Psychosomatic education: the University of Chicago's program in liaison psychiatry

Psychiatric education for the medical student addresses itself to students' and potential non-psychiatric physicians' needs in identifying and addressing the biopsychosocial aspects of patient care. The education is best based on the clinical method, using the extended interview to identify the relationship of environmental and social circumstances to the anlage, onset and reaction to illness in the patient. Within this pattern, genetic, epigenetic developmental patterns, earlier illness, behavioral and personality patterns are identified. In addition, family and social variables, including the effects of treatment procedures, hospitalization and interaction with the health team are reviewed. To whatever extent possible, the student is sensitized to this approach at the earliest phase of his(her) education, preferably in the preclinical years. The approach is reinforced during the introduction to clinical medicine and physical diagnosis. In the clinical years, individual patient consultations are arranged for students working with medical, surgical, pediatric and obstetrical patients on these services in which they review with patients their illness experiences. This is viewed as both an analytic and synthetic experience having an educational value for the student and a therapeutic one for the patient. Preceptors of such programs need thorough grounding in general and sometimes specialty medical disciplines as well as considerable exposure to psychological, behavioral and psychiatric medicine. Evaluation and support of these programs remain in question and should be addressed in discussion.