On the teaching of psychiatry to medical students: does it have to get worse before it gets better?

Attention is drawn to the principal determinants of change since World War II in the teaching of psychiatry to medical students in the United States. From the outset the goals of the educational programs were addressed to all medical students, not only those who had made a career choice in psychiatry. Although there have been minor changes, the goals have stood the test of time. For several practical reasons, current examination of our existing educational programs is timely. Comments and criticisms of generations of medical students have informed us of our successes and our failures. The ambiance of the medical school as a whole as well as that of the Department of Psychiatry have contributed to a state of dysphoria academia. Several factors are cited as possible determinants of the decline in the number of medical students who choose psychiatric careers, as well as influencing the careers of physicians other than psychiatrists. The principal recommendation is to correct the deficiencies in our teaching programs.