On the Education of a Psychiatrist: Notes from the Field

The overarching borrowed question that frames the work of this PhD asks, "What does an education in psychiatry do to a psychiatrist?" Early in my practice of child and adolescent psychiatry, the "know how" in the custodianship of care neither readily nor easily translated into "show how," resulting in a pedagogical conundrum that belatedly registered as uncomfortable emotional symptoms about my education. This nidus of professional confusion and uncertainty creates the context for my inquiry into the complexities and dilemmas of contemporary matters of medical education, specifically as it pertains to my identity as a psychiatrist. To probe these queries, three non-traditional, blended methodologies are relied upon. John Forrester's "thinking in cases" is utilized in reading memoirs and critical histories in psychiatry, such that the thesis can be read as a case of many educational cases. I stay close to the reading of Oliver Sacks' memoir whose work in neurology also grapples with questions of the mind; an idea which becomes a leitmotif in my own autoethnographic reflections for re-constructing my education in psychiatry and its potential beginnings as a trainee and educator in both Canada and Uganda. Weaving in and out of historical observations made by Foucault about psychiatry and linking them to Sacks' recall of numerous medical institutional encounters, I tackle the problem of matricide in an educational arena weary of newness and how this deadly curriculum can be generative in its intent. Through attempts at engaging a decolonizing discourse about my experiences as a clinician educator in Uganda, the concept of an educational void and how it was both ruthlessly encountered as a situational dilemma but underwent a thought transformation to understand it as a survival tactic, is described. Psychoanalytic orientations are heavily leaned upon in my interpretations, highlighting the emotional logic inherent in the transference sites constituting the human work of medical practice and education. Broad themes emerge focusing on history, place, gender, and positioning of the body as educational markers speaking to a different kind of experiential pedagogy predicated on somatic revelations to make the mind intelligible in its relevance to the temporality of education. I arrive at the fault lines of education, difficult knowledge, and the uncertainties, including the frailty of my own self as a resource for the mind, that form educational myths needed to tackle obstacles to learning. Through this process, a personal and professional awakening occurs.

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