Teaching Clinical Neuroscience to Psychiatry Residents: Model Curricula

Abstract

It has been proposed that the future of psychiatry is best grounded in the clinical neurosciences because advances in the assessment, treatment, and prevention of brain disorders are likely to originate from studies based on the clinical and translational neurosciences [1]. This exciting potential is reflected by the National Institute of Mental Health’s strategic plan for research, which emphasizes the links between the neurosciences, genomics, and individual and public health outcomes [2]. Psychiatry trainees must therefore become skilled in being able to find, understand, critically appraise, and incorporate those advances that can meaningfully contribute to mental health and to the care of people living with mental illness. Developing the requisite neuroscientific knowledge and skills for residents, however, is an especially challenging proposition for educators for several important reasons. First, there is a phenomenal rate of discovery and complexity of advances in the neurosciences and neuropsychiatry. Second, some programs are limited in the availability of faculty as well as trained educators in the neurosciences and neuropsychiatry. One early survey of program directors, for example, found that a lack of neuropsychiatric faculty was the most common reason for not providing neuropsychiatry training [3]. Last, but not least, our field has not yet really defined clinical neuroscience—a broad interdisciplinary domain that encompasses numerous areas and clearly much more than just neuropsychiatry. Much work remains to be done in characterizing clinical neuroscience, drawing connections between this basic, translational, and applied scientific field to the human aspects of human development, attachment, health, and healing that occur in the work of psychiatrists, and discerning what part of clinical or other neurosciences should be taught to residents, medical students, and our colleagues in the field (e.g., as a part of continuing medical education). Clarification of these issues should be the next step in making clinical neuroscience an integral part of what we teach. One important response to the challenges presented by the acceleration of the field coupled with insufficiently prepared faculty is to develop well-designed neuroscience curricula that are portable across residency training programs. Our patients, as well as the field of psychiatry, will be best served when training programs work together to standardize learning objectives and curricula and to share the best educational practices [4]. To this end, this edition of Academic Psychiatry presents an exceptional compendium of articles concerning the education of psychiatry residents in the neurosciences [5–15]. One of these articles reported on a survey of residency training directors confirming the earlier finding [3] that a lack of qualified faculty constituted a barrier to training in the neurosciences and neuropsychiatry [12]. The vast majority of respondents in this survey identified a need for portable curricula [12]. In another survey, chief residents indicated that they did not feel adequately prepared to translate findings from neuroscience research into clinical practice [13]. Four of the articles [7, 9–11] described a neuroscience curriculum targeted to psychiatry residents. One commentary proposed a novel idea for a pilot training program based on the “triple board approach” [15]. J. Coverdale (*) Baylor College of Medicine, Houston, TX, USA e-mail: jhc@bcm.edu