Medical
Student Education
Eric R. Marcus, M.D., Director,
Undergraduate Psychiatric Education
Janis Cutler, M.D., Associate
Director, Undergraduate Psychiatric Education
The Department of Medical Student Education in Psychiatry at the New York State Psychiatric Institute is responsible for approximately 500 medical students in five affiliated hospitals including New York State Psychiatric Institute, Creedmoor Psychiatric Center, Columbia-Presbyterian Medical Center, St. Luke's-Roosevelt Hospital Center, and Stamford Hospital. We supervise a teaching curriculum at the Columbia University College of Physicians & Surgeons that extends throughout the four years of medical school on a year round basis. The department is also responsible for helping to develop the whole medical school curriculum. We are also generating research in medical education--organization, curriculum, and the developmental process of medical students in their training. The division is administered by Dr. Eric R. Marcus, Director; Dr. Janis Cutler, Co-Director; and Ms. Edith White, Administrator. Program development and the organization of teaching and research are done by the central staff of our division. The teaching is done by the full-time and voluntary faculty of the Department of Psychiatry. Because we are one of the largest teaching departments of psychiatry in the world, we are able to offer teaching programs with a wide range and considerable depth.
The first-year course in psychiatry at the medical school begins with psychopathology. Although this is heuristically illogical, the research in our division has shown that medical students' identification with physicians starts very early in their training and is the major motivating factor for their learning. Therefore, clinical psychiatrists teach this course, the students see patients immediately, and the focus is on illness. The course thereby provides students with one of their first introductions to patient care and to the general principles of interviewing. This course was again rated outstanding and in the past few years has been one of the highest rated courses in the first year of medical school.
The second-year course continues the teaching of psychopathology, adds a developmental context and, in addition, provides an introduction to different types of therapy. Students continue to see patients. Small group discussion follows every lecture. The end of the course coincides with Department of Medicine courses on medical interviewing and physical examination. The students then receive a combined psychiatric-medicine experience integrating information and techniques in the two fields. It continues to be among the highest rated courses in the second year of the medical school curriculum.
Our third-year psychiatry clerkship, five weeks in length, is our most intensively supervised course and is the most demanding of faculty time. Student ratings consistently place it among the highest of the clinical clerkships at the medical school. Because of changes in hospital services, this course has required continued administrative attention to keep the quality of the experience high. Affiliated hospital teaching sites have struggled to do their best amidst the health care funding crisis. A major part of our job this year has been to rally enthusiastic support among full-time and voluntary faculty so that teaching remains a high priority. Dr. Scott Masters, Director of Residency and Medical Student Training, has put considerable effort into maintaining the quality of the St. Luke's/Roosevelt clerkship site. Dr. Louis Linfield at Creedmoor State Hospital continues his efforts to assure the outstanding quality of the educational experience there. The clerkship site at Stamford Hospital under the direction of Dr. Bruce Shapiro is going exceptionally well.
Our fourth-year electives continue to provide the broadest range of experience in clinical and research psychiatry. The electives attract top Columbia students as well as students from other medical schools around the country and the world. In addition, our department is one of only two in the medical school that offers humanities electives in the fourth year to medical students. Students work on artistic projects that reflected the influence of their medical training on their artistic sensibilities, skills, and approaches. In return, their work helpfully adds to our medical student education division's research on the professionalization process.
Outcome measures of the education program remain high with students performing above average on national board exams and with outstanding student reviews of courses in psychiatry.
Curricular Changes
The new curriculum introduced over the last several years in the first two years of medical education at the Columbia University College of Physicians and Surgeons has broadened the base of medical education from the basic biological sciences to include the epidemiological and human behavioral sciences. It has gone outstandingly well. The new curriculum integrates all three sciences with clinical work beginning in the first year. The Department of Medical Student Education in Psychiatry continues to play a major leadership role in providing relevant pedagogical theory, in organizing subsections of teaching, in developing curricular materials, in faculty development of teaching technique and attitude, and in implementing the teaching program of this project. The new curriculum has been greeted with great excitement by the faculty and students.
2000 continued the ability of our curriculum to place each student in a clinical selective with some patient responsibility from the first days of their medical education. None of this experimental teaching could work without the integrating format of small group discussions which take place weekly throughout the first year. Students' discussion from their own actual case experience relates their thinking processes, their basic science, epidemiological and behavioral science databases and approaches, and the clinical case topics, all under the enthusiastic leadership of their small group leader who becomes their benevolent mentor for the first year of medical education. The emotional influence of medical school is discussed with them so that a more integrated intellectual and emotional experience can result. This has enabled more immediate and beneficial rapport with patients, a better doctor-patient relationship as well as a less traumatic educational experience for students. Psychiatric faculty have been instrumentally involved in planning and manning this aspect of the medical school curriculum.
In 2000, we have intensively planned the introduction and coordination of clinical practice goals and methods into teaching in the third year of medical school. We are preparing to reorganize clinical teaching goals to make the horizontal division of classical medical education less severe and to achieve a ventrally integrated curriculum. This year we achieve agreement among the course directors from different clinical departments about the core teaching goal that would form the basis of each clerkship. For the first time at our medical school, there is agreement on general medical education goals that transcend specialities. Speciality training will now be taught as elaboration of these core medical teaching objectives instead of in replacement.
Research Projects
Research focusing on the emotional process of becoming a doctor continued with applications to the curriculum. We are now looking at feedback from the curriculum to confirm findings of developmental research after using the results of the research to devise the changed curriculum. This research is being done by Dr. Marcus. Several publications have already appeared and more have been submitted.
Dr. Cutler continues her research in two areas. The first is the use of drugs and alcohol by students and the pedagogical approach to prevention. This is a crucial area of research because we know that lifestyle is not amenable to change through education. In addition, Dr. Cutler is doing research on medical student career choice, conducting a series of interviews which we hope will tell us more about the great strengths of our department and the areas in which we still need to evolve our curriculum.
Awards
Dr. Eric Marcus was appointed Chairman
of the University and Medical Education Committee of the American Psychoanalytic
Association and is President of the Association for Psychoanalytic Medicine.
Dr. Cutler received the Edith Sabshin Award for excellence in the teaching
of psychoanalytic concepts to medical students who are not candidates
from the American Psychoanalytic Association. Dr. Michael Liebowitz received
the department's medical student lecture award.
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Dr. Eric Marcus, left, and Dr. Steven Roose |
Dr. Lisa Mellman and Dr. Janis Cutler, center, participating in a workshop at the Psychiatric Institute Annual Scientific Conference |
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Ms. Anna
Truli, center, with Ms. Ann Muzicka and
Mr. Hal Seligson, at her retirement celebration
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Ms. Claudia
Bial, left,
and Dr. Dolores Kreisman, at Ms. Bial's retirement celebration
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Mr. Peter Reynolds and
Mr. Cristobal Vargas,
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Housekeeping
staff at a holiday celebration
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Food
service staff at the Director's Holiday Brunch
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From
left to right, Mr. Leo Downes,
Mr. Corrin Daman, and Mr. Lenny Kroog at the Director's Holiday Brunch
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