Does early mentorship in child and adolescent psychiatry make a difference? The Klingenstein Third-Generation Foundation Medical Student Fellowship Program.

OBJECTIVE: There is a critical shortage of child and adolescent psychiatrists in the United States. Increased exposure, through mentorship, clinical experiences, and research opportunities, may increase the number of medical students selecting child and adolescent psychiatry (CAP) as a career choice. METHOD: Between 2008 and 2011, 241 first-year participants of a program to increase exposure to CAP, funded by the Klingenstein Third-Generation Foundation (KTGF) at 10 medical schools completed baseline surveys assessing their opinions of and experiences in CAP, and 115 second-year participants completed follow-up surveys to reflect 1 year of experience in the KTGF Program. RESULTS: Students reported significantly increased positive perception of mentorship for career and research guidance, along with perceived increased knowledge and understanding of CAP. CONCLUSIONS: Results suggest that the KTGF Program positively influenced participating medical students, although future studies are needed to determine whether these changes will translate into more medical students entering the field of CAP.

Clinical thinking in psychiatry.

I discuss the lack of precision in the term 'clinical reasoning' and its relationship to evidence-based medicine and critical thinking. I examine critical thinking skills, their underemphasis in medical education and successful attempts to remediate them. Evidence-based medicine (and evidence-based psychiatry) offer much but are hampered by the ubiquity and flaws of meta-analysis. I explore views of evidence-based medicine among psychiatry residents, as well as capacity for critical thinking in residents before and after a course in philosophy. I discuss decision making by experienced doctors and suggest possible futures of this issue.

Family-based therapy for adolescents with anorexia nervosa.

Practice guidelines advocate a multidisciplinary approach to the treatment of adolescents with anorexia nervosa. A specific type of therapy in which the family plays an integral role has yielded good outcomes. We describe 2 patients who failed to respond to conventional care in a multidisciplinary setting and subsequently underwent family-based therapy with good results. Our findings suggest that enlisting the family in the treatment of adolescents with anorexia nervosa may lead to greater weight gain, shorter treatment duration, and reduced costs.

Philosophy and psychiatry: a new curriculum for child and adolescent psychiatry.

Residents in psychiatry and child and adolescent psychiatry often seem to their preceptors to have difficulty with critical thinking. The author designed a curriculum for first-year (PGY-4) child and adolescent psychiatry residents with this perceived deficit in mind. The curriculum consisted of a blend of traditional first-year child and adolescent psychiatry didactic curriculum with a curriculum in philosophy. On the Cornell Critical Thinking Test, residents who took this course outscored residents who did not at a statistically significant level. The advantages of such a course are discussed.