The Ideal Psychiatry Training Program: A Resident\u27s Viewpoint

The journey between medical school graduation and specialty board certification in one\u27s chosen field of medicine may comprise the most challenging, exciting and important times of a young professional\u27s life. This journey is called residency education. While the most obvious objectives are cognitive education and practice in the field, trainees also face fundamental life challenges such as developing identity, intimacy and a direction for their own generative goals in the world. Psychiatry residency should be viewed as a personal as well as professional developmental process (1). It contains all of the turbulence of adolescence revisited (2), where normative crises (3) can be expected to occur. This journey through fundamental stages of emotional development actually begins long before one enters residency (4), but dealing with disorders of thought, behavior and action will constitute a major challenge to the trainee\u27s identity. Yager (5) contends that some degree of identity crisis may in fact be beneficial to growth, but that training programs should identify and control factors which magnify this crisis unnecessarily. Taintor et al (6) discussed specific stress factors and their contributions to personal and professional growth. An excellent paper by Lindy (7) presented a training director\u27s perspective on a phase-specific model for psychiatric training based on maturational steps

A Study of Prospective Ophthalmology Residents’ Career Perceptions

Objectives: The purpose of this study was to identify differences in ophthalmology resident candidates and practicing ophthalmologists’ career perceptions. A secondary aim was to evaluate specific demographic factors (e.g., gender, ethnicity, career interests, etc.) among residency candidates regarding their career perceptions. Methods: A survey instrument (Critical factors in Career Perceptions) was sent by e-mail to prospective residents (n= 122). Group differences were calculated using a one sample t-test analysis. Results: Compared to practicing ophthalmologists (n = 56), residency candidates were more likely (p < 0.05) to expect greater professional job satisfaction from a number of career factors (e.g., time with patients, physician teamwork, etc.); family-personal factors (e.g., diversity of job skills, sole professional responsibility, etc.); and financial factors (i.e., income and security) than those in practice. Gender differences between candidates revealed that women were more interested in spending time with patients and in computer technology applications. Conclusions: These results suggest that medical school and residency program leaders to consider specific factors ophthalmologists encounter in their profession so that residency candidates have a more realistic view of their chosen profession. Several recommendations for resident recruitment and curriculum development are provided

Interaction of the Opiate and Neuroendocrine Systems

Opiates are known to produce various physiological effects. Our understanding of these effects has been greatly increased by the discovery of the opiate receptor and the endogenous opioid peptides. Recent investigation has demonstrated that three distinct receptor subtypes exist; their function is currently being actively investigated

Correspondence: From Max Michael, Jr. to G. Dekle Taylor on Jacksonville Hospitals Educational Program, Inc. Letterhead, 1968-11-20

This letter contains a discussion on the proposed survey and the future of the Duval Medical Cente

Serum Ammonia and Folate Levels: Opportunities for High Value Care

High value care encompasses a variety of principles including ordering tests with high diagnostic yield, while reducing low value practice

Some reflections on Termination: Transference and Countertransference

INTRODUCTION Nearing the completion of my psychiatric residency, I ingenuously told my supervisor that I needed to know the steps of termination in therapy with patients. On the surface, this request reflected an awareness of the issues at hand and their importance. Beneath lay ambivalence and countertransference anxiety . For the graduating resident, time ordinarily invested in thought and study fills with practical considerations of job hunting and starting a practice. The resident\u27 s own unresolved and unsettling separation issues can further push aside therapeutic considerations for his patients. Termination, the art of the veteran therapist, becomes an unwelcome task at this time of professional passage when anything codifying professional identity is sought. In the unfortunate sequence of most residencies, this can be the first experience with forced termination of therapy. Forced termination is also a neglected topic within termination literature: a stepchild absent from standard psychotherapy texts from Colby to Tarachow. Weigert (1) and many others expound a necessary mutuality between patient and the rapist before termination can be set. Any prematurity on the therapist\u27s part, by definition, sets up a forced situation with its concommitant transference reactions and may be initiated by unintentional countertransference reactions. In reference to character analysis, Freud (2) doubted if even deep analysis could prevent a return of neurotic symptoms under the pressures of everyday life. The issue here becomes not whether treatment is terminable; but rather, one of understanding transference and countertransference. Supervision and the resident\u27s own therapy can make difficult terrain into a crucial learning experience. I share my experience with just one patient and my imperfect understanding of a complex interaction, in light of termination literature

Impact of global warming on the energetics of lower tropospheric ultra-long waves and the Indian summer monsoon

Analyses of 60 years (1949–2008) of monthly energetics of the zonal waves derived from NCEP/NCAR data indicate that ultra-long waves (waves 1 and 2) dominate the spectrum of lower tropospheric zonal waves during monsoon season (June–September). Westerlies over the Indian subcontinent are a source of energy to wave 1. Two oceanic anticyclones, one over Pacific and the other over Atlantic are sources of energy to wave 2. These two waves are inversely correlated. Climatology of the energetics of ultralong waves for the two epochs 1949–1978 (CLP1) and 1979–2008 (CLP2) of 30 years indicates that the intensity of wave 1 has decreased by about 33% whereas the intensity of wave 2 has increased by about 27%. Northward transport of sensible heat during CLP1 changes to southward during CLP2. Larger generation of zonal mean Available Potential Energy (APE) during CLP2 indicates more heating. A larger conversion of kinetic energy (KE) of wave 1 into APE of wave 1 leads to weakening of wave 1 during CLP2. In case of wave 2, lower rate of conversion of KE to APE leads to stronger wave 2 during CLP2