Abstract
As we think of education in psychosomatic medicine in the 21st century, it is important to learn from what is going on in this field overseas. I visited several units of psychosomatic medicine in West Germany and the U.S.A. in 1973 and 1986. I would like to introduce some of the things I learned in these coutries concerning the teaching of psychosomatic medicine. In West Germany a new law in medical education was enacted in 1970. There psychosoatic medicine is included in the subjects for the national license examination and also in the formal curriculum of medical education. Actually, independent units of psychosomatics exist in 22 of the 25 German universities which have medical faculties. In comparison, in Japan, departments of psychosomatic medicine exist in only 5 out of the 80 universities which have medical faculties. In the future, as in Germany, the number of psychosomatic units must be increased. My longest visit was at the Mannheim branch of the University of Heidelberg. Therefore, I will introduce the course of PSM training there, quoting from a paper by H. Schepank (Figure 1). In the basic course, medical psychology and sociology are included. In the clinical course, during the 3rd year, lectures on the general clinical examination of patients are given. And during the 4th year, after the main lectures on clinical pictures and psychosomatic disease therapy, the practical course on interviewing begins. Practical courses are most important in teaching psychosomatics and we need to induce these procedures into Japan. In the U.S.A., traditional teaching of psychosomatics is being continued by Professor Engel at the Rochester University (N.Y.). For instance, the combined class is held, which functions as a holistic educational system. Graduates of the Rochester University are somewhat different from others in that they look not only at the disease itself, but also at the person who has the disease. We are happy that the curriculum of medical education in the University of Tokyo has changed, and that a practical course of teaching psychosomatics has been established since this year. Table 1 shows the program of this course. As we have no inpatient ward in the department of psychosomatic medicine of Tokyo University, students learn by using their own data in lieu of patients' data in matters such as psychological testings. This experience also serves the student in cultivating his or her own therapeutic self. We are, however, in dire need of an inpatient ward to teach the students bed-side therapeutic techniques. In any case, we strongly desire to develop these systems and introduce them to other universities throughout Japan.
