American College of Physicians 'stepped out of its lane" by placing gun control in medical education. Stanley Gold-farb, formerly the associate dean of curriculum at the University of Pennsylvania's Perelman School of Medicine, argued that teaching social justice issues and population health comes "at the expense of strict training in medical science" at a time when sub-specialists are in short supply. But many physicians, ourselves included, think social issues should be at the heart of medical education.
Formal medical school typically takes four years, followed by several years of residency（住院医生实习期）and often a fellowship（研究员职位）, and during that short time students have a wide range of competing requirements. They must learn complex biological and chemical pathways that explain diseases and health. They must be educated on how to read the the scientific literature and apply it to their patients. They must master many therapies and know how to adapt them to patients' varied diseases states. On top of all this, they must learn to communicate effectively and compassionately with patients and colleagues.
Being a good doctor also demands that we understand the reasons behind poor health. Our mission is not simply to diagnose, manage and treat. Physicians should act to prevent the root causes of illness and improve well-being. Physicians are trained to tackle problems at their root. System and structural-level social issues are also drivers of poor health, and it is our duty to address them. Medical training must evolve to produce doctors who are able to not only treat the individual but also understand the larger influencers of health -- of which gun violence is most emphatically one. As medical professors, we would fail our students -- and our patients - if we expected any less.
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Wilderness Therapy
When most people hear the term “psychotherapy”, they picture traditional talk therapy – someone sitting on a couch or chair talking about their troubling thoughts and feelings with a psychologist or other mental health professional. However, talk therapy isn’t the only type of psychotherapy used to help individuals struggling with depression, anxiety, and a whole host of other challenging disorders, emotional struggles, and other types of problems. In reality, therapy takes place in all kinds of settings. One of them is wilderness therapy.
When the campsite is set up and the fire is lit, the doctor is in. Wilderness therapy is a successful, and sometimes controversial (有争议的) way to help troubled youth by teaching life and social skills on the hiking trail. Intensive group therapy and one-on-one sessions are coupled with outdoor activities like mountain climbing and fly-fishing to teach self-reliance and responsibility. Programs promise to reform even the most wayward (任性的) of offenders, including teens with depression, anger management issues, or eating disorders.
While wilderness therapy can be effective, certain methods have come under fire for using unethical, and sometimes abusive (施虐的) techniques to help struggling youth. Wilderness programs are loosely regulated, so not all programs are staffed by qualified professionals. Upon closer examination, some “therapy” groups seemed to be just military-style boot camps with little mental health benefit.
Even legal wilderness therapy groups have been criticized for partnering with teen escort (陪同) companies to forcibly remove unwilling participants from their homes to attend the program. While controversy and risk exist, wilderness therapy might be a creative way to teach life skills when other methods have failed.
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