Training at Washington University School of Medicine in Psychiatry in the late 1950's, from the perspective of an affective disorder researcher

In the late 1950s three men in the Department of Psychiatry at Washington University School of Medicine in St. Louis, MO, Drs. Eli Robins, Sam Guze and George Winokur, developed sets of criteria, based on published data and their own research, for the diagnosis and treatment of mental disorders. They also presented data on how to validate these diagnoses. They termed their endeavor, “The medical model for psychiatric disorders.” Residents were taught how to use criteria to diagnose and treat psychiatric patients. Besides clinical interviewing, the emphasis was on published data, critical literature reading and research, either basic or clinical, always using structured interviews. All residents were required to do psychiatric research, supervised by one of the full-time staff. Besides the three above, there were many other faculty members who were actively engaged in teaching and research, but they all adhered to the above model. Repetition was the most important aspect of learning. It was an exciting time to be there and that enthusiasm led to many of the trainees continuing to be committed to academic careers and the others, to a very high standard of psychiatric care. In addition, it led to the development of DSMIII and beyond, a host of validated structured interviews, a method for testing new drugs, a method for validating psychiatric diagnoses, an emphasis on the importance of genetics to psychiatry, and many important clinical findings.