Teaching psychodynamic psychiatry to students on general medical rotations.

M students’ and physicians’ training is oriented toward rapid retrieval of information and the development of those clinical skills needed to make immediate interventions. Medical students’ education in the area of psychiatry is usually limited to a sixto eight-week rotation, where they are most often exposed to a view of mental function as a simple epiphenomenon of the activity of neurotransmitters. To obtain a detailed psychosocial history that might give medical students some understanding of emotional reactions to illness is not part of their educational process. The biopsychosocial approach is given only lip service. A detailed psychosocial history is not regarded as important or necessary to understanding the illness of a person. Providing a meaningful experience of learning psychodynamic principles requires understanding the attitudes with which the medical students and residents come to their psychiatric rotation. In this paper I will describe a method that has proven successful in integrating psychoanalytic concepts into the psychiatric education of medical students and internal medicine trainees. The method is evaluation of a medical case by the use of a simple psychoanalytic tripartite structural model and its resulting psychodynamics. The description of these pedagogic tools may appear simplistic to the psychologically sophisticated reader. Psychologically sophisticated minds, however, are not the intended audience of the method; students and medical residents are. In my experience, these methods have successfully started a process that allows the students to view mental functioning in a new, psychodynamic light.