When psychiatric residents treat medical students. Passage through idealization and overidentification

The author describes a survey of psychiatric residents and faculty supervisors inquiring as to problematic aspects of the psychotherapy of medical students when treated by residents. Medical students' idealization of and identification with their resident-therapist were found to produce a significant amount of discomfort for the trainee. Difficulties in the psychotherapies were also attributed to the numerous possibilities of identification by the residents with their medical student patients. The varied forms of identification are detailed through the use of clinical vignettes submitted by respondents. It is the author's contention that psychotherapies involving these "special patients" provide a window for examining many issues in the development of the resident's professional self. Given the increasing number of medical students electing some form of personal psychotherapy and the declining number entering psychiatry residency training, the timeliness of this issue is noted.