mind-body method known as innerrelationship focusing, combining empathic listening and mind-body awareness, is quite thought-provoking. Seeing the comments of students who participated in this course, one is left wondering if such courses were included in the medical curriculum, would there be a decrease in future physician burnout? Having medical students participate in chaplain rounds, as described by Frazier et al. [5], is a unique interprofessional education activity that takes only 3 h. Using the grounded theory method of analyzing the reflections provides insights
Acad Psychiatry (2015) 39:242–245
that focus on the humanistic aspect of medical care that often is disregarded in working with physicians, especially the importance of spirituality. Like the other reflective exercises described in this issue [2–4], the importance of compassion and personal introspection were evident in the student reflections [5]. While the above studies focused on educating students in areas other than factual knowledge, the teaching of core clinical and basic science knowledge remains vitally important. McKean and Palmer [6] found that resident-led tutorials helped improve shelf exam scores. This finding reinforces the fact that students crave good teaching, and they respond when people spend time with them. Tsao [7] reminds educators that most aspects of medical education are better with a specific process to follow; her description of “learning through discussion” gives us a straightforward approach that academic psychiatrists can use as part of their teaching in small group settings. Two student-driven educational opportunities—sex workers as medical student educators by Robitz et al. [8] and students conducting depression screenings at a studentrun free clinic by Soltani et al. [9]—show the industrious nature of medical students and the desire to truly make a difference in the lives of people, even as students. Other schools can easily adopt these programs; what is so wonderful is that students are performing a valuable service in addition to learning. Balon et al. [10] provide a further, in-depth discussion of issues raised by Robitz et al. [8] in the editorial for this issue of the journal. Lehmann et al. [11] highlight an area where we can do better as educators, specifically in the area of geriatric psychiatry, as 21 % of schools lacked any geriatric components, despite the aging population of the USA. Even more concerning, given the risk of suicide in the elderly population [12], is that when geriatric content was included, it was more likely to be on the topic of cognitive impairment than on geriatric depression. We must do better if we are going to equip future physicians with the skills to recognize and treat people with psychiatric disorders—in this case, to prevent the morbidity that comes along with missing late-life depression and teach how to manage the disorder. With curriculum reform occurring across the nation, psychiatric educators need to advocate for the inclusion of a curriculum that includes the important elements of taking care of our geriatric population.
Recruitment of Medical Students into the Field of Psychiatry Leung and colleagues [13] examine the qualitative studies that are available regarding factors that might impact recruitment of students into psychiatry. This article included students from Australia, the USA, the UK, Canada, and Ghana—reflecting
243
the global challenge of recruiting students into this field. Not surprising, having committed psychiatrists as role models was an important factor for students to consider a career in psychiatry. Conversely, the stigma about the profession of psychiatry continues to be a challenge, as noted by Leung et al. [13] and the comparison study between Australian and Ghana medical students by Lyons and colleagues [14]. Ighodaro et al. [15] examined medical students and physicians in Nigeria (a nation with strongly held beliefs about mental illness), finding that clinical experience results in more positive attitudes toward people with mental illness, which is not surprising. But the question remains, how does this translate to overall long-term attitudes toward psychiatry as a field? Likewise, are we doing all that we can as educators to assure students who are considering a career in psychiatry that we will not have biases should they disclose their own mental health history? One of my own mentees, planning a career in psychiatry, asked how sharing a personal story might impact residency applications. Sadly, I could not confidently assure the student that the revelation would be looked at positively. Studies are needed in this area, not only for students planning to enter psychiatry, but other medical specialties—why should sharing about depression be any different than sharing about the impact of cancer on personal decisions? Even more specific was the article by Currant and colleagues [16] about medical students’ perspectives regarding an academic career in psychiatry. Once again, in the qualitative portion of this study, a facilitating factor was having a positive experience with research and a mentor, whereas lack of knowledge about academic careers and lack of exposure to geriatric populations were some of the barriers. The study by the Canadian Organization of Undergraduate Psychiatric Educators [17] found that the duration of preclerkship exposure predicted the number of students selecting psychiatry as their first choice as a discipline, not the number of clerkship weeks. This finding should propel psychiatric educators to become as involved in the preclinical curriculum as possible. With the move toward greater integration of clinical sciences earlier into the curriculum, psychiatric faculty should become involved in the interview skills curriculum, motivational interviewing, and interprofessional education opportunities. Offering early shadowing opportunities for medical students can also increase preclinical exposure to the field of psychiatry, especially if tailored to specific interests, like child psychiatry. With the finding (albeit a small number at this time) that students participating in longitudinal integrated clerkships (LICs) were less likely to select psychiatry as a career raises several issues, as the authors noted, it can be an opportunity for greater interdisciplinary collaboration. The study examining communication skills and specialty choice [18] by Tsao and colleagues found no significant difference in mean communication scores for medical students who entered person-oriented versus technique-oriented
244
specialties, which is different from what we might have expected. Although the study had several limitations, it does elucidate areas for further research, perhaps to further subcategorize what kinds of communication skills may or may not predict interest in psychiatry. Medfest, as described by Ahmed and colleagues [19], is an innovative idea at UK medical schools. Using short films about psychiatry with panelist-led discussions had a remarkable impact in the positive direction on views of psychiatry and psychiatrists, and 46 % of those who attended indicated that they were more likely to consider a career in psychiatry. This event has grown to 31 sites in the UK, Ireland, Latvia, and Australia; the next logical research step is to determine whether the students who attended and indicated a greater likelihood of selecting psychiatry as a career actually do so! Even more important research would be to determine if the positive attitudes toward psychiatry persisted regardless of the area of medicine ultimately selected.
Prevalence of Psychiatric Disorders in Medical Students The review article by Bacchi and Licinio [20] challenges the literature’s general consensus about medical students having a higher prevalence of depression than various comparative groups. Even so, the rates are still concerning, and as the authors state, we need to do further research in the area, especially in the form of longitudinal studies. We also need to better assess and treat medical students who are depressed. Perhaps identifying and treating students during medical school can save future physicians from the despair of depression and the consequences of suicide [21]. Tsimtsiou and colleagues’ survey of Internet addiction among Greek medical students [22] has implications for educators, as we generally begin to think about the possibility of substance use disorders or depression when students struggle. Most surprising in this study is the finding that using e-mail is negatively associated with addictive behaviors.
Acad Psychiatry (2015) 39:242–245
psychiatry, but poor as a career choice, and thus called for more innovative teaching strategies in the psychiatric curriculum. Only time will tell if the innovations and ideas described in some of this papers will have an impact—but in the meantime, we need to continue to do more research on specific factors as to the kind of students who gravitate toward psychiatry, while keeping in mind that we need to provide excellent educational opportunities for all of our students so they may be prepared to meet the demands of caring for patients with psychiatric disorders. Implications for Educators • Reflective exercise as part of the curriculum provides a unique opportunity for educators to better understand student perspectives of psychiatry and can be used to facilitate professional identity formation. • Stigma regarding attitudes toward a psychiatric illness and psychiatry as a career continues to be a challenge and should propel educators to become as involved in all aspects of the curriculum as possible. • Geriatric psychiatry content needs to be included in the curriculum for our students to be prepared to take care of the needs of our elderly population. • Depression among medical students continues to be a concern, with more longitudinal studies needed and attention given to preventing professional burnout as well as better identifying and treating students with depression.
Acknowledgments The author would like to thank Greg Briscoe for his helpful comments in preparing this commentary. Disclosures The author has no conflicts of interest.
References 1.
2.
3.
Conclusion All these articles, plus a medical student perspective on her experiences in participation in the Summer Institute for Medical Student program at the Betty Ford Center [23], showcase the innovative educational opportunities, highlight the challenges in recruiting students to the field of psychiatry, and remind us of the potential for burnout in the educational process. What is proving to be elusive is translating educational experiences and reducing stigma into improved recruitment into the field of psychiatry. A 20-year systematic review in 2013 [24] found overall attitudes to be positive toward
4.
5.
6.
Roman B, Briscoe G, Gay TL. Medical student psychiatric educators’ perceptions of supports, resources and rewards. Acad Psychiatry. 2014;38:316–9. Schattte DJ, Piemonte N, Clark M. “I started to feel like a ‘real doctor’”: medical students’ reflections on their psychiatry clerkship. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0276-7. Brown R, Griggs M, Cummins J, Nittler J, Gordy-Panhorst K, Hoffman KG. What can a brief narrative exercise reveal about medical students as patient-centered physicians and their attitudes toward patients with mental illness? Acad Psychiatry. 2015. doi:10. 1007/s40596-015-0291-3. Alexander C, Sheeler RD, Rasmussen NH, Hayden L. Teaching an experiential mind–body method to medical students to increase interpersonal skills: a pilot study. Acad Psychiatry. 2015. doi:10. 1007/s40596-014-0159-y. Frazier M, Schnell K, Baillie S, Stuber ML. Chaplain rounds: a chance for medical students to reflect on spirituality in patientcentered care. Acad Psychiatry. 2015. doi:10.1007/s40596-0150292-2. McKean AJS, Palmer BA. Psychiatry resident-led tutorials increase medical student knowledge and improve National Board of Medical Examiners shelf exam scores. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0277-6.
Acad Psychiatry (2015) 39:242–245 7. 8.
9.
10.
11.
12.
13.
14.
15.
Tsao CIP. Using learning through discussion in medical education settings. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0156-1. Robitz R, Morrison L, Ventura A, Melton MC, Bennett A. Sex workers as medical student educators. Acad Psychiatry. 2015. doi: 10.1007/s40596-014-0214-8. Soltani M, Smith S, Beck E, Johnson M. Universal depression screening, diagnosis, management, and outcomes at a student-run free clinic. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0257-x. Balon R, Tait GR, Beresin EV, Coverdale JH, Louie AK, Roberts LW. Stigma and empathy: sex workers as educators of medical students. Acad Psychiatry 2015. Lehmann SW, Blazek MC, Popeo DM. Geriatric psychiatry in the psychiatry clerkship: a survey of current education practices. Acad Psychiatry. 2015. doi:10.1007/s40596-015-0316-y. Centers for Disease Control and Prevention. Injury Prevention & Control: Division of Violence Prevention. National Suicide Statistics at a Glance. Trends in Suicide Rates* Among Both Sexes, by Age Group, United States, 1991–2009. Available at http://www.cdc.gov/violenceprevention/suicide/statistics/trends02. html. Last accessed 23 Feb 2015. Leung K, Awani A, Chima C, Udo I. What can qualitative studies reveal about recruitment into psychiatry? Acad Psychiatry. 2015. doi:10.1007/s40596-015-0290-4. Lyons Z, Laugharne J, Laugharne R, Appiah-Poku J. Stigma towards mental illness among medical students in Australia and Ghana. Acad Psychiatry. 2015. doi:10.1007/s40596-014-0147-2. Ighordaro A, Stefanovics E, Makanjuola V, Rosenheck R. An assessment of attitudes towards people with mental illness among medical students and physicians in Ibadan. Niger Acad Psychiatry. 2015. doi:10.1007/s40596-014-0169-9.
245 16.
17.
18.
19.
20.
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