Integrating clinical and research psychiatry.

Residents involved in clinical research are frequently unprepared for the problems which may arise in relation to the dual roles of clinician-investigator and patient-subject. Common problems for the clinician-investigator will be outlined including: 1. enlisting patients; 2. using treatment one does not necessarily consider first choice; 3. being blind to treatment prescribed; 4. adhering to a fixed treatment protocol; and 5. deciding when to terminate a trial. Possible solutions will also be offered. In addition, the altered role of the patient as subject will also be considered as it affects patient care within trials.