Psychosomatic education in West Germany

Psychosomatic medicine (PsM) is taught to nearly all of the 12,000 West German medical students. It has become part of the curriculum by legal act (1972) and now forms part of the national syllabus. There are independent university departments in PsM at approximately three-quarters of the 27 medical schools in West Germany. In approximately two-thirds of the medical schools PsM is taught by members of departments lacking close working links with departments of non-psychiatric health services. The topic of liaison psychiatry is virtually excluded from the national syllabus. In teaching sessions, patients with psychogenic disorders predominate, which may bias the attitudes of students. The overall reception of PsM by students is fair to good although their expectations must be dealt with carefully. Many complain that the teaching in this subject is too short. Some of them (20-30%) can be motivated to join electives in PsM. These electives are related to patient care and involve team working and may be exemplified by the so called "Peer Groups on History Taking". Members of these groups practice guided self-help and this in part overcomes the dissatisfaction amongst students caused by overpopulation of the medical school. In conclusion it is suggested that in West Germany, students should be exposed more often to places of primary care, and their lecturers should act as experts in group techniques applied to problem situations in primary care. Psychosomatic lecturers should concentrate on issues of primary care and act as supervisors of group work. They should also support student electives in PsM in order to promote interest in this subject.