Psychosomatic Medicine 14:277-283 (1952)
© 1952 American Psychosomatic Society

A Program of Teaching a Psychodynamic Orientation to Resident Physicians in Medicine

¹ Neuropsychiatric and Medical Services of the Cushing Veterans Administration Hospital Framingham, Massachusetts

This paper presents the history to date of some of the problems and experiences in teaching a psychodynamic orientation to resident physicians on the Medical Service of this teaching hospital. For the first two years joint medical-psychiatric conferences alone were used as a vehicle for the orientation. The working out of the best way to manage such conferences for the entire medical service is still in progress. To date, however, a satisfactory approach has not been reached and we are continuing to examine the subject.

When it became possible, a Psychosomatic Section made up of a member of the psychiatric staff and four advanced psychiatric residents was organized and incorporated into the Medical Service. The section performed consultations on a formal and informal basis, made regular medical ward rounds, and treated medical ward patients psychiatrically. Much was learned in the patient-internist and internist-psychiatrist relationships which was of value to both medical and psychiatric residents.

Psychiatric residents were available for only six months. Since then, the author, who remained on the Medical Service to maintain liaison between medical and psychiatric services, has continued the teaching of psychodynamics to the medical residents. On a voluntary basis, seminar groups meet regularly to discuss concepts of psychosomatic medicine and interviewing technic. The seminars are conducted according to a semidirected associative procedure, as illustrated in the text. When ready some of the group members undertook psychotherapy of individual patients. To date more than half the members are doing individual work, supervised by the author.

As yet it is too early to evaluate this program in detail. However, its effect can be observed in a greater awareness by the medical residents of the "person" with illness. This awareness of the physician, it is believed, will help round out his training and result thereby in improved patient care, the goal of all medical instruction.