Herz L R
Psychiatr Q. 1984 Summer;56(2):151-6. doi: 10.1007/BF01064951.
Much concern has centered on medical students' failure to choose psychiatry as a career. Little of this discussion focuses on the challenges of treating psychiatric patients. Although all students of psychotherapy face difficult training, the medical students' preparation is unique, especially in experiencing, tolerating, and using countertransference. Understanding and caring for psychiatric patients (whether pharmacologically, psychodynamically, or otherwise) involves exposure to extremes of emotion. A therapeutic response demands skills quite different from those culled by the medical admission process and the preclinical years. Appropriate handling of consequent problems is hampered when some of the psychotherapeutic aspects of clerk-patient relations go unrecognized and when supervisors avoid discussion of the student's reactions as an integral part of the work. Without specific attention to these areas, many students feel inadequate or frightened in the clerkship. With supervisory aid, such unwelcome situations can be converted to diagnostic and therapeutic tools of great value.
许多关注都集中在医学生未能选择精神病学作为职业这一问题上。这类讨论很少聚焦于治疗精神科患者所面临的挑战。尽管所有心理治疗专业的学生都面临艰难的培训，但医学生的准备工作独具特色，尤其是在体验、容忍和运用反移情方面。理解和照料精神科患者（无论是通过药物治疗、心理动力学治疗还是其他方式）涉及接触极端情绪。一种治疗性反应所需的技能与医学录取过程及临床前几年所培养的技能截然不同。当医患关系中的一些心理治疗方面未被认识到，且上级避免将学生的反应作为工作的一个组成部分进行讨论时，随之而来的问题的妥善处理就会受到阻碍。如果不特别关注这些领域，许多学生在临床实习中会感到能力不足或恐惧。在上级的帮助下，这种不受欢迎的情况可以转化为极具价值的诊断和治疗工具。
