Orienting medical students in the holistic approach through integrated teaching: Pediatrics and child psychiatry.

Abstract

NDER the value system! of "scientific medicine," the essential emphasis in medical education gel nerally has been on the organic, and on chemi cal aspects of illness and treatment. The basic sciences providing the body of knowledge required fo r an un;derstanding of diagnosis and the treatment of complaints tended rather exclusively to be biology and chemistry. Depart mentalization and specialization by organ systems was the system by which medical education and practice organized its knowledge and activity. Pediatrics stands out differetitly, however, as a specialization related to an age group classifi cation of p�tients rather than an organ or organ system classification. Psychiatry migllt conceivably be seen as a classification of ill ness based on an "affected" 0rgan or organ system, in this case, the mind. And it too is fu rther subdivid�d by an age group classification into child and adult psychiatry. Such fragmentation of the child-patient into a "pediatric case" or a "child psychiatry case" has tende� to parallel the system of departmentalized medical practice. The pediatrician is supposedly interested in the body and organic illness, with the child! psychiatrist interested in the mind and fu nc tional or behavior disorders . .psychiatrists and pediatricians generally have recognized the distortions in; understanding which this encouraged for all concerned, with losses in opportunities to be helpful to large numbers of dis turbed parents and children,! all of whom see their pediatricians regularly and bring all their complaints! to him. Efforts to bridge this gap are noted in many publications emphasizing the potential contributions of child psy chiatry to pediatric practice : ( 1, 2, 3, 4). Technique by which this may be accomplished is generally se�n either in a process of interreferral between pediatrician and child psychiatrist, or in the coordinated work of pediatrician and child psychiatrist within : the same setting (5, 6, 7).