Kenneth L. Matthews

Residents’ Satisfaction With the PRITE

Examinations are an integral part of resident and program evaluation, but they are considered particularly stressful on residents. The department of psychiatry of the University of Texas Health Science Center at San Antonio administered the Psychiatry Resident-in-Training Examination (PRTTE) every other year to minimize stress and anxiety among residents. When questioned about their satisfaction with the PRTTE and its administration, the residents reported high levels of satisfaction and a desire to take the examination yearly. Dissatisfaction was limited to the physical environment in which the exam was administered.

Moonlighting by psychiatric residents

Much of the literature on resident moonlighting has been editorial in nature. Very little information on psychiatric residents’ moonlighting practices and attitudes exists. The authors developed an instrument that was mailed to survey the chief residents of all 203 Accreditation Council for Graduate Medical Education—approved psychiatry residencies, with 137 (67.5%) programs responding. According to the responses, the percentage of residents moonlighting increased with each successive year of training, with an average of 31 hours per resident per month. The two major reasons given for moonlighting were payment of living expenses (58%) and repayment of student loans (24%). No supervision was provided to 22% of the moonlighting residents. Only 10% of the programs proscribed moonlighting by their residents. To better assess the positive and negative effects of moonlighting, it is time to truly monitor and guide the moonlighting experience for both residents and their programs.

Collaboration with the nonphysician therapist : a seminar for postgraduate third-year psychiatry residents.

The integration of psychotherapy and pharmacotherapy becomes more complex when two clinicians collaborate in providing patient treatment. A course for postgraduate third-year psychiatry residents was developed to review the literature, discuss various treatment models, and delineate the technical skills and treatment issues involved in the collaborative model. This article describes the course content, design, and evaluation at one institution.

Psychiatric Resident Moonlighting: A Review and Modest Proposal

Moonlighting by psychiatric residents remains controversial, with debate surrounding the ethical, legal, financial, and educational risks involved in the practice. The authors present a literature review of resident moonlighting, which encompasses the policy positions of various organizations responsible for graduate medical education; surveys of various groups and specialties regarding the prevalence, form, and justification for moonlighting; and models of moonlighting programs in several institutions. The authors conclude with specific proposals for research regarding psychiatric resident moonlighting and, more importantly, emphasize the need for research on the effects of moonlighting on resident performance and education.

A Psychotherapy Service: Preserving a Place for Psychodynamic Teaching

Striving for an educational balance between psychodynamics and psychotherapy led to the creation of a Psychotherapy Service. Psychodynamic teaching was preserved while biological teaching was increased. The history, philosophy, and structure of this service, combined with a chart review, give a picture of the kind of clinical experience and training available on such a service.

PL 94–142: Benefits for the guidance center and the school

The advent of PL 94–142, the Education of All Handicapped Children Act of 1975, served as a threat to some child mental health professionals, who feared that it would lead to the formation of mental health facilities in the schools. Contrary to that fear, this article outlines a model through which a public school district and a mental health facility used PL 94–142 to enter into a joint mental health/education venture. The model is now in its third year and has proven quite successful in (a) providing an intensive, local outpatient care alternative, (b) containing costs, and (c) reducing use of inpatient care.