Education Innovations in the Department of Psychiatry at Washington University.

The Department of Psychiatry at Washington University has been innovating psychiatric education during the second millennium at all levels of training - undergraduate medical, general residency, and child and adolescent psychiatry (CAP) fellowship training. Undergraduate medical education now occurs in three phases. The 18-month pre-clerkship phase is divided into seven multidisciplinary modules that span basic, social, and clinical sciences. Psychiatry is part of the seven-week long Brain and Behavior module. The yearlong second phase includes a six-week traditional psychiatry clerkship-like experience bracketed by an introductory foundational week and a one-week consolidation period. The third phase is 18 months in length and provides in-depth exploration of both clinical and non-clinical areas. The residency training program has enlarged the number of residents undergoing training and simultaneously greatly expanded the clinical exposure to include rotations in eating disorders and perinatal psychiatry. In addition, our residents can choose to enhance their training in either our research or leadership focused options, both of which are also available to trainees in our child and adolescent program. Additionally, our CAP trainees are exposed to several unique areas including eating disorders and substance use disorders. We believe that these innovations across the educational spectrum allow us to prepare our learners for the practice of psychiatry in the 21st century.

Folie a deux and the courts.

Folie à deux is a condition that presents distinct challenges in the legal system. The authors searched the LexisNexis database for cases involving folie à deux and provide a review of criminal and civil case law involving individuals with the diagnosis. The case surrounding Elizabeth Smart's abduction from her Utah home is highlighted. Folie à deux is a formally recognized mental disorder, although it is intrinsically different from most other primary psychiatric conditions. It can cause considerable confusion among mental health experts and legal professionals alike. It is difficult to make a reliable diagnosis of a condition that is, to date, not well validated. The authors discuss possible directions for future research and suggest methods for examining evaluees with suspected folie à deux.