Teaching medical students psychosomatic medicine: of substances and approaches

The author describes a curriculum in which the emphasis is on teaching of medical students a general systems approach to health and illness from the first year of medical school through the fourth year. In the first year, a three-part course in behavioral science includes: Introduction to the Patient; Social and Ethical Issues in Medicine; Exercises in Decision-Making; and a didactic lecture series, Determinants of Behavior. This is followed in the second year by a course in psychopathology taught from environmental, psychological and social perspectives. The third-year clerkship emphasizes a liaison approach where students return to the medical and surgical services to work-up patients from a broad multidimensional perspective. The formal program in psychiatry and behavioral science is supported by more than 40 electives in human development, biological, social and psychological psychiatry, including behavior. During these phases the student has experience in working as a member of a team. She/he approaches the health of an individual in terms of the life phase of the individual, the present life of the individual, his/her past experiences, previous personality, reaction to the current illness phenomenon while following the illness through the hospital phase of the present illness, studying coping and adaptational processes.