I think about the patients I come into contact with often. As a psychiatry resident, I think about their symptoms, ideas for pharmacology/psychotherapy, and the biological, psychological, and social aspects of their illness. I feel so blessed that I get to enter into patients’ most troubling times with their trust in me to help them feel better.
My psychiatry residency has been everything I could have hoped for — and more. There are so many positives to training. However, there are also areas where I feel that residents need to learn more about. There are areas that are not as well understood or discussed enough, and addressing these areas will better prepare residents in becoming practicing psychiatrists.
In so many areas, psychiatry residency offers a great education. But with the emergence of neuroscience, neuroimaging, and better understanding of neurobiology, psychiatry residents need to continue to learn more about these areas.
In addition, much emphasis is being put on biomarkers in treating various psychiatric conditions. We should try to better understand how to use biomarkers in helping to make a diagnosis or helping to determine what is the best course of treatment. Even though this is a burgeoning area, residents should still begin to learn about their potential use.
Perhaps the biggest area I would like psychiatry residencies to improve is its awareness on nutrition. It is very well known that nutrition is not studied in depth in medical school. Nutrition is important for a lot of reasons, but it is vital to mood, and overall health. With the interplay of diet with medication — whether monitoring food intake with a medication like ziprasidone (Geodon), or help in balancing weight gain associated with many psychotropic medications — nutrition is something that is not emphasized or discussed enough, even though it influences many psychiatric conditions.
Too many times, I have patients ask about nutrition and the answers I am able to give them are not satisfactory to them or me. We need to incorporate research and learn more about the “gut-brain.” For example, what is the interaction between the gastrointestinal system and the brain? How does what we eat and drink affect our mood? Might certain kinds of food, for different mental disorders, become an adjunct for treatment?
This is a very exciting time to be specializing in psychiatry. There are many unanswered questions, but with the advancements in science, we are beginning to understand the brain and all it entails much better. As always, we must focus on the biological, psychological, and social aspects of our patients to provide them with the best care.
My hope is that with the increasing awareness of neurobiology, coupled with advances in biomarkers and a dedication to better understanding nutrition’s role in mental illness, we can make psychiatry residencies even better. I have met many colleagues, both locally and nationally, and it is clear that our profession is headed in the right direction. But, as physicians, we must always remember to constantly challenge ourselves and look for ways to improve what we are taught to provide the best possible care to our patients.
Brad Zehring, DO, is a psychiatry resident at Banner Good Samaritan Medical Center in Phoenix, Arizona. He maintains a blog, Dr. Z’s Ramblings, related to issues in mental health and is a contributor to the American Psychiatry Association’s Healthy Minds Healthy Lives blog.