Norbert B. Enzer

Recent Trends in the Recruitment of Child and Adolescent Psychiatrists

Recruitment in child and adolescent psychiatry has long been a concern of the profession. The 1980 report of the Graduate Medical Education National Advisory Committee (GMENAC) identified child psychiatry as the specialty most in need of expansion. Estimates of prevalence of disorders indicate that more child and adolescent psychiatrists are required to meet the patient care needs. Although the number of residents in child and adolescent psychiatry has increased somewhat over the last ten years, it will fall far short of the GMENAC 1990 target of 9,000. Academic units need to increase the number of child and adolescent psychiatry faculty by approximately 30%. Some recommendations are presented to address continuing problems in recruitment.

Interferences in collaboration between child psychiatrists and pediatricians: a fundamental difference in attitude toward childhood.

The relationship between pediatrics and child psychiatry has been discussed at length. Opportunities seem to exist for cooperation between the two specialties, and yet difficulties exist. This study compared attitudes toward childhood held by pediatricians and child psychiatrists, as well as by residents at the beginning and end of training in pediatrics, psychiatry, and child psychiatry. The attitudinal assessment tool was a 30-item questionnaire consisting of literary quotations with which respondents were asked to agree or disagree. The results suggest that pediatricians view childhood more positively than do child psychiatrists. These attitudinal differences exist at the beginning of residency training. Recommendations are made regarding how to facilitate better collaboration between pediatricians and child psychiatrists.

BOOK AND MEDIA REVIEW

Closely examining the process by which pain has been politicized, most recently (historically speaking) and extravagantly in the United States, is not for the faint of heart or weak of stomach. Keith Wailoo, a historian on the faculties of the Department of History and the Woodrow Wilson School of Public and International Affairs at the Johns Hopkins University, is uniquely qualified to take on this challenge, having previously written the highly acclaimed Dying in the City of the Blues: Sickle Cell Anemia and the Politics of Race and Health in America. Despite the ineluctable fact that pain in America has become highly politicized and thus, given the nature of our politics, polarized, the “P” word (politics) has rarely found its way into the title of a book on pain. A notable exception before this volume was the publication in the mid-1970s of the sociological study by Fagerhaugh and Strauss Politics of Pain Management: Staff-Patient Interaction. Foreshadowing the major reform measures in the decades that followed, the political dimensions of which are a major focus of Wailoo’s book, Fagerhaugh and Strauss offered the following remarkable assessment: