Kahne (10) (has also) recorded a decrease in suicide when “psychiatrically sophisticated” (i.e. residents) were the personnel that were changing. In the situation described here only the chief resident was psychiatrically sophisticated. The other resident had just graduated from medical school. Furthermore, to a ward that previously had a senior psychiatrist in the position of authority, any resident, no matter how experienced, might appear to be “unsophisticated.”
An outbreak of violence among inpatients coincident with the beginning of a residency training program is described. The phenomenon is viewed as an example of covert staff disagreement resulting in the scapegoating of black patients. Suggestions are made as to how to avoid the occurrence of similar phenomena through a process of re-education of ward staff.