While in London and in the summers back in the United States, Kramer enrolled in the science courses that prepared him for medical school. In 1972, he entered Harvard Medical School and quickly began exploring the multiplicity of theories and models found within psychiatry.
"I started seeing psychiatric patients in my spare time, such as it was, from the first month I was in medical school at Harvard. I saw patients at Beth Israel Hospital, working mostly with Ted [Theodore] Nadelson, M.D.," he said. "By the time I had finished my undergraduate training, I had almost the equivalent of a residency in the model that Harvard used at that time, which was very Freudian." On a more informal basis, Kramer studied community psychiatry with Milton Mazer, M.D.; psychiatric theory with Leston Havens, M.D.; and social psychiatry with Robert Coles, M.D.
After Harvard, Kramer interned at the University of Wisconsin Hospital in Madison. Although he had a medical internship, he informally began studying group and family psychotherapy with James Gustafson, M.D., and Carl Whitaker, M.D.
When it came time for Kramer to do his psychiatric residency, Havens suggested that he experience an alternative to Harvard's psychoanalytic model by going to Yale University, which emphasized biological psychiatry and community mental health.
"Leston Havens was right to expose me to nonpsychoanalytic psychiatry. I think he saw a pragmatic streak in me. Although I considered myself to be intellectual, I was prone to a brusque practicality," Kramer said.
Havens encouraged taking a broad view of psychiatry. "Yale sent me in that direction," Kramer added, "as did my work in the government, where as a young man, I had oversight of a very broad research portfolio."
From 1980 to 1982, he worked as acting director of the Division of Science for the Alcohol(Drug information on alcohol), Drug Abuse, and Mental Health Administration and then as special assistant for science to the agency's administrator. Kramer often served as a liaison between the scientific community and members of Congress. During those same years, he became an instructor and then assistant clinical professor in the department of psychiatry at George Washington University in Washington, D.C. He also rose from assistant professor in 1982 to clinical professor in the department of psychiatry and human behavior at Brown University.Psychiatric Times
Just after his residency, Kramer wrote a novel. Although the novel was never published, Kramer said it did help him become a columnist for PT.