Teaching psychosomatic (biopsychosocial) medicine in United States medicalschools: Survey findings

Objective: A survey of US medical schools regarding the incorporation of ps ychosomatic (biopsychosocial) medicine topics into medical school curriculu m was conducted. The perceived importance and success of this curriculum, b arriers to teaching psychosomatic medicine, and curricular needs were also assessed. Methods: From August 1997 to August 1999, representatives of US m edical schools were contacted to complete a survey instrument either by tel ephone interview or by written questionnaire. Results: Survey responses wer e received from 54 of the 118 US medical schools contacted (46%), Responses were obtained from representatives of both public (57%) and private (43%) institutions. Only 20% of respondents indicated that their schools used the term "psychosomatic medicine"; the terms "behavioral medicine" (63%) and " biopsychosocial medicine" (41%) were used more frequently. Coverage of vari ous health habits leg, substance use and exercise) ranged from 52% to 96%. The conceptualization and/or measurement of psychosocial factors (eg, stres s and social support) was taught by 80% to 93% of schools, Teaching about t he role of psychosocial factors in specific disease states or syndromes ran ged from 33% (renal disease) to 83% (cardiovascular disease], Coverage of t reatment-related issues ranged from 44% [relaxation/biofeedback) to 98% (do ctor-patient communication). Topics in psychosomatic medicine were estimate d to comprise approximately 10% (median response) of the medical school cur riculum. On a scale of 1 (lowest) to 10 (highest), ratings of the relative importance of this curriculum averaged 7 (SD = 2.5; range = 2-10), Student response to the curriculum varied from positive to mixed to negative. Perce ived barriers to teaching psychosomatic medicine included limited resources leg, time, money, and faculty), student and faculty resistance, and a lack of continuity among courses. Sixty-three percent of respondents expressed an interest in receiving information about further incorporation of topics in psychosomatic medicine into their school's curriculum. Conclusions: Resu lts of this survey reveal variable coverage of specific psychosomatic medic ine topics in the medical school curriculum and differential use of nomencl ature to refer to this field. There is a need for further curricular develo pment in psychosomatic medicine in US medical schools.