Since 1988 there has been nearly a 40% decline in the number of US medical school seniors entering psychiatry. This decrease, from 745 in 1988 to 462 in 1997, is the result of the uncertain medical marketplace, with psychiatry being particularly vulnerable to managed caredriven change. How much this decline is due to competing ideological schools of psychiatry and problems within the specialty itself is a subject of debate.
Mount Misery by Samuel Shem (a pseudonym for Dr Stephen Bergman, a psychiatrist) is the long-awaited sequel to The House of God and could lead to an even more precipitous decline in the medical specialty if it is as widely read as its predecessor. This novel takes the same hero, Dr Roy Basch, through his first year of psychiatric residency at Mount Misery, an apocryphal private psychiatric hospital near Boston. Hoping to find his identity as a healing physician in psychiatry