How do you train a psychiatrist?
Should a residency program be focused on producing can-do clinicians, whose training and experience prepares them to work with unpredictable patients and ever-changing diagnostic assessments? Or does the ideal residency produce young scientists, who contribute to the academic community through meeting attendance and literature, and incorporate current scientific research into daily practice?
If we place clinical practice is our paramount goal, then do we mean psychopharmacology, cognitive behavior therapy, family therapy, group psychotherapy - or any of the hundred permutations of these techniques. If, on the other hand, we place science first then what kind of science: genomics, biomolecular neuroscience, fMRI imaging of neural networks, bundled and un-bundled comparisons of DBT against alternative manualized psychotherapies, longitudinal studies of defense mechanisms?
Yet - perhaps there's something beyond science and clinical practice that is the defining factor in the training of a psychiatrists: a tradition of disciplined humanistic thought and practice that begins with Charcot and extends through the greats of the 19th and early 20th centuries - Freud, Kreapelin, Bleuler, Jaspers - to name a few - giants of independent thought who defined the problems we still engage today. Surely any training program is incomplete that does not its graduates placed themselves in this procession?
And yet - isn't there something more to the making of a psychiatrist than clinical, scientific and intellectual development? Isn't it the case that psychiatrists - uniquely among physicians - face a special challenge to both understand mental illness, to establish intimate relationships with their patients, and to simultaneously maintain a professional and intellectual position of independence from them? Isn't it the case that almost every psychiatrist must - to one extent or another - inevitably confront themselves, and develop personally and morally, if they are to find their way in what some have called "the impossible profession"?
The answer to each of these questions, as surely you surmise, is - "yes." Modern psychiatric training is deficient if it does not include awareness of all of these domains of knowledge, and likely many others I've failed to mention.
The problem of integrating diverse data and theoretical concepts, represents one more aspect of the challenge psychiatrists face on a daily basis - and one of the reasons psychiatry remains the most fascinating branch of medicine.
The goal of our training program is to begin a process of lifelong learning. In addition to our four-year adult psychiatric residency training program, we also have fellowships in Child and Adolescent Psychiatry and Psychosomatic Medicine. Our yearlong OPD rotation includes training in broad range of psychotherapies. Psychoanalytic courses taken by residents trained in either adult or child may be integrated into a separate advanced psychoanalytic training program or a selective during the PGY4 year. We are building our curriculum in biological psychiatry and psychopharmacology, and building a Department-wide commitment to education and research.
Under the leadership of Dr. Stephen Ferrando, our Chairman, we are committed to the mentorship of our residents as leaders, scholars and clinicians. We welcome your interest in our program, and hope that you will consider building the next stage of your career with us.
Alexander Lerman, M.D.
Assistant Professor of Clinical Psychiatry
Vice Chairman for Education and Residency Training Director
New York Medical College at Westchester Medical Center
Department of Psychiatry and Behavioral Sciences
Behavioral Health Center 3rd floor
Valhalla, New York 10595