[Summary] Mind the Gap: Neuroscience Literacy and the Next Generation of Psychiatrists (Chung, Insel 2014)
TLDR; Psychiatry training is outdated and must incorporate new scientific understandings of the brain. NIMH will encourage more clinician-researchers and more neuroscience literacy in new clinicians.
https://zero.sci-hub.do/2637/c4c6131cfa2a0521b41737910088d870/chung2014.pdf
TLDR; Psychiatry training is outdated and needs to incorporate new scientific understandings of the brain. NIMH will encourage more clinician-researchers and more neuroscience literacy in new clinicians in order to facilitate development and informed use of new therapeutic approaches and technologies.
Intro
Psychiatry training and requirements are based off old models of the brain and mostly ignores modern brain science
“Even more vexing is the separation of psychiatry from modern neuroscience, especially because neuroscience has transformed our understanding and approaches to that organ, the brain [1]. Despite the revolution in brain research of the past few decades, psychiatry continues to train its newest practitioners according to an outdated model of how the brain works or, in many cases, just ignores it. Fewer than half of US psychiatry residency programs provide any education in modern systems neuroscience [2, 3]. This educational pattern may be a byproduct of the written requirements for psychiatry residency programs as outlined by the Psychiatry Residency Review Committee (RRC), which does not include the term neuroscience. The word brain occurs only once, in the term “traumatic brain injury” [4].”
Psychiatry interest has reduced whereas undergraduate and graduate interest in neuroscience is expanding rapidly.
“This gap between modern neuroscience and psychiatry training seems especially unfortunate given the different trajectories of these fields. Whereas the recruitment to psychiatry has decreased over the past two decades, interest in neuroscience has expanded rapidly, as evidenced by the growth in the number of members of the Society for Neuroscience (now exceeding 40,000) and the popularity of neuroscience as an undergraduate major and graduate program. Today’s students appear to be even more interested in “brain and behavior,” “the biology of emotion,” and “the unconscious” than previous generations, but many of these students have been choosing neuroscience, not psychiatry, as the field to pursue these topics.”
Because of unmet mental health needs, NIMH seeks to generate next-generation “clinical neuroscientists” and add neuroscience training for psychiatry residents.
“This trend not withstanding, psychiatry continues to face a workforce shortage. We see this shortage in two general areas. More psychiatrists are required to address the unmet treatment needs of the public [5], and we need a next generation of scientific leaders who will transform our diagnostics and therapeutics using neuroscience tools to address these needs. Given these twin goals, the National Institute of Mental Health (NIMH) is taking a two-pronged approach that includes next-generation efforts to identify and support trainees who will redefine psychiatry as “clinical neuroscience,” and neuroscience literacy efforts that encourage the integration of neuroscience into the training of psychiatry residents.”
Next Generation of Clinical Neuroscientists
NIMH will continue to sponsor events, fellowships, and grants, to encourage clinicians to spend more time in research.
Enhancing Neuroscience Literacy
Neuroscience literacy will help clinicians treat psychiatric conditions with novel therapeutic approaches and new technologies. NIMH now has two online courses teaching neuroscience.
“One example of how NIMH has contributed to neuroscience literacy is a pair of online Neuroscience and Psychiatry teaching modules that introduce trainees to neuroscience research that underlies the basis for novel therapeutics. The modules include a compelling science story that links a clinical case to neuroscience concepts and provides important insights to the formulation and treatment of the clinical problem [9, 10]. We anticipate that psychiatrists will increasingly need to integrate knowledge of neuroscience with clinical expertise to use novel therapeutic approaches and new technologies to treat psychiatric conditions.”
9. NIMH Neuroscience and Psychiatry Modules. 2012a. http://www. nimh.nih.gov/neuroscience-and-psychiatry-module/index.html. Accessed 11 Nov 2013
10. NIMH Neuroscience and Psychiatry Module. 2012b. http://www. nimh.nih.gov/neuroscience-and-psychiatry-module2/index.html. Accessed 11 Nov 2013
The RDoC can also be used as a basis of teaching relevant neuroscience since it reclassifies brain/mental disorders on biology.
“An innovative neuroscience course for psychiatry residents using RDoC is described by Etkin and Cuthbert [11].”
Etkin A; Cuthbert B: Beyond the DSM: development of a transdiagnostic psychiatric neuroscience course. Acad Psychiatr 2014; 3
Literacy will also be important since the public will be hearing about neuroscience breakthroughs and asking their doctors.
“The fundamental argument underlying the case for neuroscience literacy, however, is not just that a deeper understanding of neural circuits and biomarkers will be essential for the psychiatry of the future but that the public and patients have expectations. Our patients, who increasingly understand mental disorders as brain disorders, will expect that psychiatrists know and can educate them about neuroscience breakthroughs described in the media”