Shirah Vollmer MD

The Musings of Dr. Vollmer

Keeping Up With The New Generation: Psychiatry in Transition

Posted by Dr. Vollmer on April 5, 2012

The Psychiatric Clinical Faculty Association (PCFA) is a group of voluntary psychiatrists who give their time to support UCLA Psychiatry Residency Education. Mostly, this is a group, including myself, of private practice psychiatrists who are interested in nurturing the next generation of psychiatrists. “The problem is that we do not understand this cohort,” I say in a recent meeting. “Until we know how they think of their work and their field, we will not know where we fit in,” I repeat, trying to say, that as with all interventions, one must understand the baseline before attempting to make a change. My idea was well-received, with a group notion, that we need to first see how the group of trainees are relating to this field that we call psychiatry. This is a group that grew up with electronics, but they seem as fearful and weary of electronic medical records as we do. Yet, unlike most of the clinical faculty, they seem comfortable with a “medication model” where their only role with a patient is one who prescribes psychotropic medication. By contrast, most of my committee feel the importance of medication within a larger scope of understanding the context in which the medication can then contribute to a better quality of life. As one colleague said “we have a tool chest with many different tools, but the residents seem to think that one tool is inherently better than another, rather than understanding that we keep trying our tools until we see what fits best for the patient.” As Paul Wachtel PhD wrote in his new book “Inside The Session” integrating different kinds of therapies seems to be taboo, and yet, most of us do this in our offices, even though we tend not to share this with multimodal approach with  younger colleagues, thereby leaving young people to believe that they must “choose” one way of treating patients.

UCLA, as an academic institution, has tenured faculty who are experts in their field. We, as the Clinical Faculty, do not claim to be “experts,” but we do claim to have the experience of seasoned professionals. Most residents do not stay in academic medical centers. Most will benefit from the expertise of people, like myself, who have been “in the trenches.” Yet, some of them do not understand that until well into their professional career and maybe that is how it should be. Then again, maybe if we understood what they were thinking, we could advise them to better utilize our services earlier in their training. Sure, some of us know a couple of trainees, but “none of us have the pulse of the entire group,” I say, highlighting the need for a representative sample. “Journal club,” one colleague suggested. We can review an article in an informal setting and get to know them that way. “That’s a good beginning,” another colleague says. It was a good meeting.

4 Responses to “Keeping Up With The New Generation: Psychiatry in Transition”

  1. Shirah, perhaps these residents should take some time to read “Healing the Soul in the Age of the Brain…Becoming Conscious in an Unconscious World” by psychiatrist and psychoanalyst, Elio Frattaroli, M.D. Brilliantly written and reminds us all that there is always a person…a “soul”, behind the symptoms.
    http://www.eliofrattaroli.com/main.asp

    • Hi Eleanor,
      Thanks for the book recommendation. The issue is how to get the residents to read this book. They are flooded with demands on their time, so our goal is to somehow help them prioritize reading about the “soul” as something that is worth their time. This is the challenge. Thanks Again.

  2. Shelly said

    I’m agreeing with Eleanor, but instead of a book, write an academic article which then will become required reading. Shirah, you have so much experience and teach in an academic institution. You have so much to give, and these untrained residents have only book learning thus far. I understand you have so much on your shoulders already…however, I advocate for putting your efforts into a journal article so that you can transfer your knowledge to the trenches. I have faith in you!

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