What we are dealing with here is fashion, politics and money. I view with no surprise that psychiatric training is being systemically disavowed by American medical school graduates. This must give us cause for concern about the state of today's psychiatry. It must mean at least in part that they view psychiatry as being very limited and unchallenging. DSM-IV is the fabrication upon which psychiatry seeks acceptance by medicine in general.
Insiders know it is more a political than scientific document.
It confines and defines practice, some take it seriously, others more realistically. It is the way to get paid. Diagnostic reliability is easy to attain for research projects. They don't, and can't, because there are no external validating criteria for psychiatric diagnoses. There is neither a blood test nor specific anatomic lesions for any major psychiatric disorder.