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Dr. Kubie has attempted in a short summary to give us the benefit of his thinking on the important subject of the future education and training of the psychiatrist of tomorrow. There is a good deal of evidence that changes are already in the wind, and that some of the reforms which Dr. Kubie thinks should be introduced have been given a try-out. There is a growing momentum in the effort to cut down the hospital population and to develop all-inclusive centers for preventive services, emergency care, and rehabilitation of ex-hospital patients. For the future it is the hope that the hospital will come to be an emergency resource rather than a facility for residential confinement, and so will come to be thought of as an essential part or the center of a total community program, rather than an isolated institution.
The vast programs of community psychiatry now in the planning stages will necessitate the recruiting of numbers of mental health personnel to man the new facilities. This challenge must somehow be met by our specialty if we are not to lose the leadership position in the planning and implementing of these community programs, to which tradition and special competence entitle us. Programs of psychiatric education in future must take into account this need above all else. The day of the psychoanalyst and his couch as the image of the only reputable psychiatrist is due for a fade-out There are fewer and fewer young psychiatrists who consider complete psychoanalytic training a necessity, although a large majority are either deciding on a personal analysis or join some group therapy sessions in their own hospitals in the hope of acquiring greater sensitization to the subtleties of emotional exchange and of stress reactions in themselves.
Dr. Kubie is right in emphasizing the resistance to change in long-established systems, but the image which he presents as the ideal image for a modern psychiatrist seems to come close to the traditional image of renaissance man. I dou