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The Role of Academic Psychiatry Faculty in the Treatment and Subsequent Evaluation and Promotion of Medical Students: An Ethical Conundrum

Received March 24, 2006; revised July 5 and September 8, 2006; accepted October 11, 2006. Dr. Kavan is Associate Dean for Student Affairs, Associate Professor of Family Medicine, and Associate Professor of Psychiatry, Dr. Malin is Assistant Professor of Psychiatry, and Dr. Wilson is Professor and Chair of Psychiatry, and Professor of Anthropology, at Creighton University School of Medicine in Omaha, Nebraska. Address correspondence to Michael G. Kavan, Ph.D., Associate Dean for Student Affairs, Creighton University School of Medicine, 2500 California Plaza, Omaha, NE 68178, (402) 280-2905; FAX (402) 280-2599; michaelkavan{at}creighton.edu (e-mail).

OBJECTIVES: This article explores ethical and practical issues associated with the Liaison Committee on Medical Education (LCME) provision that states health professionals who provide psychiatric/psychological care to medical students must have no involvement in the academic evaluation or promotion of students receiving those services. METHOD: The authors address the pros and cons of this provision as they relate to the overall well-being of the student. RESULTS: Arguments in support of this provision include students’ desire for confidentiality, avoidance of dual-relationships, and fear of documentation in the academic record. Arguments against this provision include the elimination of student autonomy to select a psychiatrist, the suitability and accessibility of academic psychiatrists to treat students, and the delimiting nature of this standard. CONCLUSION: In general, the LCME provision eliminates potential barriers to the mental health treatment of medical students. However, research and debate on its impact and appropriateness on a case-by-case basis should continue.

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