ECT Education in Medical School: Novel Elective From Texas

 Out on PubMed, from researchers in Texas, is this paper:

A Novel Refractory Mood Disorders and Electroconvulsive Therapy Elective for Medical Students: Fighting Stigma through Experience.

Yau BN, Rong C, Findley JC, Selek S.Psychiatr Q. 2021 Jun 7. doi: 10.1007/s11126-021-09929-4. Online ahead of print.PMID: 34097246

The abstract is copied below:

Treatment resistant mood disorders (TRMD) have a significant impact on patients and society. Electroconvulsive therapy (ECT) has been shown to be effective for treatment resistant depression (TRD). Despite the effectiveness and safety of ECT, there remains significant stigma surrounding its use. Studies worldwide have shown that many medical students receive their knowledge from the media, which often portrays ECT in a negative light, and very few have exposure to ECT prior to their psychiatric clinical rotations. In this article we highlight the importance of medical education and introduce a novel approach in helping to fight the stigma of ECT through educational intervention for medical trainees that combines active, longitudinal and theoretical learning. By ensuring that trainees have a robust education in this arena, we can help them educate patients about treatment options, improve confidence in prescribing and administering these therapies, and ultimately improve patient and societal outcomes.

Keywords: Electroconvulsive therapy; Medical education; Treatment resistant depression; Treatment resistant mood disorder.

And from the text:

Course Description

At McGovern Medical School at UTHealth, all third-year medical students are required to
observe one session of electroconvulsive therapy during their core psychiatry clerkship.
The Treatment Refractory Mood Disorders Elective was created to provide interested students
more in-depth exposure to ECT. This is a one-month clinical course available to all
fourth-year medical students. The learning objectives of the course are: (1) Describe the
definition of treatment resistant mood disorders, (2) Understand the contributing factors to
treatment resistance, and (3) Understand the indications and clinical applications of interventions for treatment resistant mood disorders, including electroconvulsive therapy. The
course takes place at the Harris County Psychiatric Center, a large academic psychiatric
hospital serving a predominantly severely mentally ill and disadvantaged patient population.
The treatment team typically consists of the supervising faculty member (who is also
the director of the Treatment Resistant Mood Disorders Program), a PGY-2 and/or PGY-4
psychiatry resident, and fourth and third-year medical students. The course components are
described in Fig. 1

Kudos to these clinician educators for putting ECT front and center in medical student education. Overall, ECT education at all training levels is woefully deficient; it is just not adequately covered in most curricula. This results in lack of familiarity with the treatment, reluctance to prescribe/recommend it, and ultimately, gross underuse. Furthermore, it is unclear if there will be enough adequately trained ECT clinicians in the next generations of psychiatrists.

This article is a nice addition to the ECT education literature and deserves a full read,~10 minutes.