While the mean duration of psychiatry clerkships has not changed significantly, the "norm" of an 8-week freestanding clerkship is no longer a reality. In our sample only 18.9% of clerkship directors reported having a full 8 weeks. Even among these programs, 24% stated they had to share some of their time with other disciplines, and only 15% of all clerkship directors reported having an entire 2 months devoted exclusively to psychiatry. Yet, only a relatively small number actually voiced concern that clerkship length was a major problem. This percentage might have been higher if the question had been asked directly, and not embedded in a question of whether evaluation strategies reflected clerkship objectives. More research is needed into what makes for high and low course director satisfaction. Faculty are busy with patient care and administrative concerns and have learned to be flexible and "roll with the punches," but this may not translate into being satisfied with the status quo of psychiatry education. Also, perceived training deficiencies in relation to clerkship length need to be investigated further. Since student performance on the NBME Subject Exam seems unaffected by clerkship length (6); one might surmise that students in short rotations receive more focused instruction and spend more time memorizing facts. Many clerkship directors are concerned that their evaluation procedures do not really measure their true objectives. Clerkship duration is cited more often as a problem in this regard in the 4-week group. Oral exams, a good test of clinical knowledge and reasoning, are uncommon in four-week clerkships. Most clerkships deal with severe mental illness, while the shelf exam covers a broader content. Therefore, much of what the students study for their exams is based on book learning and multiple-choice recognition, rather than clinical experience. The tendency for the shortened clerkships to rely more on assessments of knowledge (e.g., the NBME shelf test) and less on assessments of skills and professionalism (OSCEs and oral exams) is also potentially problematic. High scores on Subject Exams and Step 2 of the Boards can result in a false sense of "successful" psychiatry training, shared by clerkship directors, chairmen, deans, and curriculum committees alike. The apparent trend toward a time reduction and combined experiences in the core clerkship short-changes students’ education, unless psychiatry is well integrated in the rest of the curriculum from the beginning, for example, in case-based teaching and in psychopharmacology instruction in the pre-clinical years. Psychopathology is highly prevalent in the general medical population, and it is often not recognized, diagnosed, or properly treated. Nowadays, most psychiatric problems are treated by primary care physicians. Psychiatric interventions in primary care tend to be limited to medication management, which may not always be the treatment of choice, or the only plausible treatment. There needs to be a strong focus on the comprehensive biopsychosocial treatment of patients throughout medical school, and psychiatry educators must take the lead. Medical school is the place to instill an awareness of the complexity of human behavior, to expose students to the art of medicine, and to give them the tools they can use. Laymen’s opinions notwithstanding, empathic listening and communication skills are not all there is to psychiatry. However, ours is the specialty most focused on instilling these skills in students, and they are best learned by observation and guided practice. This is more than can be accomplished even in a 2-month clerkship. The psychiatric educator can contribute a vast body of knowledge and skill by evaluating and treating patients in teaching settings outside of the traditional psychiatric turf: Somatization, mood and anxiety disorders, depression, personality issues, delirium, dementia, dual diagnosis, substance abuse, and behavioral problems are relevant to, and prevalent in all aspects of medicine. Psychiatry instruction should not be limited to a psychiatry clerkship. Students who only have a truncated exposure to the practice of psychiatry, in short clerkships with patients with serious mental illness, may never appreciate the prevalence of psychiatric problems or learn appropriate evidence-based psychiatric interventions. If the "shrinking clerkship" truly reflects diminishing student exposure to psychiatry, psychiatric educators need to take the lead and find creative ways to connect with other disciplines throughout the curriculum to maintain and prove their legitimacy as a "core" component of medical education. The students would welcome such an approach, and ultimately, the patients will benefit.