Sexual health curricula in U.S. medical schools: current educational objectives.

OBJECTIVE: The authors identify the explicit and implicit objectives that shape decisions about what medical schools teach regarding human sexuality. METHODS: The authors reviewed relevant articles in journals, physician licensing examinations, and publications by professional organizations to identify learning objectives for human sexuality in undergraduate medical curricula. RESULTS: There is consensus about many of the attitudinal objectives and some of the skills medical students should acquire in sexual health. There is less consensus on the sexuality-related information student physicians need to master. The few common informational objectives focus narrowly on diagnosing sexual dysfunction and disease. CONCLUSION: The model sexual health curricula, licensing exams, and guidelines from professional organizations mainly focus on the pathological aspects of sexuality. Student physicians should master fundamental information on healthy sexual function and become familiar with the roles of practitioners in various therapeutic disciplines in addressing sexual concerns and enhancing patients' sexual functioning and well-being. Instruction should also address ways to incorporate this important topic in time-limited interactions with patients.

Geriatrics education in psychiatric residencies: a national survey of program directors.

OBJECTIVE: The authors describe the current characteristics of geriatrics training within general psychiatry training programs. METHODS: In the fall of 2006, a survey was mailed and made available online to all U.S. psychiatric residency program directors (N=181). RESULTS: The response rate was 54% (n=97). Of the responding psychiatry programs, 96% (n=93) required a clinical experience in geriatrics, with a mean of 54.9 half days of required clinical training. The predominant training sites were inpatient geriatric psychiatry acute care units, ambulatory care experiences precepted by one or more geriatric psychiatrists, and outpatient geriatric psychiatry assessment centers. The mean number of physician faculty per residency program available to teach geriatrics was 2.8 full-time equivalents, and the mean number of physicians certified in geriatric psychiatry was 3.2 per program. Conflicting time demands with other curricula was ranked as the most significant barrier to expanding geriatrics training. CONCLUSION: Variability in the amount of time devoted to geriatrics training exists across general psychiatric residency programs. Some residents spend very little time in specific required geriatric psychiatry clinical experiences and have limited exposure to well-trained geriatric psychiatrists. Therefore, some psychiatrists who will take care of older patients in the future may be ill prepared to do so.

A review of ethics in psychiatric research.

PURPOSE OF REVIEW: To summarize important recent contributions to the literature on the subject of ethics in psychiatric research. RECENT FINDINGS: Current literature reflects an expansion in the range of psychiatric research on ethics topics. Articles continue to appear on core ethics subjects such as informed consent, but many recent contributions focus on diverse issues such as third-party privacy, the ethics of Internet-based research, revisiting the wisdom of imposing medical ethics requirements on observational research, and psychiatric research ethics as applied to special populations such as children or older persons. SUMMARY: Psychiatric research is critical for the elucidation, prevention, and treatment of mental diseases. Increased attention and novel approaches taken to obtain informed consent, correcting therapeutic misconception, and guarding privacy will advance the research enterprise and continue to ensure that the subjective experiences of participants in psychiatric research remain positive.

Cross-cultural issues in forensic psychiatry training.

OBJECTIVE: Forensic psychiatry was officially recognized as a subspecialty by the American Board of Medical Specialties in the 1990's. In 1994, the American Board of Psychiatry and Neurology (ABPN) gave its first written examination to certify forensic psychiatrists. In 1996, the Accreditation Council for Graduate Medical Education (ACGME) began to officially accredit one-year residency experiences in forensic psychiatry, which follow a 4-year residency in general psychiatry. The extra year of training, colloquially known as a fellowship, is required for candidates who wish to receive certification in the subspecialty of forensic psychiatry; since 2001, completion of a year of training in a program accredited by ACGME has been required for candidates wishing to take the ABPN forensic psychiatry subspecialty examination. With the formal recognition of the subspecialty of forensic psychiatry comes the need to examine special issues of cultural importance which apply specifically to forensic psychiatry training. METHODS: This paper examines the current literature on cross-cultural issues in forensic psychiatry, sets out several of the societal reasons for the importance of emphasizing those issues in forensic psychiatric training, and discusses how those issues are addressed in the curriculum of one forensic psychiatry fellowship at the Medical College of Wisconsin (MCW). CONCLUSION: While much has been written about cross-cultural issues in general psychiatry, very little has appeared in the literature on the topic of cross-cultural issues in forensic psychiatry.