Novel Michigan Program Teaches Residents to Teach

In Michigan, one residency program is turning out psychiatrists who not only practice excellent clinical skills but also teach them. The Resident Educator Track of the University of Michigan’s department of psychiatry is believed to be the nation’s first full-fledged program focused on training residents in teaching, administration, education, and research.

“Until we established this program, there was no preparation beyond clinical training for those entering the clinical track,” said Michael Jibson, M.D., codirector of the Resident Educator Track and director of residency education. Jibson heads the track with Joseph Himle, Ph.D., the director of education of the adult ambulatory division and the Clinical Mentorship Program at the University of Michigan.

Most psychiatry departments at major universities have both a clinical track and a tenure track; the clinical track focuses on teaching residents how to care for patients, while the tenure track prepares residents for a career in research.

According to Jibson, the Resident Educator Track was created in response to the trend of the last few years of more faculty following the clinical track than the tenure track.

Jibson said this is happening for two reasons. “For those on the tenure track, the demands of research have grown more stringent, leaving researchers less and less time to do research and clinical work.” He also said there has been an increasing need for clinicians to provide direct patient care in psychiatry, prompting departments to expand the number of clinicians on faculty to address that need.

The Resident Educator Track was established in 1998 and enables residents to work in an academic setting and simultaneously teach medical students, residents, nonpsychiatric physicians, and different groups in the community.

The residents in the program also receive one-on-one mentoring by nine faculty members in the department and participate in a variety of programs created and managed by the residents themselves.

One of these programs, Addiction Psychiatry Day, is held annually and has become very popular with trainees in Michigan. Maher Karam-Hage, M.D., a clinical assistant professor of psychiatry at the University of Michigan, created the program when he was in the Resident Educator Track to heighten awareness of substance abuse issues among psychiatry and primary care residents.

The Third Annual Addiction Psychiatry Day was held on April 10 and attracted 80 residents from three universities in Michigan—Wayne State University, the University of Michigan, and Michigan State University, according to Karam-Hage.

Residents and faculty led such seminars as “Medical Education in Addiction and Barriers” and “Nicotine and Psychiatric Comorbidity.” Karam-Hage led a seminar titled “Early Recovery From Alcoholism and Relapse Prevention.”

Karam-Hage surveyed participants at the first Addiction Psychiatry Day in 1999 about attitudes toward and knowledge of addiction. He found that physicians showed interest in further addiction training and that the seminar had enhanced the physicians’ beliefs that they could motivate addicted patients to become involved in treatment. The results appeared in the spring issue of the American Journal of Addictions.

Another program created by and for residents in the program is Teacher Day. Sherri Hansen-Grant, M.D., a clinical assistant professor at the University of Wisconsin, developed the annual project several years ago with the goal of gathering residents in training throughout Michigan to attend workshops and seminars on teaching. Speakers from the University of Michigan and elsewhere have helped the annual program to become successful.

Residents in the educator track must participate in programs such as Addiction Psychiatry Day and Teacher Day as part of a structured and increasingly demanding schedule of activities.

In their first two years in the program, for example, residents teach medical students on a one-on-one basis and attend national conferences, such as those of the American Association of Directors of Psychiatric Residency Training (AADPRT) and the Association for Academic Psychiatry.

In their third year, residents concentrate on a teaching and research area in which they have particular interest and give lectures to medical students. They must also help to teach a psychotherapy course to second-year residents.

In their fourth year, residents are expected to complete an education research project, produce a publication or a conference poster presentation, and coordinate Resident Teacher Day, for example.

Residents also can sign up for optional activities, such as leading community workshops with homeless shelters, lecturing to primary care physicians affiliated with the university, or teaching psychopharmacology to students in the university departments of social work and psychology.

Thomas Cobb, M.D., is a fourth-year resident in the educator track and an APA/GlaxoWellcome Fellow serving on APA’s Commission on Judicial Action.

“With such a boom in medical knowledge over the past decade, being able to translate that knowledge and put it into the hands of physicians and nonphysicians alike to be used as a tool is just as important as the acquisition of knowledge,” said Cobb.

Cobb originated the program’s “Lunch and Learn” series, in which residents meet once a week in an informal setting to hear a guest speaker lecture on different aspects of education in psychiatry. Former speakers have included Allan Tasman, M.D., and Jerald Kay, M.D., both past presidents of AADPRT.

To assess the need for education training, codirector Jibson, along with Karla Blackwood, M.D., who was then a fourth-year resident in the track, surveyed the clinical-track faculty at the University of Michigan’s department of psychiatry.

They asked the faculty members about their training and how well it prepared them for the academic aspects of their last jobs. “We found that few had any training in how to teach, administer a teaching program, or conduct research in education,” Jibson said.

He added that almost all of the faculty members said that they would have preferred to receive formal training in these areas.

“In addition,” said Jibson, “we have observed that the amount of teaching done by clinical-track faculty is much greater than that done by those on the tenure track.”

“This program is an acknowledgement that more and more academic faculty are filled with clinician educators,” said APA Vice President Michelle Riba, M.D., one of the program’s nine faculty mentors and the associate chair for education and academic affairs in Michigan’s department of psychiatry. She added that there has been a great deal of enthusiasm from residency training directors in other programs.

More information on the Resident Educator Track can be obtained by calling the university’s Office of Residency Education at (734) 764-6875. ▪