Perspectives from a psychiatrist in an office of advising resources

Abstract

In this chapter, Dr. Raymond seeks to assist administrators, faculty, and student support services colleagues in identifying and understanding many of the academic and personal challenges faced by medical students during their training by sharing her experiences and observations from 14 years as director of the Office of Advising Resources (OAR) at Harvard Medical School (HMS). She describes the staffing, function, and experience of the OAR; the importance of early screening and intervention; the special developmental challenges of medical students (e.g., reshaping the role in the family, dealing with major medical, mental health issues for the first time, managing the emotional impact of care, forming a professional identity); their most common presenting problems (e.g., attention, sleep, self-sabotage) and the differential diagnosis (e.g., attention deficit disorder, verbal and nonverbal learning disorders, depression); and some common issues that arise with medication management. Dr. Raymond shares a number of interesting observations which should influence remediation in medical education practice, including that anxiety, depression, and perfectionism may be secondary to treatable attention deficit or learning disorders. She also describes the characteristics of "successful compensators"-resilient students who struggle, seek help, and ultimately, by all accounts, do well.