Shirah Vollmer MD

The Musings of Dr. Vollmer

Psychiatric Curriculum

Posted by Dr. Vollmer on July 18, 2011

I imagine a curriculum where a leader asks me to teach to the medical students, residents, and/or fellows, topics which this thoughtful person has deemed important for the education of these particular students, given where they are in their training. Yet, in my various volunteer teaching activities, the common theme is “there is no curriculum. Professors come and talk about something that the professor thinks is important.” I am stunned and disturbed. Further  I question my complicit role in these educational systems. Universities, in general, are well known for this problem. Professors get paid to publish, not to teach. Teaching is supposed to be something they “squeeze in” to their paid responsibilities. Consequently, there is no quality control on the teaching or the content. Not only is no one paid to teach, no one is paid to coordinate the teachers. Sure, there are administrators who email confirmations and make sure the audio-visual equipment is up to speed, but there is no thought leader pulling the train forward.

Last week, I gave medical students a lecture entitled “Psychiatric Emergencies.” I thought it was an interesting and relevant topic. The forty students seemed to laugh at my  jokes; I did not see anyone sleeping. This was an improvement from last year. Yet, there seemed to be a lack of interest in the topic. Questions at the end always mean the students have to sit there longer, so I can see that if they wanted to get up and stretch their legs then they would not engage me in conversation when I was finished with my lecture. Sometimes, people come up and ask questions on their own-not this year. Sure, I can take it personally and say that I need to change my delivery and/or my content. Yet, I do not think that is the problem. I think that without a curriculum, the students are forced to learn on random topics, such that they feel that they just have to “show up” and then they can get back to what they really want to be doing-whatever that might be. Every year I think, maybe I won’t do this again. There is a system problem that needs changing, I think to myself. Yet, every year I go back, with the small hope that maybe if I can gain some traction with the students, then maybe I can be heard at a higher level in the system. As I say that, I know I am kidding myself. I will go back next year. I will have a similar angst. Still, I will hope that maybe, just maybe, one student will spark a fire in the administration to create a better learning experience. I know this is my imagination, but sometimes dreams come true.

4 Responses to “Psychiatric Curriculum”

  1. Shelly said

    Are these residents whose specialties have already been chosen (i.e. medicine)? Do they not care about psychiatry? Do they not think it is important and they have nothing to learn? Do they not believe in psychiatry? Are they prior to their board exams? Do any of the subjects you teach appear in their board exams? Is anything you teach relevant to their actual clinical experience? Can you ask them what they want to learn about before your lecture and tailor your lectures as such?

    • I teach in a variety of areas in medical training, including medical students, psychiatric residents and child psychiatry fellows. Most of the programs I work with lack a curriculum. This issue extends beyond psychiatry to medical training in general.
      I like the idea of asking the students what they feel the need to learn about, but clearly there needs to be a combination of input from students along with input from seasoned clinicians in order to come up with a balanced program.

  2. danny said

    wow you’re in private practice, teach all these different groups and still have to type all these blogs ? thats pretty impressive. when do you have time to sleep. Is it possible to use a different Font for these blogs, might make it a bit easier to read .
    PS. with so many smart people being highly trained in these fields, its hard to go near any type of physician without any health insurance, as the “US” health system is in free fall !! do you think that it will change / get better ?

    • Hi Danny,
      Thanks for your comments. Do you have a suggestion for a different font? I am certainly open to trying one that is easier to read.
      Sorry, but commenting on the the state of US health care is beyond my scope. The issues are very complicated. Shirah

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