Resident's Perspective

The Department of Psychiatry at Yale enjoys the heritage of a venerable, world renowned university. By the time the next incoming residency class graduates, Yale College, founded in 1701, will be entering its fourth century as an institution of learning. During the past three hundred years, the college has spawned eleven graduate and professional schools, including the School of Medicine. The university is now an international center of education, culture and research. It has a Book and Manuscript Library, and the Peabody Museum of Natural History. In addition, these opportunities for scholarly pursuits.

Yale's resources are particularly valuable because of psychiatry's interdisciplinary nature. The human mind, a remarkably complex and elusive entity, has been a source of inquiry by many academic disciplines. Included among these are psychology, sociology, neuroscience, artificial intelligence, philosophy and the humanities. Yale University has strong departments in all of these fields, and as part of a larger academic community, psychiatry residents have unlimited access to the collective resources of this broad range of disciplines.

One of Yale's strongest Departments is its Department of Psychiatry. It is the second largest in the School of Medicine, reflecting the influence it holds in the medical center as a whole. The diversity of its faculty provides trainees with extensive opportunities for guidance and mentorship. Its clinical facilities are equally diverse. they include the Connecticut Mental Health Center, Yale-New Haven Hospital, West-Haven Veterans Administration Medical Center, Yale New Haven Psychiatric Hospital, Hospital of Saint Raphael, Yale University Health Services, and the Yale Child Study Center. The Department of Psychiatry's strengths are the product of a tradition of leadership in research, clinical care and education. Many of Yale's faculty members have made historical contributions in these areas. Arnold Gesell was one example. Dr. Gesell was Director of the Yale clinic of Child Development from 1911 to 1948 and devoted his career to the observation of children. His model for normal infant development concentrated on five primary areas of behavior: gross motor, fine motor, adaptive, language and personal-social. Dr. Gesell developed an ontogeny of the mind through the meticulous mapping of early behavior. His research produced detailed maturational descriptions which include his classic text, An Atlas of Infant Behavior.

Throughout this century, Yale has also attracted pioneers in the field of psychoanalytic theory. for instance, Erik Erikson, who conceptulized the eight stages of ego development across the life cycle, joined the faculty in 1936. He studied at the Institute of Human Relations, now called the Yale Psychiatric Institute. YPI developed into a center for psychoanalytic practice and theory. Erikson's research at the Institute helped shape his interest in cross-cultural studies. One of his greatest gifts was his ability to comprehend individual psychodynamics in a cultural and historical context. Erikson demonstrated this talent in his psychological biographies of great religious leaders, such as Young Man Luther and Gandhi's Truth.

Anna Freud was another well known historical figure at Yale. Her research at the university was instrumental to the understanding of child development in psychoanalytic theory and practice. During the 1960's, Anna Freud spent much of her time as both a student and a teacher at Yale. She held faculty appointments at the Child Study Center, Davenport College, and Yale Law School. Her activities on campus were highly diverse. They included preparing a pamphlet on Sex and the College Student, giving seminars on The Child Law, and co-authoring her controversial book, Beyond the Best Interests of the Child.

Yale scientists have also made contributions to neuroscience and psychopharmacology, including lithium augmentation for depression, antidepressant use for panic disorder, and clonidine, naltrexone and flumazenil treatment for opiate withdrawal. Psychiatrists at Yale pioneered the use of clozapine and other atypical neuroleptics for the treatment of Schizophrenia. They also led the field in OCD research with the creation of the Yale-Brown OCD Scale and by demonstrating the effectiveness of the selective serotonin reuptake inhibitors. Currently, a multitude of other projects are being undertaken that will certainly have lasting effects on the field of biological psychiatry.

Yale has a history of preparing its residents for leadership positions at other hospitals, academic institiutions and corporations. For example, no other residency training program in the country has produced more current chairmen of departments of psychiatry at major academic medical centers than Yale. Psychiatry departments whose current (1977) chairs did their residency training at Yale include: the Albert Einstein College of Medicine, the University of California at San Francisco, the University of Illinois at Chicago, the University of Indiana, Jefferson Medical College, the University of Washington, Wayne State University, the Western Psychiatric Institute and Clinic, and Yale University.

Another way of viewing Yale's history is through the broader perspective of the history of medicine and psychiatry. Yale has a separate graduate program in the History of Medicine and Science which offers both M.A. and Ph.D. degrees. The program is interdisciplinary in nature and emphasizes historiographic pluralism. Once of its primary resources, the Sterling Hall of Medicine, houses one of the three largest medical historical libraries in the Western Hemisphere. The library is a campus treasure as well as an invaluable collection of information. In addition, the program's faculty, students and library help provide a cultural and historical context which allow for a broader understanding of the field of psychiatry.

Yale's Residency Training Program in Psychiatry has been enriched by its university environment and longstanding history. The university's resources are tremendous and allow residents to study the mind and the brain from the perspectives of numerous other academic disciplines. In addition, the scope of the university is reflected by the department's own vastness and diversity. The combination of these resources has provided an environment in which many scientists and clinicians have made historical contributions to the field. They have also allowed for the development of residency training program with limitless opportunities for intellectual exploration, clinical refinement and scientific discovery.

Jonathan Harland, M.D.
Yale Psychiatry Residents Association

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