Academic Psychiatry 29:155-161, June 2005
© 2005 Academic Psychiatry
Who Is Teaching Psychopharmacology? Who Should Be Teaching Psychopharmacology?
Steven L. Dubovsky, M.D.
Dr. Dubovsky is with the Department of Psychiatry, University at Buffalo, Buffalo, New York. Address correspondence to Dr. Dubosky, 462 Grider St., Room 1182, Buffalo, NY 14215-3098; dubovsky{at}buffalo.edu (E-mail). Copyright © 2005 Academic Psychiatry.
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ABSTRACT
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OBJECTIVE: To review the current status of psychopharmacology education for medical students, residents, and practitioners in psychiatry and other specialties. METHODS: A search of the MEDLINE and PsychInfo data bases was conducted using four keywords: pharmacology, psychopharmacology, teaching, and student. Additional references were obtained from citations in these articles. Published material was supplemented with the experience of the author and others involved in psychopharmacology teaching. RESULTS: The majority of psychopharmacology education is provided by faculty from disciplines that include psychiatry, primary care medicine, basic science, and pharmacy. The pharmaceutical industry supports a substantial amount of continuing medical education (CME) by psychiatrists, pharmacists, and other medical practitioners, while much of the information that office practitioners receive and an increasing amount of material provided to residents comes from pharmaceutical representatives. The most important attributes of the effective psychopharmacology educator are knowledge, enthusiasm, honesty, an ability to encourage critical thinking, and genuine interest in the student. However, the primary criteria for participation in psychopharmacology education are faculty who are most available and willing in the academic medical center and those who engage in paid CME activities. CONCLUSIONS: Educators with clinical experience should play a core role in helping students to integrate research with actual clinical practice and should be able to teach students how to evaluate new research in psychopharmacology, especially if it is industry sponsored.
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INTRODUCTION
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The widespread application of psychopharmacological interventions in nonpsychiatric and psychiatric settings has broadened the scope of psychopharmacology education considerably. As an increasingly diverse body of students emerges, it is becoming important to define who should teach what to whom about psychopharmacology. In this article, I will review the scant amount of data that are available on who is currently learning and teaching psychopharmacology. I will then suggest which educators may be best suited to specific students, which qualities of the teacher are essential in any setting, and which outcomes should be evaluated to see if the right person has been selected for the right audience.
There are many potential students for a psychopharmacology curriculum, each with different needs. For example, medical students need to learn basic psychopharmacology. Residents in psychiatry can master more advanced topics such as mechanisms of medication action and how to evaluate clinical trials critically. For residents in other specialties, it may be most appropriate simply to teach how to master a finite number of psychotropic medications that can be used in patients in primary care and how to identify psychotropic medication side effects and interactions. However, primary care practitioners who are being called upon to treat increasingly complex mental disorders in the absence of sufficient psychiatric capacity and who are subject to aggressive marketing of new psychiatric drugs require more sophisticated information, especially how to evaluate claims by pharmaceutical representatives of psychotropic applications, efficacy, and safety. Academicians are likely to be more interested in basic research findings, while psychiatric practitioners must understand the practical applications of research and keep current with information their patients may obtain from the Internet. Nonmedical mental health specialists, who play an expanding role in educating patients about what to expect from pharmacologic treatments, need accurate information about therapeutic and adverse effects of new medications, as do advocacy groups and the general public.
Not much formal effort has been applied to determining the ideal faculty for teaching psychopharmacology to each of these groups. Educators have suggested that each center should designate faculty members with special expertise in psychopharmacology to be liaisons for psychopharmacology training (1), but they do not say how to identify such expertise. A model psychopharmacology curriculum proposed by the American Society of Clinical Psychopharmacology (ASCP) included introductory lectures, a journal club, case conferences, psychopharmacology supervision, and psychopharmacology units, and it proposed specific content and how to teach this content. It did not, however, make recommendations about who should do the teaching (2).
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Any Interested Student? Any Willing Teacher?
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In the majority of published descriptions of psychopharmacology courses, students of different specialties and, oftentimes, different levels of experience have been enrolled in the same or similar curricula, which are taught by faculty of different disciplines and orientation. For example, the faculty in an innovative clinical pharmacology teaching clinic consisted of three Ph.D.s, four M.D.s, one M.D./Ph.D., one PharmD, and one B.S. in pharmacy (3). The group developed units for clinical psychopharmacology to be used for teaching medical students, pharmacy students, residents in various specialties, fellows in clinical pharmacology, and individuals preparing for a board examination in clinical pharmacology but did not specify who should teach each group.
A clinical pharmacist is the course director of a psychiatry resident psychopharmacology curriculum at the University of Texas Medical Branch in Galveston (4) and in an Israeli psychopharmacology curriculum for junior residents (5). Seminars in these programs are taught by psychiatrists, clinical pharmacists, neurologists and a "basic scientist" in the Texas program. An approach to integrating the diverse areas of knowledge that must be understood to master modern pharmacology was proposed by an educational symposium involving a biochemist, an internist, a pharmacist, a pharmaceutical industry official, and a health care administrator (6), but it was not clear who would do the actual teaching.
In a curriculum aimed at staff psychiatrists, fellows, psychiatry residents, psychopharmacology graduate students, medical students, and pharmacists (1) at the Sunnybrook Health Sciences Centre, peer teaching moderated by a single faculty facilitator in case conferences was the primary approach, supplemented by lectures by a researcher and by invited speakers. Graduate students presented their research projects at the end of the year to demonstrate how a question gets translated into a study. Peer teaching was well accepted by the students.
In the absence of any guidelines in model curricula about how faculty should be selected, it appears that the faculty members who teach psychopharmacology are the ones who are interested and available. The "any available/willing educator for any student" model may be realistic, but it does not necessarily optimize the educational environment. Different teaching styles may be more effective in different settings, and some individuals may be more knowledgeable than others about some topics and better with students at some levels than others. The problem is that there are no empirical data to guide the optimal student-teacher match.
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Interdisciplinary Issues
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There are unanswered philosophical issues in determining who should teach psychopharmacology in specific settings. For example, some leaders in the field of psychology have maintained that only "minor modification" is needed to prepare graduate level psychology students to prescribe medications and practice as "independent, full-fledged health care providers" (7). A proposed curriculum for these students includes "focused training" in medical diagnosis and psychopharmacology during the psychology internship (8). Psychiatrists are capable of providing such training. But should they do so? If psychiatrists believed that a few extra courses could prepare psychologists to practice as physicians, they would not have gone to medical school. Medical educators who contribute to the certification as competent of unqualified practitioners might face an ethical dilemma. Proposals for educating psychologists to become psychopharmacologists include a proviso for medical backup in case of serious adverse effects to medications or other complications, and agreeing to integrate such backup into the education of the clinical psychologist could present substantial clinical and medicolegal problems (9).
At the same time that pharmacists are playing a leadership role in the psychopharmacology education of psychiatrists, including pharmacy students in the same coursework as residents, further enhances the development of an overlapping identity of the two disciplines, as do the increasing number of CME programs that are led and taught by pharmacists. In such programs, it is not always clear how the clinical practice of the pharmacist differs from that of the psychiatrist. While an interdisciplinary model can help to integrate different aspects of knowledge and medical care, the experience of psychiatric educators during the years when psychiatrists were considered identical to other practitioners who provided psychotherapy might be worth recalling. It might be useful to clarify the boundaries of knowledge and skill of each discipline and to determine whether information presented by pharmacists, basic scientists, and those in other disciplines is retained and integrated, along with clinical data presented by clinicians.
Primary care practitioners have always written the majority of prescriptions for psychotropic medications, and their role is expanding as managed care protocols have made it more difficult to refer to specialists. Marketing of psychotropic medications to these practitioners has been especially aggressive, and some marketing extends beyond the available data. For example, use of atypical antipsychotic medications by primary care physicians to treat bipolar disorder has increased substantially, as manufacturers have convinced these physicians that many of their patients have disorders in the "bipolar spectrum" (10). However, there are few data demonstrating the actual prevalence of bipolar disorder in primary care practice and none on the prevalence of subsyndromal bipolar disorder in primary care. Even if the prevalence is high, accurate identification by primary care physicians is low, and atypical antipsycchotics have only been studied in more severe forms of bipolar disorder, primarily mania (11, 12). Since primary care physicians have less time than specialists with each patient and less time and training to evaluate material on new medications critically, it would seem particularly important for physicians, who have sufficient credibility, to provide postgraduate psychopharmacology education that can place claims of the usefulness and risks of psychotropic medications in primary care practice in perspective. Psychiatrists and primary care physician educators would appear to have the best credentials in this context.
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The Role of Industry
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Nothing in medicine is static, and psychopharmacology education must continue after formal training has been completed (13). In the absence of other sources of funding for such education and in response to marketing pressures, most of this teaching has been provided directly by pharmaceutical representatives or has occurred in symposia and other activities supported by industry. In the past, the "consumers" of such education were primarily psychiatrists and primary care physicians, who did most of the prescribing, and the teachers were psychiatrists and, to some extent, physicians in other specialties. More recently, the student body has been expanded to include other professionals who prescribe psychotropic medications themselves (e.g., nurse clinicians) or who advise patients about which medications to take.
At major meetings, the most popular educational programs are sponsored by pharmaceutical manufacturers, at the same time that industry detailers are often a primary source of information about new medications for office practitioners. Academic institutions receive $1.5 billion yearly from industry, and individual faculty members receive significant industry support for speaking engagements and other collaborations (14). Institutional policies can limit some of the more obvious influences of pharmaceutical marketing on teaching within the institution (15, 16), but they do not eliminate corporate pressure on the faculty created by the implicit promise of repeat sponsorship for educational activities that meet with the company’s approval or by a need for industry support of research and other activities that the educational institution can no longer afford (16). Such pressures can be profound, even for faculty with established international reputations. To help those who are even more susceptible to these influences, the effective psychopharmacology teacher, who is likely to have industry associations, should be able to demonstrate how to maintain positive industry interactions without being unduly influenced.
The current trend toward severely regulating any industry sponsored psychopharmacology teaching seems to have the unintended effect of requiring faculty to follow package inserts on one product or group of products and preventing them from discussing off-label uses of medications, which accounts for the bulk of treatment in psychiatry. Interventions designed to regulate marketing are likely to have the paradoxical effect of limiting participation in industry sponsored events to faculty who are willing to serve as extensions of a company’s marketing plan. These kinds of regulations are also likely to make it more difficult for the teacher to demonstrate how to resist industry pressure to slant information in one direction, an essential lesson for practitioners who will not have someone sitting in their offices interpreting information with which they have been provided (17, 18). A more useful check on inappropriate bias might involve true peer review of industry sponsored faculty activity by other educators rather than simple assessment by participants of how well they liked a program.
Marketing in psychopharmacology is not limited to the pharmaceutical industry. Clinicians who never look at promotional material still market their own expertise, ideas, and biases to their patients and colleagues. Assertions by the experts about the superiority of one treatment or another can be reinforced with prestige and self-confidence as well as with gifts and brochures. The effective educator should be able to teach students how to identify and evaluate the biases of influential opinions to which they are exposed, including those of the educator.
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Qualities of an Effective Educator in Psychopharmacology
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There are no data about whether professional students are more likely to learn psychopharmacology (or anything else) from teachers in the same discipline. Regardless of the discipline or training of the educator or the student, certain factors appear to be associated with greater efficacy in teaching psychopharmacology. Most important, teaching should be student-centered (3). Effective learning depends on student participation and interaction with peers (1). Since the interaction between the student and the educator is a crucial factor that motivates learning and provides a role model for the application of knowledge in actual practice (3), educators who are able to involve students in active learning will be more effective.
It is probably easier to give a lecture than to provide more interactional forms of teaching. However, in a lecture format, more than one-third of the information conveyed is in the pace and inflection of delivery, and another 55% is conveyed in body language (13). Retention of whatever information is included in a lecture is more dependent on the ability of the teacher to engage the learner than it is on the actual content of the lecture. In more informal educational settings, such as case conferences, seminars and journal clubs, it is even more important to be able to facilitate interactions between student and teacher as well as between students. The latter interaction serves as a model for lifelong peer learning. A learner centered journal club has been described, in which a student chooses the topic and reviews and critiques the literature on the topic, while the faculty member provides guidance and advice (19). In order to engage students with each other in such venues, the teacher’s beliefs and personality must take a back seat to the experience of the student.
As more innovative teaching methods emerge, those who teach psychopharmacology should be able to use them. For example, computerized self-instruction modules and standardized educational materials can reduce the need to convey rote information in lectures and to review the same basic issues with each successive group of students, but maximizing their benefit depends on the faculty’s ability to encourage creative discussion. Personal mentoring is probably the most powerful teaching method for students at any level (20), and whether it occurs one-to-one or in group settings, psychopharmacology faculty should be able to serve as mentors. A consensus is emerging that the qualities of an effective mentor include charisma, enthusiasm, availability, integrity, compassion, empathy, patience, competence, leadership, motivational skills, genuine interest in the student, and not being overly competitive (20). However, the very traits that are extremely desirable in mentors create a demand for them in other activities, limiting their availability for teaching psychopharmacology.
In addition to being able to teach students how to critically evaluate information provided by industry (13), the effective educator must be able to foster the ability to think creatively about theories and data, the interpretation of which is likely to change as more knowledge accumulates. Even the most scientific psychopharmacologists are not above marketing their own ideas and promoting their own biases. The challenge is to market curiosity and critical thinking about even these biases. The ability to step back from one’s preconceptions is a crucial trait of a competent practitioner that is best learned if it is modeled by a teacher with whom the student identifies.
Much modern teaching in psychopharmacology seems to be organized around a model of the patient as a collection of organs and molecules that reacts predictably to medications. Actual clinical psychopharmacology is quite different. Medications are not metabolized or distributed and do not act at target sites in the same way in all patients. Data derived from multicenter industry-sponsored trials do not necessarily apply to patients seen in everyday practice who have more complex and comorbid disorders. Often, a person’s feelings about taking a medication influence not only whether the medication will actually be taken as prescribed, but how well it will work. There is a good deal of overlap between target symptoms for medications and target symptoms for psychotherapy, making it necessary for psychopharmacology to be psychodynamically informed (21). Teaching the interaction between psychological and pharmacological therapies requires experience and appreciation of both domains that is derived from experience providing each domain, not from theory.
The knowledge and skills that are necessary to teach psychopharmacology to clinicians are probably different than those needed to teach basic scientists. Since most students of psychopharmacology are future or current clinicians, the educator must be able to help them to appreciate the relevance of new basic science data and to be scientists in the clinical setting. Like the laboratory researcher, the effective psychopharmacologist must be able to formulate hypotheses, test these hypotheses, and then revise the conceptualization of the best treatment based on the patient’s response. It is much more difficult to adhere to the scientific method in the clinic than it is in the laboratory. Each patient encounter must represent an independent experiment and early but not precipitous data analysis is necessary because the clinician does not have the luxury of being able to start over from scratch after a bad outcome. Teaching the clinical application of the scientific method and the integration of psychiatric treatments with other medical and psychological therapies would seem to be much more of a challenge to faculty who are not extensively involved in clinical work themselves.
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Evaluation of Psychopharmacology Teaching
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Objective assessment of teaching efficacy is essential to ensuring the continuing development of the educator. How useful are evaluations of efficacy of the psychopharmacology educator? Currently, most evaluations consist primarily of more or less sophisticated satisfaction ratings. In a survey of all child psychiatrists who graduated from U.S. child psychiatry residencies between 1996 and 1998 (392 of 797 responding), psychopharmacology was rated most relevant to their current practices (22). These psychiatrists believed that the quality of their psychopharmacology training was higher than what was required for their current practices. Psychopharmacology education was rated among the most important aspects of the training experience, and the majority of these psychiatrists considered mentorship to be the most valuable aspect of their experience. In a 1-year follow-up of 21 psychiatry residency programs that used the ASCP Model Curriculum in psychopharmacology, 62% rated it as improving psychopharmacology teaching (23). In the Canadian psychopharmacology curriculum mentioned earlier, all activities (lectures, case conferences, research tutorials) were rated 4 out of a possible 5 for presentation style and educational value (1). Two factors that predicted better evaluations by residents were preparation by the presenter and audience participation. Do such positive ratings mean that psychopharmacology educators are effective, that a structured curriculum makes any educator appear effective, that one’s professors are more likely to be evaluated positively in retrospect, or that a good feeling about the educational experience leads the student to feel overprepared in a field for which it is impossible ever to be prepared enough?
Most of us have completed evaluation forms that ask for detailed opinions about specific topics such as the relevance of the information presented to the audience’s practice, the skill of the teacher, the balance of the teaching, the quality of the handouts and the like. It remains unclear whether such methods of evaluation provide any more data than simply asking whether the students liked the teacher. Ultimately, the efficacy of psychopharmacology teaching may be best measured by the performance of the student in clinical practice, which presents obvious challenges and for which multiple intervening variables make it difficult to know how much is attributable to a specific educator. As in other academic endeavors peer review of specific skills—especially the ability to motivate students and convey concepts and data accurately—with individualized feedback to the instructor that extends beyond popularity ratings may be the most meaningful approach to improving teaching skills. If excellence and honesty in teaching do not result in meaningful academic and financial rewards, however, the ultimate impact on teaching skills may be limited, and at least excellent teachers will be driven into more remunerative activities in academic medical centers.
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Recommendations
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In the absence of careful studies, it appears that anyone teaching psychopharmacology should be skilled at communicating information enthusiastically and facilitating communication of students with the educator and each other. Within this general guideline, course leaders from the same discipline as the student are in the best position to match the content and process of coursework to the needs and level of expertise of the student and to provide meaningful role models. For example, psychopharmacology education of physicians should be directed by physicians, probably in the same specialty. Course directors who can integrate diverse sources of knowledge should coordinate input from experts in other fields. A basic scientist may know the most about new research in psychopharmacology, but when research is presented to clinicians and residents in clinical specialties, the teacher or course coordinator must be able to demonstrate its clinical relevance.
In order to address overlapping target symptoms and coordinate psychotherapy with pharmacotherapy, nonphysician mental health specialists should be knowledgeable about pharmacotherapy. Psychiatrists are probably best qualified to teach these individuals as they are able to address their comments to the level of knowledge of the therapist. The decision to teach psychopharmacology to psychologists or other practitioners so that they can prescribe independently is more complicated. If educators in psychopharmacology believe that these practitioners will be able to prescribe competently and responsibly, educators with the most clinical experience in the setting in which the nonphysician is likely to be practicing should teach them. However, there may be ethical and even medicolegal consequences to contributing to the certification of clinicians who do not believe that substantial effort is necessary to learn and practice clinical psychopharmacology. Psychiatrists might prefer not to participate in this kind of teaching.
It is difficult to understand how anyone other than a clinician can fully appreciate the complexities of the application of pharmacological knowledge in actual patients. Patients in clinical trials and those encountered in tertiary care settings in which most national experts practice are not necessarily representative of patients seen by the average clinician, and practice guidelines derived from these patients may not always apply to patients in other settings. As noted earlier, the practice of psychopharmacology consists of more than prescribing medications, and the competent psychopharmacologist must be able to address overlapping and interacting target symptoms for somatic and pharmacotherapies. Clinicians participating extensively in psychopharmacology education, therefore, should see patients regularly themselves. It is too easy to forget how complicated the most straightforward pharmacological intervention can be in real life. Only someone who has ongoing clinical experience can help students at any level to learn the difference between theory and practice.
As marketing by manufacturers intensifies, and as research, expert opinion and CME activities proliferate, it is becoming increasingly important for educators in psychopharmacology to be able to evaluate new information critically and to be able to teach students to do so. Faculty who cannot view their own as well as others’ work with a critical eye will have difficulty teaching this skill to their students. Teaching how to evaluate research critically will be more helpful to clinicians who are inundated with marketing from various sources than will attempting to restrict industry influence in education. At the same time, academic recognition should be as easy for the excellent psychopharmacology educator to obtain as industry support.
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Conclusions
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As with any area of medicine, the success of any psychopharmacology curriculum depends on those who are teaching it. Depending on the student, psychopharmacology is currently being taught by clinical psychiatrists, researchers, pharmacists, primary care physicians, and pharmaceutical representatives. The most effective faculty in any of these venues will be dedicated to developing innovative teaching methods, to encourage more peer learning, and to motivate students to keep learning on their own. Since industry supports so much CME and plays an increasing role in other activities in academic medical centers, it is unrealistic to try to build more firewalls between psychopharmacology educators and pharmaceutical manufacturers. Instead, the faculty should teach students how to critically evaluate all the information they receive, including what the teacher says.
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ACKNOWLEDGMENTS
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Research support for this article was granted by the National Institute of Drug Abuse, Forest, Pfizer, Johnson & Johnson, Bristol-Myers-Squibb, Janssen. Speaker support was granted by Wyeth, Pfizer, BMS, Forest, and AstraZeneca.
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REFERENCES
|
- Naranjo CA, Shulman RW, Ozdemir V: Evelopment and evaluation of a clinical psychopharmacology educational curriculum. J Clin Pharmacol 1997; 37:474–479[Abstract]
- Glick ID, Doraiswamy PM, Halper J, et al: The American Society of Clinical Psychopharmacology Curriculum, for Psychiatric Residency Programs, Training Directors, and Teachers of Psychopharmacology. New York: American Society of Clinical Psychopharmacology; 1998
- Lathers CM, Smith C: Development of innovative teaching materials: clinical pharmacology problem-solving (CPPS) units: comparison with patient-oriented problem-solving units and problem-based learning- a 10-year review. J Clin Pharmacol 2002; 42:477–491[Abstract]
- Santy PA, Bryant SG: Teaching clinical psychopharmacology on an inpatient psychiatric research center. J Clin Pharmacol 1994; 34:215–221[Abstract]
- Dorevitch A: A psychopharmacology education program for psychiatry residents- the role of a clinical pharmacist. Israel J Psychiatry & Related Sciences 1994; 31:287–291
- Tanaka M, Misawa M: Proposals for innovative pharmacology education from the perspective of several fields- in response to rapidly changing times. Nippon Yakurigaku Zasshi- Folia Pharmacologica Japonica 2000; 116:163–170[Medline]
- Sammons MT, Sexton JL, Meredith JM: Basic science training in psychopharmacology. How much is enough? Am Psychologist 1996; 51:230–234[Medline]
- Dunivin DL, Southwell GD: Psychopharmacology training in psychology internships: a brief curriculum. Professional Psychol - Res & Practice 2000; 31:610–614[CrossRef]
- Pies R: The "deep structure" of clinical medicine and prescribing privileges for psychologists. J Clin Psychiatry 1991; 52:4–8
- Abboud L: Should family doctors treat serious mental illness? Wall Street Journal 2004 March 24;Sect. D1-D4
- Tohen M, Jacobs TG, Grundy SL, et al: Efficacy of olanzapine in acute bipolar mania: a double-blind, placebo-controlled study. The olanzapine hggw study group. ArchGenPsychiatry 2000; 57:841–849
- Tohen M, Zarate CA, Jr: Antipsychotic agents and bipolar disorder. Journal of Clinical Psychiatry 1998; 59 Suppl 1:38–48
- Stahl S: Sharpen the saw with selective choices of continuing medical education programs. J Clin Psychiatry 2000; 61:401–402[Medline]
- Boyd E, Bero LA: Assessing faculty financial relationships with industry: a case study. JAMA 2000; 284:2209–2214[Abstract/Free Full Text]
- Educational Council RTPIM: Development of residency program guidelines for interaction with the pharmaceutical industry. Can Med Assoc J 1993; 149:405–408[Abstract]
- Guyatt G: Academic Press medicine and the pharmaceutical industry: a cautionary tale. Canadian Medical Association Journal 1994; 150:951–953[Medline]
- Arkinstall WW: Interaction between physicians and the pharmaceutical industry (Letter). Can Med Assoc J 1995; 153:398–399
- Carpenter WT: How the doctor can counter commercial bias in the dissemination of pharmacotherapeutic knowledge. J Nerv Ment Dis 2002; 190:593–596[Medline]
- O’Sullivan P, Pinsker J, Jeremiah J, et al: A learner-centered journal club. Teaching Learning Med 1995; 7:121–124
- Rodenhauser P, Rudisill JR, Dvorak R: Skills for mentors and proteges applicable to psychiatry. Acad Psychiatry 2000; 24:14–27[Abstract/Free Full Text]
- Cabaniss DL: Shifting gears: the challenge to teach students to think psychodynamically and psychopharmacologically at the same time. Psychoanalytic Inquiry 1998; 18:639–656
- Stubbe DE: Preparation for practice: child and adolescent psychiatry graduates’ assessment of training experiences. J the Am Acad of Child & Adolescent Psychiatry 2002; 41:131–139
- Glick ID, Janowsky DS, Zisook S, et al: How should we teach psychopharmacology to residents? Results of the initial experience with the ACSP Model Curriculum. Acad Psychiatry 2001; 25:90–97[Abstract/Free Full Text]
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ABSTRACT
INTRODUCTION
