Teaching residents the reality of current mental health care.

Abstract

1Such changes have received little attention in programs that train psychiatry residents, and as a result, trainees frequently leave their residency with inadequate knowledge of the political and economic realities of the medical marketplace in which they will practice.2 Residents clearly need well-supervised training experiences in managed care clinical settings.3 Equally important, however, is providing them with a grounded understanding of the concepts, policies, and philosophies that shape the operation of these clinical settings and the historical forces that contributed to their creation and development. This article describes a course for psychiatry residents in their fourth postgraduate year (PGY-IV) that attempts to explicate the current economic and political realities of delivering health and mental health care in our current system. Our aim is to provide trainees with the understanding and knowledge they will need to both work within and work toward improving the practice world they are about to enter. The eight-session course, entitled “Current Mental Health Care,” is the PGY-IV component of the 3-year Psychiatrist and Society module of the core curriculum of the Harvard Longwood Psychiatry Residency Training Program in Boston. Taught annually since the residency’s inception in 1994, the course has evolved into a 2-hour-per-session format featuring presentations by guest experts, followed by group discussion of the session’s topic (led by the core faculty) and integration of that topic with previous ones. The first session provides a foundation of the current concepts, terms, and acronyms used in health care today.