Annamalai Aniyizhai, Rohrbaugh Robert M, Sernyak Michael J
Yale University, New Haven, CT, USA,
Acad Psychiatry. 2014 Aug;38(4):473-5. doi: 10.1007/s40596-014-0106-y. Epub 2014 Mar 25.
With the current emphasis on integrated care, the role of psychiatrists is expanding to either directly provide medical care or coordinate its delivery. The purpose of this study was to survey general psychiatry programs on the extent of general medicine training provided during residency.
A short web-based survey was sent to 173 residency program directors to recruit participants for a larger survey. Thirty-seven participants were recruited and surveyed, and of these, 12 (32.4%) responded. The survey assessed the extent of general medicine training and didactics during and after the first postgraduate year and attitudes towards enhancing this training in residency. This study was approved by the local institutional review board.
Seventy-five percent of programs require only the minimum 4 months of primary care in the first postgraduate year, and didactics during these months is often not relevant to psychiatry residents. Some programs offer elective didactics on chronic medical conditions in the fourth postgraduate year. Respondents are in favor of enhancing general medicine training in psychiatry but indicate some resistance from their institutions.
These results suggest that very few programs require additional clinical training in relevant medical illnesses after the first postgraduate year. Respondents indicated favorable institutional support for enhancing training, but also expected resistance. The reasons for resistance should be an area of future research. Also important is to determine if enhancing medical didactics improves patient care and outcomes. The changing role of psychiatrists entails a closer look at resident curricula.
鉴于当前对综合医疗的重视,精神科医生的角色正在扩大,要么直接提供医疗服务,要么协调医疗服务的提供。本研究的目的是调查普通精神科住院医师培训项目中住院医师阶段提供的普通医学培训程度。
向173名住院医师培训项目主任发送了一份简短的基于网络的调查问卷,以招募参与者参加一项更大规模的调查。招募了37名参与者并进行了调查,其中12人(32.4%)做出了回应。该调查评估了研究生一年级期间及之后的普通医学培训和教学情况,以及对在住院医师阶段加强此类培训的态度。本研究获得了当地机构审查委员会的批准。
75%的项目在研究生一年级仅要求最少4个月的初级保健培训,而且这几个月的教学内容通常与精神科住院医师无关。一些项目在研究生四年级提供关于慢性疾病的选修教学。受访者赞成加强精神科的普通医学培训,但表示其所在机构存在一些阻力。
这些结果表明,很少有项目要求在研究生一年级之后进行相关疾病的额外临床培训。受访者表示机构对加强培训给予了积极支持,但也预计会有阻力。阻力的原因应是未来研究的一个领域。同样重要的是确定加强医学教学是否能改善患者护理和治疗效果。精神科医生角色的转变需要更仔细地审视住院医师课程设置。