Psychiatric Residency Training
Leston Havens was Chief of service, Massachusetts Mental Health Center/Boston Psychopathic Hospital from 1957 to 1958 and then until 1960 was the Staff visit and Senior Psychiatrist. In both these positions, he was responsible for a forty bed inpatient service, its first-year psychiatric residents, staff nurses, social workers, and mental health workers. In the 60’s he began supervising medical students as well.
“Young people can find what they want to do. I never speak about having students. I hate the idea of having students. It’s awful. It makes people into students. But I have a lot of young colleagues whose work I think I have helped, and they certainly sound like they felt that way too. Their way of working is often very different than mine, but there is some connection.”
CONSIDERATIONS IN THE EDUCATION OF PSYCHIATRIC RESIDENTS 1962
Elvin Semrad, M.D. was the Clinical Director of Mass Mental Health Center.
The discussion below is between him, Havens Dana Farnsworth MD, Director Harvard University Medical School, Leston Havens, MD. Director of Medical Student Education, Francis D’Eseaux, M.D. Psychoanalyst and Senior supervisor Mass. Mental Health Center
The questioning of Semrad covers a wide range of issues concerning the details of residency training and compelling responses from Semrad who was not known as a one to vocalize all of what he really thought. However, this interview of him in preparation for a conference on clinical teaching is as pertinent today as it was then.
Discussion of Residency Training
Interviewing Semrad for The Graduate Education Conference “The Teacher“
On being a resident taught by Les Havens George Vaillant M.D. video
“Know the grief that fills Mass. Mental Health today…” Letter commenting on Havens leaving for The Cambridge Hospital George Vaillant MD, 1982 (Complete PDF)
“I do not believe that I have seen a single group of students who have not talked glowingly and often in awe about what they learned in clinical psychiatry with you…” Charles Pinderhuges, Prof. Psychiatry Boston University May 27, 1981 (Complete Letter PDF)
Following the untimely death of Lee Macht, M.D., The Cambridge Hospital Chief of Psychiatry, Havens felt it important to join their staff.
He was Supervisor and Clinician from 1982-84, then Principal Psychiatrist until 1987 when he became Director of Adult Psychiatric Residency Training Program. From 1996-2004, he was Co-Director of Education. During these years he lectured, debated and interviewed patients at psychotherapy continuing education conferences, grand rounds, at other affiliated hospitals, clinics, psychiatric conferences, in the United States, England, Australia, New Zealand, and Tasmania.
A selection of these videos and audiotapes can be found in the Approaches/Interviewing Section of this website.
ADVICE TO THOSE ENTERING THE PROFESSION 1990
“Don’t be discouraged by managed care and certain aspects of the field. This work is one of the greatest opportunities in human life. This is a privilege far beyond what I could have conceived.
I think I would have had fun being a lawyer. Lawyers hear great stories the way we do. They are better paid than we are but they don’t have the chance to stick and be very helpful often.
Ministers and rabbis have extraordinary opportunities. They hear great stories. They are often very very helpful but they don’t get paid.
The reason it is valuable to be paid, and this may just conceal my greed, is that it gives you some independence in the world. You are not beholding to an institution.
I am profoundly mistrustful of institutions. I was always linked (to an institution) but I was always ready to walk away and I could afford to because I had a place where I could make my living.
I have never known an institution I could trust. I think institutions and I am sure there are exceptions, are much more dangerous than individuals, more destructive, more mad, because all the members agree about some crazy thing. Maybe I am too harsh. I am hypocritical because I have profited from a lot of institutions including Harvard. I walk through Harvard Yard and I feel safe. Isn’t that mad? I know they don’t give a damn about me. They would see me gone in a moment and never even know it. ”