Review by: Emmanuel Persad, MBBS, FRCPC
How times have changed. I was a resident in psychiatry from 1966 to 1969, in a Canadian training program. My fellow residents and I approached our training experiences with an amazing degree of trust, acceptance, and as some might say, naivete. The apprenticeship model was alive and well. The brain remained a mysterious and yet-untapped frontier. We learned that, to acquire the skills for our profession, we had to learn from our patients rather than from textbooks. Perhaps, most important, we were blissfully unaware of our rights.
Dr Peterkin’s book establishes how all this has changed and why such a book may be helpful or even be necessary. The book in its second edition is described as a concise manual designed for medical students, interns, residents, and post- doctoral fellows in all areas of specialization. The book begins with a chapter entitled “The Risks of Residency Training.” Subsequent chapters include such titles as “Choosing a Humane Residency,” “Living, Learning and Teaching with No Time,” “Protecting your Mental Health,” and “Protecting Personal and Professional Relationships.” Several other chapters deal with new and emerging issues, such as those concerning women, international medical graduates, gay and lesbian residents, and residents with disabilities or chronic illnesses. There is also a chapter on finances and on the resources that are available for residents.
The chapter, “Thoughts on the End of Residency” is quite revealing. Dr Peterkin begins this chapter with a reference to Greek mythology and the infamous Procrustes. He concludes that
residency is truly a modern Procrustean voyage where conformity, even to deforming principles, can be the price of success. Musical, creative, playful, spontaneous, even romantic aspects of our lives may be cut off. There is no modern day Theseus to intervene to preserve our integrity to remind us of our need to remain whole. Our superiors and patients often expect too much of us.
Are things that bad? This disturbing analogy brings to mind the ongoing discussions that are currently taking place in psychiatry with respect to the challenges of postgraduate education in Canada and the belief that residency training may require significant overhaul. If residency training in any specialty or for family practice remains such a burden and an experience to escape from, then we are in significant difficulty, and the profession and society will not be well served.
Buried and given little emphasis in this book is the vocational nature of our calling as physicians and healers. Dr Peterkin deals with the spiritual aspects of our practice in his chapter on unique concerns. I was particularly interested in the physicians’ prayer on page 98, which reads as follows:
Give skill to my hand, clear vision to my mind, kindness and sympathy from my heart. Give me singleness of purpose, strength to lift at least a part of the burden of my suffering fellow mortals and a true realization of the privilege that is mine. Take from my heart all guile and worldliness that with the simple fate of a child, I may rely on thee.
I commend Dr Peterkin for the comprehensive collection of relevant information, which alone would be well worth the price of the book.
Rating Scale/ Échelle dévaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé