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MEDTECH Delve into the fascinating world of an integrated approach to brain medicine that amalgamates neurology and psychiatry, ushering a new era in patient care.
Our understanding of the brain is constantly expanding. This unprecedented knowledge blurs the boundaries between neurology and psychiatry. However, an issue arises: current clinical training maintains a dichotomy stemming from 19th-century practices.
This divergence is creating a shift. Neurologists, traditionally untrained in psychiatric management, find themselves treating more psychiatric patients. Likewise, new neuroscience-based precision treatments and diagnostic biomarkers demand skills beyond the psychiatric training purview. This status quo poses a significant challenge to training future doctors.
We need to focus on establishing competence in whole-brain aspects and fostering subspecialized expertise. Additionally, implementing feasible and practical programs is paramount. In response, this article proposes a novel 4-year residency program. The first two years concentrate on common and urgent neurology and psychiatry aspects, followed by two years of elective subspecialty tracks. This concept mirrors internal medicine residencies and fellowships, without necessitating changes to existing departmental structures.
The article further introduces ‘brain medicine’ as a fitting term for this unified practice. The name emphasizes a holistic focus on all brain aspects. Conventionally, the division between neurology and psychiatry relates to ‘structure’ versus ‘function’, with no universally applicable definition. This divide dates back to the 19th-century distinction made by neurologists Jean-Martin Charcot and Sigmund Freud between ‘functional’ and ‘organic’ diseases. However, this divide often complicates the care of patients with brain diseases that cross these imaginary boundaries.
Consequently, the current segregated neurology and psychiatry training might not be sufficient. This calls for a new paradigm integrating the skillsets of neurology and psychiatry training. The proposed program, ‘brain medicine’, provides a comprehensive scope of training that integrates brain sciences in the initial years and allows for subspecialized depth in the later years, without lengthening the overall training.
‘Brain medicine’ denotes the practice of medicine involving any brain disease or dysfunction. This term simplifies the practice, reducing confusion commonly associated with terms like ‘neuropsychiatry’. In addition, it might help destigmatize ‘psychiatry’ by emphasizing the biological basis of function and behavior. Ultimately, the proposal is to adopt ‘brain medicine’ as the title for this new residency program to transcend traditional neurology and psychiatry boundaries and unify these disciplines.
