Evidence based medicine

Evidence-based medicine (EBM)—with its focus on treatment approaches based on data and evidence, as opposed to intuition or clinical knowledge—goes to the heart of the differences between the education systems of the United States and many foreign countries. In order to emphasize a broader, patient-centered understanding and approach, EBM has evolved into evidence-based practice (EBP). This practice is a particular challenge for psychiatry, with its suboptimal diagnostic system and the extensive range of biopsychosocial–cultural–spiritual factors that move psychiatrists from generalities to an individualized understanding and treatment of patients. The institution, department, and teachers require strong commitment to effectively implement evidence-based psychiatric practice (EBPP) and help psychiatry residents become proficient in it. Although some international medical graduate (IMG) physicians are disadvantaged due to little or no previous exposure to the EBM paradigm, this disadvantage needs to be addressed with sensitivity. IMG physicians are clearly capable of delivering patient outcomes that are on par with those of graduates from medical schools in the United States.