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The Continuing Forum is open to all readers so that they may send their reactions, suggestions, criticism and contributions to the topics which are presented in The Psychoanalytic Forum.
To the Editors: Dr. Kubie is most persuasive and from an educationist's point of view there is much to be said for arranging a series of experiences for a learner in such a way that he deals with the least complex problem first and works towards the most complex. However, such a sequence must be tempered by a careful consideration of the motivation and preparedness of the individual learner. So I would question one thesis. The “confrontation” of the “inexperienced resident” with the “psychotic patient” need not of itself be a hindrance to the learning. And an important factor is the extent to which the young resident must assume responsibility for patient care. If there is then a keen interest in psychosis and its treatment, he may be highly motivated, thus greatly facilitating learning—as long as he is not overwhelmed with a service load and responsibility for administering patient care, for which task he is at that point ill-prepared.
Also, his proposal for a “School of Psychological Medicine” is a provocative challenge to all those concerned with psychiatric education. The unfortunate concomitant to this must also be considered: is the college graduate ready to make such a decision concerning his career without continued opportunity for exploration? Perhaps it is indeed time for all of medical education to review its position concerning early choice of and training in specialization areas.
Stephen Abrahamson, PH.D.
(Dr. Abrahamson is Professor of Education and Director of the Division of Research in Medical Education at the University of Southern California School of Medicine.)