Dr. Lisa Joson describes a fairly typical day for our first year child and adolescent psychiatry residents. She nicely outlines the usual time constraints for our residents—that is, how much time to devote to patient care, to teaching medical students, and to their own learning and education. The balance of work and family is also important.
During the course of the day, Dr. Joson has worked with at least three separate faculty members that served as potential mentors and/or role models. She has received direct feedback on her interview and psychotherapeutic skills on the inpatient service and in the family therapy clinic, and also had the opportunity to provide feedback to the medical students on their skills. Both clinical settings emphasize a multidisciplinary approach to treatment, which is very important in child and adolescent psychiatry. During the family therapy clinic, each trainee has the opportunity to conduct therapy with live supervision and immediate feedback, as well as the opportunity to observe others doing therapy, with discussion from behind the mirror about technique and process issues. As an educator, I think it is critical for each resident to have at least some live (or potentially videotaped) supervision. I feel confident when residents graduate from our program that faculty members have directly observed their work and know they have the skills necessary to become good child and adolescent psychiatrists.
Our didactic program emphasizes self-directed learning through a problem-based learning format. Residents are expected to research "learning issues," in Dr. Joson’s case, posttraumatic stress disorder related to childhood sexual abuse, and present their findings to the other residents. Although this format entails somewhat more preparation by the residents than traditional lectures, we believe learning is enhanced when it is active, self-directed, and offers the opportunity for discussion and integration of "learning issues" with clinical material.
Dr. Joson is particularly conscientious about her role as teacher for medical students. She recognizes the importance of helping medical students gain an appreciation for mental illness, as well as helping them understand the importance of considering psychological factors in any medical treatment.
My hope is that during this day, Dr. Joson further develops her enthusiasm for learning and teaching. I know she has an interest in teaching, and may one day choose to be an academic psychiatrist. She continues to learn the importance of working within a multidisciplinary team, with opportunities to refine her communication and leadership skills. She has also learned firsthand some of the struggles we face as educators, such as how best to teach (i.e., lectures versus problem-based learning) and how best to balance clinical/service demands with educational activities during training. The multiple roles she has filled during the day, as physician, educator, and learner, will prepare her well for her future career in child and adolescent psychiatry.
Drs. Joson and Santos are affiliated with the University of Texas Medical School at Houston, Houston, TX.