The clinical section of the Department of Internal Medicine at the University of Ulm consists of a 300-bed hospital. The 17 wards are divided into 12- to 20-bed units. There are no specialty wards but routine specialty rounds each week on all wards. An intensive psychosomatic consultation service was instituted in 1970. It covered 5 wards and the intensive care unit. The consultants were advanced residents in internal medicine and also candidates in psychoanalytic training. The consultation technique was threefold: (1) consultee-oriented, (2) patient-oriented and (3) operational group-oriented. This setting will be described in some detail.
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