Psychosomatic medicine and psychiatry residents: a pan-Canadian survey.

BACKGROUND: Psychosomatic medicine (PM) is recognized as a psychiatric subspecialty in the US, but continues to be considered a focused area of general psychiatric practice in Canada. Due to the unclear status of PM in Canada, a national survey was designed to assess the perception of and training experiences in PM among psychiatry residents. METHODS: Residents enrolled at one of 13 psychiatry programs in Canada participated in the study. Logistic regression analyses were conducted to assess the effect of PM training experiences and career interest in PM on the perception of PM, controlling for number of months already completed in PM, training level, and residency program. RESULTS: The response rate was 35%, n = 199. 68% of respondents identified PM as a definite subspecialty, with the majority of respondents believing that PM was as important a subspecialty as child (53%), forensic (67%) and geriatric psychiatry (75%). Eighty percent of the respondents believed a PM specialist should complete more than 3 months of additional training to be competent/qualified. There was significant heterogeneity in training experiences across programs, with a differential effect of certain training components-seminar, journal club-associated with a more favorable perception of PM as a subspecialty. CONCLUSIONS: The above results challenge the notion that PM represents only a focused area of general psychiatric practice in Canada. PM appears to require additional training beyond residency for trainees to feel competent and qualified. Results from this survey suggest Canada should follow the US lead on recognizing PM as a subspecialty.

Using the literature in developing McGill's guidelines for interactions between residents and the pharmaceutical industry.

Evidence suggests that the pharmaceutical industry exerts a large influence on residents' education and practice. Yet existing guidelines by professional bodies do not cover the specifics of residents' interactions with the pharmaceutical industry. At the psychiatry residency program of the McGill University Health Center, the authors set out to systematically evaluate areas of concern for residents and to develop guidelines for use by residents during and outside their training. Areas of concern included educational activities, training, fundraising, and other specific resident-industry interactions. In 1998, a committee of residents and faculty systematically evaluated areas of concern and, based on a review of the literature and discussions with experts, in 2000 developed guidelines for use by McGill's psychiatry program residents. The process for guideline development and methods for their implementation in 2001 are described. Education and training of residents on resident-industry interactions were included early in the curriculum. Guidelines were developed to address limitations on fundraising activities; restriction of direct gifts to residents; the appropriateness and awarding of industry fellowships; and the handling of drug samples, meals, and other presentations to residents. While guidelines for residents are useful adjuncts for guiding residents' interactions with the pharmaceutical industry, the authors conclude that they need to be reinforced with education and sensitization by faculty.