Psychosomatic medicine. A context for the teaching of physician-patient relationships

The objectives and contents in teaching behavioural science and interviewing skills to medical students has found widespread acceptance. However, the context in which this teaching takes place differs widely. Neither psychiatry and special interviewing courses, nor basic behavioural science and training in internal medicine provide, in their present form, an appropriate context for this teaching. The contention is advanced that psychosomatic medicine, stressing the hermeneutic dimension in the diagnosis and treatment of somatic illness, can provide the appropriate context. Preliminary results from a continuing evaluation program of psychosomatics teaching at the University of Heidelberg are presented here to illustrate the viewpoint that the most relevant changes in students' behaviour should be sought for in the connotative meaning of patient-generated signs and in the emotional significance of the patient's and the physician's perceptions.