Attitudes toward psychiatry among students entering medical school

The influencing factors of stigma towards people with mental illness among nursing students: a mixed-method systematic review

The stigma of nursing students towards people with mental illness (PMI) creates significant barriers to diagnosis, treatment, and recovery for those with PMI. It can also have a significant impact on the future career choices of nursing students in the field of psychiatry. Current research has found various influencing factors, including personal characteristics and educational influences. However, a comprehensive analysis that encompasses all aspects is lacking. The aim of the study was to conduct a convergent mixed-method systematic review to synthesize the influencing factors of the stigma of nursing students towards PMI according to Framework Integrating Normative Influences on Stigma (FINIS) at micro, meso, and macro levels. PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL and PsycINFO were searched from 1990 to 31 December 2023. The reference lists of the included literature were further checked to identify potentially relevant articles. Two authors independently screened all titles, abstracts, and full-text articles and extracted data. Study quality was assessed by two authors using the Mixed Method Appraisal Tool (MMAT). A total of 4865 articles were initially retrieved, and 73 of these articles were included. The results suggested that the stigma towards PMI by nursing students was influenced by micro, meso and macro levels. At each FINIS level, the most frequent influencing factors are personal characteristics, the treatment system and media images. Numerous interconnected factors exert an influence on the stigma towards PMI among nursing students. Our research can be used to identify barriers and facilitators to nursing students' stigma towards PMI and to provide supporting information for interventions designed to reduce this stigma.

Impact of clinical rotational posting on attitude toward psychiatry of undergraduate medical students in Malaysia

Background

Almost all over the world, psychiatry training of undergraduate medical students has been criticized to be deficient in imparting required knowledge and improving the perception of students towards psychiatry and psychiatric treatment. Considering the large mental health need gap in the community, it is essential to improve undergraduate students' attitude toward psychiatry.

Aim

Hence, this study was planned to study the impact of psychiatry clinical posting on attitude toward psychiatry of undergraduate medical students.

Materials and Methods

Undergraduate medical students undergoing psychiatry posting were assessed on the first and last day of clinical posting with the help of semi-structured proforma consisting of sociodemographic information, favored future career choice, the relevance of psychiatry to their future careers, the usefulness of particular knowledge and skills, the value of knowledge of psychiatric specialties and the utility of different settings for learning psychiatry.

Results

After their clinical posting, students had a more positive attitude towards the usefulness of psychiatry knowledge in future general practice and the usefulness of psychiatry knowledge from undergraduate training in the future. Knowledge of alcohol withdrawal management, detection and management of delirium, and Mental Health Acts were perceived more essential in the future. Also, specialties such as deaddiction and child and adolescent psychiatry were felt more useful in future practice. After posting, students perceived that psychiatry can also be learned at medical and surgical wards as well as during home visits. However, despite some positive changes in attitude toward psychiatry, there was no significant change in choosing psychiatry as a career by the students after posting.

Conclusion

Undergraduate psychiatry training during clinical posting was able to make some positive changes in the knowledge and attitude of students. However, still, there were lacunae in some areas of concern. Preference of psychiatry as a branch of specialization was not increased after posting. This indicates the need for better reforms in psychiatry education at the undergraduate level to improve the perception of undergraduate students about psychiatry.

Diversity of the physician workforce: Specialty choice decisions during medical school

Background

Despite efforts to increase the overall diversity of the medical student body, some medical specialties have a less diverse applicant pool based on both gender and race than would be expected based on medical graduate demographics.

Objectives

To identify whether women and Underrepresented in Medicine (URiM) medical students have baseline differences in their career interests or if their career plans change more during medical school when compared to men and non-URIM students.

Methods

Secondary data analyses of all medical students who applied through ERAS from 2005–2010 was conducted. Binary logistic regression models with the response being a planned career in one of four medical specialties (internal medicine, pediatrics, OB/GYN, and general surgery/surgical specialties) at medical school entry and graduation. Regression models included demographics, student attitudes, debt, academic metrics, and medical school experiences.

Results

Comparatively, women were less likely to be interested in internal medicine and surgery and more interested in pediatrics and OB/GYN at matriculation. URiM students expressed more interest in OB/GYN and surgery when starting medical school. At graduation, women were less likely to plan for internal medicine and surgery and were more interested in pursuing OB/GYN and pediatrics. URiM students were more likely to plan for a career in internal medicine and less likely to choose pediatrics.

Conclusions

From matriculation to graduation, women have relatively stable preferences regarding planned medical specialties. In contrast, URiM students’ specialty plans shifted over time among the four specialties, with variation in preferences occurring between matriculation and graduation.

Stigma, Empathy, and Attitude (SEA) educational module for medical students to improve the knowledge and attitude towards persons with mental illness

OBJECTIVE

The objective was to develop an educational module on stigma, empathy, and attitude towards mental illness and evaluate its effectiveness among undergraduate medical students.

METHODS

In phase I, the authors developed the Stigma, Empathy, and Attitude (SEA) module consisting of interactive teaching-learning components through an experts-based consensus (two rounds of Delphi). In phase II, the effectiveness of the module was evaluated. SEA module (one-hour interactive lecture and three hours' small group teaching) was delivered to the fifth-semester undergraduate medical students (N = 240) once during their psychiatry rotation. Students were assessed with the Mental Health Knowledge Schedule (MHKS), Mental Illness: Clinician's Attitudes (MICA) scale, Jefferson Scale for Empathy (JSE), and Social Distance scale (SDS), to measure mental health knowledge, attitude, empathy, and stigma, at baseline and after delivery of the module. Feedback on the module was obtained from the participating students and faculty.

RESULTS

Baseline data was obtained for 157 students, and post-intervention assessment was completed for 66 students. There was a significant increase in MHKS score (p < 0.001, Cohen's d = 0.59) and a significant reduction in the MICA score (p = 0.016, Cohen's d = 0.31) after the intervention. However, there was no change in empathy and social distance, as measured by JSE (p = 0.23) and SDS (p = 0.31). A majority of the faculty and students were satisfied with the module and felt it should be part of the psychiatry curriculum.

CONCLUSIONS

The SEA module was found to improve medical students' knowledge and attitude towards mental illness and could be integrated as part of the psychiatry curriculum. However, it was ineffective in changing empathy and stigma in the students.

Attitudes of participants of master degree in family medicine in Gezira University, Sudan towards Psychiatry: A vision to sustain continuous gain

Introduction:

Family medicine physicians are first contact of patients in the community and their role in treating mental health is highly recommended. The aim of the current study is to assess attitudes towards psychiatry among doctors enrolled in master degree in family medicine in Gezira University before and after training in psychiatry.

Methods:

This study was a quantitative cross-sectional study with two stages – pre- and post-psychiatry training. It has included one batch of master students of family medicine at Gezira University, Sudan. The whole master program lasts for 18 months, of which 3 weeks are dedicated to psychiatry training. All students in the batch were invited to participate in both stages – before and after psychiatric training.

Result:

31 students participated in the study, 35.5% of them were males (N = 11). Mean age was 39.4 (SD ± 5.34) and mean number of years after graduation was 13.3 (SD ± 4.96). 26 students (83.9%) earned Attitudes Toward Psychiatry (ATP) scores >90, which indicates a positive attitude. The ATP mean score for all participants was 104.26 (SD ± 12.56). The least score was 79 while the maximum was 130. Doctors’ attitudes toward psychiatry became more positive after psychiatric training and this difference was statistically significant (P value = 0.038) and this was found to be statistically significant only among participants below age of 40 years and those who have been graduated less than 15 years ago.

Conclusion:

Psychiatric training for family physicians in training was associated with significant improvement in attitudes towards psychiatry.

Associative stigma among mental health professionals in Singapore: a cross-sectional study

OBJECTIVES

(1) Investigate and explore whether different classes of associative stigma (the process by which a person experiences stigmatisation as a result of an association with another stigmatised person) could be identified using latent class analysis; (2) determine the sociodemographic and employment-related correlates of associative stigma and (3) examine the relationship between associative stigma and job satisfaction, among mental health professionals.

DESIGN

Cross-sectional online survey.

PARTICIPANTS

Doctors, nurses and allied health staff, working in Singapore.

METHODS

Staff (n=462) completed an online survey, which comprised 11 associative stigma items and also captured sociodemographic and job satisfaction-related information. Latent class analysis was used to classify associative stigma on patterns of observed categorical variables. Multinomial logistic regression was used to examine associations between sociodemographic and employment-related factors and the different classes, while multiple linear regression analyses were used to examine the relationship between associative stigma and job satisfaction.

RESULTS

The latent class analysis revealed that items formed a three-class model where the classes were classified as 'no/low associative stigma', 'moderate associative stigma' and 'high associative stigma'. 48.7%, 40.5% and 10.8% of the population comprised no/low, moderate and high associative stigma classes, respectively. Multinomial logistic regression showed that years of service and occupation were significantly associated with moderate associative stigma, while factors associated with high associative stigma were education, ethnicity and occupation. Multiple linear regression analyses revealed that high associative stigma was significantly associated with lower job satisfaction scores.

CONCLUSION

Associative stigma was not uncommon among mental health professionals and was associated with sociodemographic factors and poorer job satisfaction. Associative stigma has received comparatively little attention from empirical researchers and continued efforts to address this understudied yet important construct in conjunction with future efforts to dispel misconceptions related to mental illnesses are needed.

Assessing the attitudes of medical students towards psychiatry: A new paradigm

BACKGROUND

Gauging the probability that medical students will select psychiatry as a career is a challenge, especially in Saudi Arabia, where the profession of psychiatry has still to gain ground. Thus, the aim of the current study was to investigate the attitudes of Saudi medical students towards psychiatry.

METHOD

A total of 317 medical students were recruited in a cross-sectional study. An ATP-30 questionnaire was used. In addition to the suggested cut-off point of 90 in previous studies, the data were also categorized using the visual binning procedure. To enhance the number of significant predictors and obtain more realistic results, an Ordinal Logistic Regression model was applied.

RESULT

The attitudes of medical students towards the three outcomes (dependent) variables; "Overall attitudes towards psychiatry, I want to be a psychiatrist, and Attitudes towards psychiatric treatment" varied across the five explanatory (predictor) variables, when assessed using Ordinal Logistic Regression. Age and gender proved significant with the three outcome variables, whereas Exposure to Psychiatric Clerkship identified "Overall attitudes towards psychiatry" and "Attitudes towards psychiatric treatment". Significant effects from a "Psychiatrist Relative" was found in "Overall attitudes towards psychiatry"and "I want to be a psychiatrist". The predictor variable; "Having a relative who is a psychiatric patient" was found to be significant only with, "I want to be a psychiatrist".

CONCLUSION

The attitudes of medical students towards psychiatry can be predicted in the presence of specific factors. This is discussed in more detail in the relevant part of the study.

Some Australian reflections on problems with recruitment into the profession of psychiatry

Psychiatry has probably always been the least attractive of the medical specialties. The choice of psychiatry as a career has been consistently low in the English-speaking world over the past 50 years (British Medical Journal, 1973; Feifel et al, 1999; Brockington & Mumford, 2002). Over the past decade there has probably been a further decline in the proportion of medical graduates choosing to train in psychiatry (Sierles & Taylor, 1995; Feifel et al, 1999).

Factors that discourage medical students from pursuing a career in psychiatry

Aims and method

This cross-sectional study investigated the evolution of intentions among medical students to pursue a career in psychiatry and the factors that might discourage them from becoming a psychiatrist. A questionnaire survey was sent to medical students in years 1–5 at Aberdeen University.

Results

From 918 students, 467 (51%) returned useable responses. Proportions of students across the 5-year groups who definitely or probably intended to become psychiatrists remained fairly stable at 4–7%. In their final year, psychiatry remained a possible career option for a further 17% of students. The most potent discouraging factor was the perception of poor prognoses among psychiatric patients. Perceptions of a lack of scientific/evidence base reduced enthusiasm for becoming a psychiatrist. Issues relating to the prestige of the specialty were also important.

Implications

If recruitment to the specialty is to improve, these negative perceptions among students should be addressed by their teachers and more widely within psychiatry.

Recruitment into psychiatry: views of consultants in Scotland

AIMS AND METHOD

By use of a postal survey we sought to determine attitudes and beliefs about recruitment to psychiatry. Members of the Scottish Division of the Royal College of Psychiatrists were asked to complete a questionnaire asking their views on the importance of various factors in relation to recruitment (n=387).

RESULTS

Response rates were low from non-consultants and we focused on the views of the 212 consultants (55%) who responded. The perceived low status of psychiatry among other doctors and the belief that individuals with psychiatric disorders are difficult to deal with emerged as the two most important factors seen to affect recruitment. Improving undergraduate teaching in psychiatry was deemed important in enhancing recruitment.

CLINICAL IMPLICATIONS

Dealing with stigma, within and out with the profession, and improving undergraduate exposure to psychiatry may be important in recruiting doctors to psychiatry.

Attitude of undergraduate medical students toward psychiatry: A cross-sectional comparative study

CONTEXT

Both psychiatry as a specialty and mental illnesses carry a lot of stigmatizing attitudes. Even medical professionals are not immune to prevailing stigma. Psychiatrists are perceived to have less scientific attitude, earn less money, to be less respected, and to have less prestige.

AIMS

The present study was designed to know the attitude of medical students with different years of exposure to medical education, toward psychiatry as a specialty.

SETTINGS AND DESIGN

The study was conducted at JLN medical College, Ajmer. The participants were divided into two groups, undergraduate and interns, respectively. It was a cross-sectional descriptive study.

MATERIALS AND METHODS

Self-administered sociodemographic and Attitude Toward Psychiatry-30 items questionnaires were given to the second-year and medical intern and the scores were analyzed using appropriate statistical tools.

STATISTICAL ANALYSIS USED

Student's t-test and Chi-square test using SPSS version 21.

RESULTS

Nearly 84% of second-year medical students and 52% of interns had positive attitude toward psychiatry (P = 0.001). Only five second-year (5%) and two intern (1.8%) students affirmatively indicated to choose psychiatry as a career choice, while 73% denied choosing psychiatry as a specialty.

CONCLUSIONS

Second-year medical students showed more positive attitude than the intern group. Increasing negative attitude in higher classes might be due to poor teaching of psychiatry in under graduate training, ridiculous stereotypic comments and remarks by medical teachers and practitioners belonging to other specialty branches.

Influencing Factors on Choosing Psychiatry as a Career: An Exploration in Chinese University Students

There is a consistent need of psychiatric professionals in the world including China, and a consistent challenge to recruit more medical students into the psychiatric careers. We aimed to look for factors which have an impact on career-choosing of psychiatry in Chinese university students. We invited 508 non-medical students (NM), 304 medical students without (MO) and 123 medical students with clinical internship experience (MW), to answer a matrix of 43 questions regarding factors influencing career-choosing of psychiatry. Answers to these questions were analyzed through exploratory and confirmatory factor analyses, once the latent factors were identified and structurally-validated, their mean scores in three groups of students were calculated. Five factors with five items each were identified, namely social status inferiority, career importance, practice reward, career preference, and practice stress. NM scored lower than MO and MW did on Social Status Inferiority; NM group scored higher than MO and MW groups did on Career Importance; MW scored lower than NM and MO did on Practice Reward and on Career Preference; Regarding Practice Stress, NM scored higher than MO did, who then in turn, scored higher than MW did. In addition, Practice Stress was positively correlated with advice of the medical educators; and Social Status Inferiority and Career Preference were positively correlated with the psychiatry teaching of the medical educators. Raising career rewards, improving social status, and reinforcing psychiatric education might help to recruit more medical students to specialize in psychiatry practicing.

Beginning the Work of Integration: An Investigation of Primary Care Physicians' Attitudes Toward Psychiatry

OBJECTIVE

The authors sought to better understand the attitudes of primary care physicians toward psychiatrists in order to assess their receptivity for further psychiatric education.

METHODS

A survey about attitudes toward psychiatrists in comparison to other specialties was distributed among four family medicine residency programs at Southern Illinois University.

RESULTS

Respondents rated psychiatry lower than other specialties in the areas measured. However, family medicine physicians expressed a desire to work with psychiatrists and receive further education in psychiatry.

CONCLUSION

Favorable attitudes toward psychiatrists and education in psychiatry suggest the potential for additional family medicine training in psychiatry.

Improved Attitudes to Psychiatry: A Global Mental Health Peer-to-Peer E-Learning Partnership

OBJECTIVE

Health links aim to strengthen healthcare systems in low and middle-income countries through mutual exchange of skills, knowledge, and experience. However, student participation remains limited despite growing educational emphasis upon global health. Medical students continue to report negative attitudes to psychiatry in high-income countries, and in Somaliland, the lack of public sector psychiatrists limits medical students' awareness of mental healthcare. The authors describe the design, implementation, and mixed-methods analysis of a peer-to-peer psychiatry e-learning partnership between UK and Somaliland students arising from a global mental health link between the two countries.

METHODS

Medical students at King's College London and Hargeisa and Amoud universities, Somaliland, were grouped into 24 pairs. Participants aimed to complete ten fortnightly meetings to discuss psychiatry topics via the website MedicineAfrica. Students completed initial and final evaluations including Attitudes toward Psychiatry (ATP-30) questions, a stigma questionnaire, and brief evaluations after each meeting.

RESULTS

Quantitative findings demonstrated that enjoyment, interest, and academic helpfulness were rated highly by students in Somaliland and moderately by students in the UK. Somaliland students' attitudes to psychiatry were significantly more positive post-participation, whereas UK students' attitudes remained stable. Qualitative findings identified more gains in factual knowledge for Somaliland students, whereas UK students reported more cross-cultural learning. Reasons for non-completion and student-suggested improvements emphasized the need to ensure commitment to the program by participants.

CONCLUSIONS

This partnership encouraged students to consider global mental health outside the standard medical education environment, through an e-learning format solely utilizing existing resources. This new approach demonstrates potential benefits to students in contrasting locations of brief, focused online peer-to-peer education partnerships, expanding the scope of health links to the medical professionals of the future.

"Why not psychiatry??" Interns of a medical college in Northern Kerala responds

PURPOSE

This study is to assess the attitude of the medical interns toward psychiatry, psychiatrists and patients with mental health problems.

MATERIALS AND METHODS

A personal data sheet and the Balon et al. questionnaire was used to assess the attitude among medical interns (n = 44) of a medical college in Northern Kerala.

RESULTS

There was modestly good attitude toward psychiatry throughout the study. Data were compared between interns who have completed their posting in psychiatry and those who have not. There was no significant difference except for their awareness about consultation liaison services and the authoritative power of psychiatrists in mental health field. The stigma toward psychiatry is on the decline at least among medical professionals, and more interns are interested in taking up psychiatry as a future specialty.

CONCLUSION

Although the study has evidenced a positive attitude to psychiatry, there is still room to improve. A clearer picture could be attained by conducting similar studies in a bigger sample size. A structured curriculum and compulsory internship during the undergraduate course have greatly contributed toward building a more positive opinion of the subject.

Social dominance theory and medical specialty choice

Understanding how medical students select their specialty is a fundamental issue for public health and educational policy makers. One of the factors that students take into account is a specialty's prestige which hinges partly on its focus on technique rather than whole person. We examine the potential of a psychological framework, social dominance theory, to explain why some students, and not others, are drawn to more prestigious, technique-oriented specialties, based on their desire for hierarchy. We conducted a cross-sectional study among medical students at Institution X (N = 359). We examined the link between medical students' characteristics i.e. social dominance orientation (SDO), gender, age, and their career intention. We also examined level of medical students' SDO at different stages of the curriculum. SDO scores were significantly associated with technique-oriented career intentions (OR 1.56; 95 % CI [1.18, 2.06]; p = 0.001). The effect was independent of gender. Medical students' SDO scores were significantly higher in later stages of the medical curriculum (F = 6.79; p = 0. 001). SDO is a significant predictor of medical students' career intention. SDO scores are higher in students during the clinical phase of the curriculum. Medical socialization, involving the internalization of implicit and explicit norms, particularly in hospital settings, is likely to underpin our findings. This theory illuminates consistent findings in the literature on specialty prestige and the influence of medical school on career choice.

Perception, knowledge, and attitude toward mental disorders and psychiatry among medical undergraduates in Karnataka: A cross-sectional study

CONTEXT

Globally, psychiatry as a subject, psychiatrists as professionals, and patients with psychiatric disorders are subjected to cultural stereotypes and negative attitude by the general population. What is of alarming concern is that these prejudices exist within the medical community as well.

AIMS

This study aims at evaluating the perception, knowledge, and attitude toward psychiatric disorders, therapeutic modalities used in psychiatry, psychiatry as a subject and psychiatrists as professionals among undergraduate medical students in Karnataka.

SETTINGS AND DESIGN

This is a descriptive, cross-sectional type of study conducted in three medical colleges located in Karnataka.

MATERIALS AND METHODS

A sample of 500 students from all three professional phases of MBBS was selected using purposive sampling. A semistructured prevalidated questionnaire was used to assess the perception, knowledge, and attitude of undergraduate medical students toward psychiatric disorders and psychiatry.

STATISTICAL ANALYSIS

Data were analyzed using Statistical Package for Social Sciences, version 16.0.

RESULTS

The undergraduate medical student population had significant shortcomings in knowledge and attitude pertaining to psychiatric disorders, more glaring in the initial years of education. A comparatively positive opinion was obtained regarding psychiatry as a subject and psychiatrists as professionals, which may reflect the changing trends and concepts, both in society and medical community.

CONCLUSION

This study highlights the need for better educational measures at undergraduate level in order to shape a positive attitude of the health care providers towards psychiatry, which is essential for ensuring better care for patients as well as reduction of stigma surrounding psychiatric disorders.

Associative stigma related to psychiatric nursing within the nursing profession

This study deals with stigmas towards mental illness, individuals with mental illness, psychiatric nurses, and the role of psychiatric nursing within the nursing profession. Responses from 108 psychiatric nurses and 108 non-psychiatric nurses indicated that stigmas towards mental illness, individuals with mental illness, and the role of psychiatric nursing, are more prevalent among non-psychiatric nurses; associations between these stigmas were found among both psychiatric and non-psychiatric nurses. The findings suggest that both psychiatric and non-psychiatric nurses harbor associative stigma related to the practice of psychiatric nursing. Implications are discussed.

Changing Medical Students' Attitudes to Psychiatry through Newer Teaching Techniques

The significance of mental health in the entire health scenario has increased. However, the representation of psychiatry in the current MBBS curriculum for undergraduate students in India still remains much less than desirable. Further, stigmatising attitudes lessen these future doctors’ ability to detect and manage patients with psychological problems despite adequate knowledge about psychiatry. Students believe that psychiatrically ill patients are unpredictable and can be dangerous to others. Some feel that psychiatry is unscientific, imprecise and treatment is not effective. Traditional teaching methods are directed more towards imparting knowledge than changing the attitudes of students. Newer teaching and assessment techniques should be used to bring about attitudinal changes and develop interest among medical students. Case based and problem based learning, small group teaching, simulated patients, using movies, multidisciplinary seminars, integrated teaching, attitude questionnaires, objective structured clinical examinations etc., could be introduced in the curriculum to achieve this objective.

Differential stigmatizing attitudes of healthcare professionals towards psychiatry and patients with mental health problems: something to worry about? A pilot study

PURPOSE

This study compares stigmatizing attitudes of different healthcare professionals towards psychiatry and patients with mental health problems.

METHODS

The Mental Illness Clinicians Attitude (MICA) questionnaire is used to assess stigmatizing attitudes in three groups: general practitioners (GPs, n = 55), mental healthcare professionals (MHCs, n = 67) and forensic psychiatric professionals (FPs, n = 53).

RESULTS

A modest positive attitude towards psychiatry was found in the three groups (n = 176). Significant differences were found on the total MICA-score (p < 0.001). GPs scored significantly higher than the FPs and the latter scored significantly higher than the MHCs on all factors of the MICA. Most stigmatizing attitudes were found on professionals' views of health/social care field and mental illness and disclosure. Personal and work experience did not influence stigmatizing attitudes.

CONCLUSIONS

Although all three groups have a relatively positive attitude using the MICA, there is room for improvement. Bias toward socially acceptable answers cannot be ruled out. Patients' view on stigmatizing attitudes of professionals may be a next step in stigma research in professionals.

Images of psychiatry and psychiatrists

OBJECTIVE

This study surveyed medical teaching faculty to determine their attitudes toward psychiatry and psychiatrists.

METHOD

We conducted a multisite survey of a probability sample of 1057 teaching medical faculty members from 15 academic teaching centers in the United Kingdom, Europe, and Asia stratified by early, middle, and late career stage. The average response rate across countries was 65%.

RESULTS

The outstanding findings were that 90% of respondents considered that psychiatrists were not good role models for medical students, 84% thought psychiatric patients were unsuitable to be treated outside of specialized facilities, and 73% thought psychiatric patients were emotionally draining. We noted statistically significant differences by country, gender, career stage, and specialty.

CONCLUSION

These results highlight why recruitment into psychiatry is problematic in many countries and suggest that greater attention should be given to improving the perception of psychiatrists as good role models and the efficacy of psychiatric treatments.

Study of attitude of interns toward psychiatry: A survey of a tertiary level hospital in Ahmedabad

BACKGROUND

Worldwide, multiple studies demonstrate a negative attitude of interns toward psychiatry. Scenario in Gujarat state has never been looked upon. The objective of this study is to identify the situation in this region by studying the attitude of interns toward various areas of psychiatry and to study the gender differences if any.

MATERIALS AND METHODS

For study, all 122 interns who attended psychiatry posting for the 1st time in their internship, over a period of 8 months were approached amongst which 100 (56 males and 44 females) consented to be a part. Attitude was measured with 30 items attitude toward psychiatry (ATP 30) questionnaire on the 1st day of their posting. The data thus collected were analyzed by SPSS version 20.

RESULT

The results showed a neutral to the negative attitude in major areas of psychiatry. Most neutral responses were seen regarding contribution of psychiatric hospitals in the treatment, regarding psychiatric patients considered to be interesting and psychiatry enabling people to have rewarding relationships. Negative attitude toward areas on scientific information in psychiatry and psychotherapy's validity were obtained. While attitude was positive in areas of psychiatric knowledge and teaching, but female interns were lagging behind their male counterparts. Psychiatric treatment lessens worries and psychiatric illness should be considered at par with other medical illnesses, were most common positively viewed attitude.

CONCLUSION

Interns overall shared a neutral to negative ATP. Adequate rectification is required in existing medical curriculum, and more exposure to the subject is essential to improve the attitude of interns toward mental health.

Updating medical school psychiatry curricula to meet projected mental health needs

OBJECTIVE

In view of the growing disease burden of mental disorders, we consider the pressing need to update medical school psychiatry education to better equip doctors to recognise and treat these conditions. Key challenges to the delivery of medical school mental health curricula, and possible directions for reform, are reviewed with the aims of stimulating collaboration and enhancing the efficiency across schools.

CONCLUSIONS

In Australia, medical school expansion provides opportunities to prepare many training doctors to meet growing mental health care needs. Despite this, published reviews of practice and curriculum models are notably lacking. Australia, unlike other countries, has yet to agree on a core curriculum in medical school psychiatry, with practices varying widely between schools. Curricula should equip doctors to better recognise and treat common mental disorders during early stages, as well as preparing some for specialist psychiatry training. High-quality, multidisciplinary teaching in varied clinical settings may boost teaching resources. Additionally, medical education provides opportunities to better equip doctors to take care of their own mental health. Key challenges are to achieve a consensus on core curricula across Australian medical schools, and an appropriate proportion of medical school curriculum time for mental disorders, relative to their complexity and large disease burden.

Non-graduate and graduate entry medical students attitudes to psychiatry

OBJECTIVE

Graduate entry medical students' views of psychiatry may differ from those of school leavers. This study hypothesised that (i) exposure to a psychiatry attachment is associated with a positive change in attitudes towards psychiatry in both graduate entry and non-graduate entry students, (ii) graduate entry students exhibit a more positive attitude to psychiatry compared to non-graduate entry students and (iii) graduate entry students are more interested in a career in psychiatry than non-graduate entry students.

METHODS

In this study 247 medical students (118 females and 129 males) completing their psychiatry rotation were invited to complete questionnaires examining career choice, attitudes to psychiatry and career attractiveness for a range of specialties including surgery, medicine, general practice and psychiatry before and after their psychiatry attachment. Questionnaires were distributed prior to commencement of their attachment and redistributed on the final day of the attachment.

RESULTS

Of the 165 participants in the study, 75 students entered medicine via the traditional route (without a primary degree), 49 entered via the graduate entry programme and 41 had a primary degree. Overall, medical students displayed positive attitudes towards psychiatry. However, while there was an improvement in attitudes towards psychiatry and the career attractiveness of psychiatry on completion of the rotation, no differences were found between graduate and non-graduate entry students. Psychiatry and general practice had lower ratings for career attractiveness than other specialities. No significant changes were found in the first and second choice of specialty.

CONCLUSION

Our results show that improvements in attitude and career attractiveness do not necessarily correlate with increased choice of psychiatry as a specialty. Graduate entry has been considered a possible opportunity for increasing recruitment in psychiatry but our results suggest that this may not be the case. Follow-up studies are required to determine whether career attractiveness correlates with future career choice.

Effect of medical education on students' attitudes toward psychiatry and individuals with mental disorders

OBJECTIVE

This study aimed to explore the effect of medical education on students' attitudes toward psychiatry and psychiatric patients, and examined the usefulness of a new evaluation tool: the 6-item Psychiatric Experience, Attitudes, and Knowledge (PEAK-6).

METHOD

Authors studied the attitudes of 116 medical students toward psychiatry and individuals with mental disorders, using two questionnaires before and after a 12-week module of "psychosocial medicine." Results of the 30-item questionnaire Attitudes Toward Psychiatry (ATP-30) were compared with the results of PEAK-6.

RESULTS

With the ATP-30, no change in attitudes toward psychiatry was observed at the end of the module. With the PEAK-6, the item "attitude toward psychiatry" significantly improved. Knowledge of and experience with psychiatry as well as knowledge of and experience with individuals with mental disorders improved significantly; however, attitudes toward individuals with mental disorders did not improve.

CONCLUSION

PEAK-6 seems to be a promising tool with regard to nuanced information about psychiatric learning experiences. Participation in a psychiatric module may be associated with a positive effect on students' knowledge about, experience with, and attitudes toward psychiatry, but not attitudes toward psychiatric patients.

Recruitment to psychiatry in the Czech Republic: 'waiting for resuscitation'?

Recruitment to psychiatry is becoming a serious obstacle in providing first-class mental health treatment in many countries worldwide. We attempt to address this burning issue by examining medical student's attitudes towards psychiatry and factors influencing their career choice in the Czech Republic. In 2010, 71 students in their last year of medical school at the First Faculty of Medicine, Charles University, Prague were recruited in this quantitative cross-sectional online study. From the sample, 16% (n = 11) of students were considering psychiatry as a career path. An important factor in choosing psychiatry as a career path was personal/family presence of mental illness. Longer experience with psychiatry placement also contributed to the choice of psychiatry, as well as participation in elective courses or psychiatric research projects. Students considering psychiatry were less systematic compared to the group not considering psychiatry. Low reported levels of recruitment to psychiatry present a problematic issue in the Czech Republic. To make psychiatry more appealing to medical students, proactive steps by the relevant stakeholders need to be implemented. These strategies should include steps such as allocating more time for psychiatry in the medical curriculum, better quality of lectures, and the inclusion of additional elective courses.

Exploring the ideas and expectations of German medical students towards career choices and the speciality of psychiatry

The aim of this study was to explore the ideas and expectations of medical students toward their career choices and the speciality of psychiatry. A total of 323 students of the Hannover Medical School filled in a questionnaire about their career choices, preferred medical specialization, factors of influence on career choices and attitude towards psychiatry. The three most important factors of influence appeared to be: (1) work-life balance, (2) flexible working hours, (3) career prospects. Although expectations towards the professional life of psychiatrists were quite positive among the students, there was only a small number of students (n = 53 of 318 respondents, 17%) interested in specializing in psychiatry. Important reasons for choosing psychiatry included personal experience with somatic or mental health issues and practical experience in psychiatry. Most of the students experienced clinical exposure to psychiatry but at a much later period in the curriculum. For a career choice of psychiatry as a speciality it seems to be important to start psychiatric education in medical school early. The positive aspects of the professional life in psychiatry, such as flexible working hours, career prospects and good work-life balance should be more emphasized.

Motivations of medical students towards psychiatry: a perspective from Turkey

Recruitment in psychiatry has been an ongoing challenge worldwide; Turkey is no exception. In this article we have reviewed the issue from multiple aspects. Negative opinions on psychiatry among medical students have been associated with various matters, such as problems with scientific soundness, stigma, prestige and financial incentives. It has been reported that these negative opinions could be reversed by clinical exposure, improved knowledge base and increased affiliation with the field. Unfortunately, reversed attitudes do not have permanency. Considering that there has not been any study focusing on recruitment problems in Turkey, we attempted to provide a perspective by reporting the results of our study conducted with Turkish medical students. Attractive qualities of psychiatry were of particular interest. We found that brain research, neuroscience, philosophy, psychotherapy and academics are main areas of interest in psychiatry. We attempt to discuss our findings in view of current literature while noting current setbacks of psychiatry residency training in Turkey. We conclude that there exists a great need for working strategies in order to improve recruitment in psychiatry, addressing the stigma and correcting false beliefs such as treatment inefficacy or compromised scientific solidity.

Psychiatrists and GPs: diagnostic decision making, personality profiles and attitudes toward depression and anxiety

OBJECTIVES

The objective of this article is to explore diagnostic decision making around psychological symptoms presenting to general practitioners (GPs) and psychiatrists, identify attitudinal and personality factors of possible relevance in these decisions, and compare GPs and psychiatrists to help identify potential educational targets.

METHODS

GPs and psychiatrists attended separate peer-facilitated workshops in which two case presentations were discussed. Decision making was explored by structured questions embedded in the workshop, with responses recorded by electronic keypad technology. Participants completed demographic questionnaires and measures of personality and attitudes to depression.

RESULTS

GPs and psychiatrists accorded emphasis to different elements of the history, and assigned different diagnoses based on the same set of symptoms. Both groups relied on non-pharmacological management for milder psychological symptoms; GPs were less likely to make a diagnosis of bipolar disorder. Traits of Extraversion and Agreeableness were associated with greater ease in treating depression.

CONCLUSIONS

Differences in diagnostic decision making likely reflect the different contexts of specialist and generalist practice. Educational targets may include information about key symptoms to assist in diagnostic precision, but further information is needed to determine the best match between diagnostic processes, context and outcome. An awareness of the role of personality factors may help when designing education and support programs.

Which students will choose a career in psychiatry?

OBJECTIVE

In Canada, availability of and access to mental health professionals is limited. Only 6.6% of practising physicians are psychiatrists, a situation unlikely to improve in the foreseeable future. Identifying student characteristics present at medical school entry that predict a subsequent psychiatry residency choice could allow targeted recruiting or support to students early on in their careers, in turn creating a supply of psychiatry-oriented residency applicants.

METHOD

Between 2002 and 2004, data were collected from students in 15 Canadian medical school classes within 2 weeks of commencement of their medical studies. Surveys included questions on career preferences, attitudes, and demographics. Students were followed through to graduation and entry data linked anonymously with residency choice data. Logistic regression was used to identify early predictors of a psychiatry residency choice.

RESULTS

Students (n = 1502) (77.4% of those eligible) contributed to the final analysis, with 5.3% naming psychiatry as their preferred residency career. When stated career interest in psychiatry at medical school entry was not included in a regression model, an exit career choice in psychiatry was predicted by a student's desire for prestige, lesser interest in medical compared with social problems, low hospital orientation, and not volunteering in sports. When an entry career interest in psychiatry was included in the model, this variable became the only predictor of an exit career choice in psychiatry.

CONCLUSION

While experience and attitudes at medical school entry can predict whether students will chose a psychiatry career, the strongest predictor is an early career interest in psychiatry.

Who picks psychiatry? Perceptions, preferences and personality of medical students

OBJECTIVES

This study aimed to characterise the personality profiles of junior medical students most likely to choose psychiatry as a career, determine aspects of psychiatry that most attract potential recruits, and identify misperceptions about psychiatry that may dissuade students from pursuing this specialism.

METHOD

A total of 580 second-year medical students from the University of New South Wales, Australia completed a set of questionnaires that measured the likelihood with which various medical specialties were being considered as careers, personality traits using the NEO Five-Factor Inventory (NEO-FFI), and the degree to which students perceived each specialty as attractive across a number of parameters.

RESULTS

Only 86 students (15%) indicated a strong likelihood of choosing psychiatry, compared to other specialties which attracted higher proportions of students (range 19-49%). These 86 students had significantly higher openness scores than those who indicated a lesser likelihood of pursuing psychiatry. Students who were highly interested in psychiatry ranked it as very attractive in respect to providing interesting and challenging subject matter, and relatively attractive in respect to financial reward, work enjoyment, good lifestyle, having a bright and interesting future, and association with colleagues. However, psychiatry remained less attractive with respect to prestige, perceived low effectiveness of treatments, degree to which it draws upon aspects of medical training, and lack of reliable scientific foundation. Within the entire sample, psychiatry was ranked most unattractive compared to the other specialties across eight of the 13 parameters assessed.

CONCLUSIONS

Students interested in psychiatry are more likely to be 'open' and view the specialty as interesting and challenging. Such characteristics should be promoted more widely along with countering myths that as a specialty, psychiatry lacks a scientific foundation or is somehow different from mainstream medicine in terms of training and outcomes. Championing psychiatry in this manner may attract more recruits and enhance its prestige.

WPA guidance on how to combat stigmatization of psychiatry and psychiatrists

In 2009 the WPA President established a Task Force that was to examine available evidence about the stigmatization of psychiatry and psychiatrists and to make recommendations about action that national psychiatric societies and psychiatrists as professionals could do to reduce or prevent the stigmatization of their discipline as well as to prevent its nefarious consequences. This paper presents a summary of the Task Force's findings and recommendations. The Task Force reviewed the literature concerning the image of psychiatry and psychiatrists in the media and the opinions about psychiatry and psychiatrists of the general public, of students of medicine, of health professionals other than psychiatrists and of persons with mental illness and their families. It also reviewed the evidence about the interventions that have been undertaken to combat stigma and consequent discrimination and made a series of recommendations to the national psychiatric societies and to individual psychiatrists. The Task Force laid emphasis on the formulation of best practices of psychiatry and their application in health services and on the revision of curricula for the training of health personnel. It also recommended that national psychiatric societies establish links with other professional associations, with organizations of patients and their relatives and with the media in order to approach the problems of stigma on a broad front. The Task Force also underlined the role that psychiatrists can play in the prevention of stigmatization of psychiatry, stressing the need to develop a respectful relationship with patients, to strictly observe ethical rules in the practice of psychiatry and to maintain professional competence.

Development and responsiveness of a scale to measure clinicians' attitudes to people with mental illness (medical student version)

OBJECTIVE

We report the rationale, reliability, validity and responsiveness studies of the Mental Illness: Clinicians' Attitudes (MICA) Scale, a 16-item scale designed to measure attitudes of health care professionals towards people with mental illness.

METHOD

Items were generated through focus groups with service users, carers, medical students and trainee psychiatrists. Psychometric testing was completed in a number of student samples. The responsiveness of the scale was tested after a 1.5 h mental illness stigma related intervention with medical students.

RESULTS

The MICA scale showed good internal consistency, alpha = 0.79. The test-retest reliability (concordance) was 0.80 (95% CI: 0.68-0.91). The standardised response mean for the scale was 0.4 (95% CI 0.02-0.8) after a mental illness related stigma intervention.

CONCLUSION

The MICA scale is a responsive, reliable and valid tool, which can be used in medical education and mental health promotion settings and studies.

Familiarity breeds respect: attitudes of medical students towards psychiatry following a clinical attachment

OBJECTIVE

The aim of this paper was to examine the influence of a clinical attachment in psychiatry on medical students' attitudes to psychiatry as a specialty and potential career.

METHOD

Medical students at Sydney Medical School were surveyed following an 8-week clinical attachment in psychiatry. Secondary analyses sought to identify associations with variables such as age, gender and level of clinical experience as a medical student.

RESULTS

Following a clinical attachment in psychiatry, 80% of students rated their attitude to psychiatry as more positive. Approximately 32% rated themselves as likely or very likely to choose a career in psychiatry. No differences were seen with respect to gender, age or stage of training. The quality of the teaching, enthusiasm of the clinical teachers, the holistic approach and scientific basis of psychiatry were cited by students as factors influencing attitudes.

CONCLUSIONS

The clinical rotation in psychiatry is a significant factor influencing medical student attitudes towards psychiatry.

Strategies to Improve Recruitment into Rheumatology: Results of the Workforce in Rheumatology Issues Study (WRIST)

Objective.

By 2026, there will be a 64% shortfall of rheumatologists in Canada. A doubling of current rheumatology trainees is likely needed to match future needs; however, there are currently no evidence-based recommendations for how this can be achieved. The Workforce in Rheumatology Issues Study (WRIST) was designed to determine factors influencing the choice of rheumatology as a career.

Methods.

An online survey was created and invitations to participate were sent to University of Western Ontario (UWO) medical students, UWO internal medicine (IM) residents, Canadian rheumatology fellows, and Canadian rheumatologists. Surveys sent to each group of respondents were identical except for questions related to demographics and past training. Participants rated factors that influenced their choice of residency and scored factors related to the attractiveness of rheumatology and to recruitment strategies. Statistical significance was determined using chi-squared and factor analysis.

Results.

The survey went out to 1014 individuals, and 491 surveys were completed (48.4%). Responses indicated the importance of exposure through rotations and role models in considering rheumatology. Significant (p < 0.002) differences between groups were evident regarding what makes rheumatology attractive and effective recruitment strategies, most interestingly with rheumatologists and trainees expressing opposite views on the latter.

Conclusion.

Recommendations are made in 2 broad categories: greater exposure and greater information. As medical students and IM residents progress through their training, their interest in rheumatology lessens, thus it is important to begin recruitment initiatives as early as possible in the training process.

Psychiatric curriculum and its impact on the attitude of Indian undergraduate medical students and interns

CONTEXT

Psychiatry is given very less importance in the Indian undergraduate medical curriculum and this affects the attitudes of students toward psychiatry and mentally ill patients.

AIM

To study the attitude of undergraduate medical students and interns toward psychiatry and mentally ill patients.

MATERIALS AND METHODS

Undergraduate medical students and interns of a private medical college and research institute in South India consented to form our sample. We studied the General Health Questionnaire, overall level of satisfaction in ongoing Medical course using Visual Analog Scale, attitudes toward psychiatry scale and the attitudes toward mentally ill patient's scale of the students, with their informed consent. SPSS version 18 was used for analysis of data.

RESULTS

Participation rate was 96%. Mean age of entire sample was 20.56 years. The total mean score on the General Health Questionnaire was 13.52 in first year but became worse toward internship (18.2). The level of satisfaction in the medical course dipped from 86% at baseline to 20% during internship. Equally high scores were noted in the attitude toward mentally ill scale. On the attitude toward psychiatry scale, there were more views on psychiatry as being an unscientific specialty, psychiatrists being considered poor role models, and psychiatric teaching was of low quality and psychiatry was the least preferred career choice.

CONCLUSIONS

The undergraduate medical students have a very unfavorable attitude toward psychiatry and mentally ill patients.

Attitudes of Flemish physiotherapy students towards mental health and psychiatry

OBJECTIVES

In general, psychiatry is not very popular among healthcare providers, although no information is available concerning the attitudes of physiotherapy students towards mental heath. This study examined the attitudes of physiotherapy students towards psychiatry considering the subject's gender, previous experience with psychiatry and the impact of a specific course.

METHOD

This experimental study compared the attitudes of physiotherapy students (n=219) with those of students without a biomedical background (n=112) towards psychiatry. All students were between 17 and 28 years of age, and completed an established international questionnaire entitled 'Attitudes Towards Psychiatry'. Within the group of physiotherapy students, the effect of a 65-hour course on psychiatric rehabilitation on their attitudes was evaluated.

RESULTS

Attitudes towards psychiatry were moderately positive [mean (SD) 103.3 (9.9)]. There was a small but significant difference between physiotherapy students and non-medical students (Cohen's d=0.31). Female students had a more positive attitude towards psychiatry than their male peers (Cohen's d=0.44). Prior experience with mental illness was associated with more positive attitudes (Cohen's d=0.68). Attitudes increased in positivity after completion of a psychiatry course (Cohen's d=0.72).

DISCUSSION AND CONCLUSION

To ensure basic physiotherapeutic treatment for the mentally ill, physiotherapy education should aim to promote positive attitudes towards mental illness as well as psychiatry. High-quality courses and personal interaction with patients are the best strategies to achieve this goal.

Choosing a career in psychiatry: factors associated with a career interest in psychiatry among Canadian students on entry to medical school

OBJECTIVE

To report the proportion of Canadian medical students interested in a career in psychiatry at medical school entry and to describe the unique demographics and career influences associated with this early interest.

METHODS

From 2001 to 2004, during the first 2 weeks of medical school, a 41-item survey of career choice, demographics, and attitudes toward various aspects of medical practice was distributed to all students in 18 classes at 8 Canadian medical schools. Associations between early career interest, demographics, and career influences were explored.

RESULTS

Of the 2096 completed surveys, 3.2% of students named psychiatry as their first career choice. While 34% of students considered psychiatry a possible career option, 54.9% stated that they had not considered this option. Students interested in psychiatry were more likely than other students to have an undergraduate education in the arts, to have close family or friends practicing medicine, and to have worked voluntarily with people with mental illness. Students interested in psychiatry had a lesser social orientation than students interested in family medicine but had a greater social orientation and lesser hospital orientation than students interested in other specialties.

CONCLUSIONS

Enhanced psychiatric care may be aided by the selective recruitment into medical school of students with a demonstrated empathy toward people with mental illness, an educational background in the arts, and a strong social orientation. As career influences change throughout medical school, participants in this study will be re-surveyed at graduation to better understand the evolution of career choice decision-making throughout medical school.

Medical students' attitudes towards a career in psychiatry before and after viewing a promotional DVD

OBJECTIVES

The objectives were, first, to determine attitudes towards psychiatry as a career among medical students currently enrolled at the University of Sydney and, second, to establish the immediate impact on those attitudes of a promotional DVD, released by the Royal Australian and New Zealand College of Psychiatrists.

METHOD

Medical students enrolled in the University of Sydney in 2008 were invited to complete a voluntary online questionnaire, in which their attitudes towards psychiatry were explored, and the immediate effects of a 15-minute DVD were ascertained.

RESULTS

A total of 123 students participated. Only one student identified psychiatry as their chosen career. Medical students viewed psychiatry as the least attractive specialty for the degree to which patients are helped effectively and in terms of having a reliable scientific foundation. However, it rated well in regard to being intellectually challenging, a rapidly advancing field of medicine, and providing research opportunities and a good lifestyle. Psychiatry is less respected than most other specialties by students and they perceive this discipline to be poorly respected by other medical students and current medical practitioners. After viewing the DVD, there were improved student ratings of the benefits of a career in psychiatry, especially in relation to the specialty being enjoyable, offering effective treatment and having a scientific foundation. There was also enhanced understanding of the role of a psychiatrist in just over half of the participants and increased interest in psychiatry in about 30% of participants. The DVD was most effective in increasing awareness of the diversity of subspecialties available within psychiatry, good lifestyle factors, and the training involved.

CONCLUSION

Among medical students, psychiatry is perceived as unattractive and fails to command the respect afforded other specialties. The viewing of a promotional DVD by medical students was found to be effective in improving their attitudes towards psychiatry and increasing their interest in pursuing a career in the specialty. However, the long-term impact of this modest improvement is unknown and the low survey response rate limits the extent to which the results can be generalized.

Influence of educational programs on attitudes of medical students towards psychiatry: Effects of psychiatric experience, gender, and personality dimensions

BACKGROUND

Attitudes of medical students form the basis for medical actions. Because of the specific characteristics of psychiatric patients, positive attitudes of medical students towards psychiatry should be a higher goal in medical education.

AIM

We hypothesize that medical students in different educational programs develop different attitudes towards psychiatry.

METHODS

In a cross-sectional study, students enrolled in different educational programs completed the 'attitudes towards psychiatry' questionnaire (ATP-30). Data concerning experiences in psychiatry, personality traits and socio-demographic variables including gender were also analyzed.

RESULTS

The response rate of students in the PBL-curriculum (n = 61) was >90%, in the traditional curriculum (n = 280) >75%. Attitudes towards psychiatry of male students in the Problem-Based Learning program were equal to the female students' attitudes in both programs. Female students' attitudes in the traditional curriculum reached comparably good results while male students' displayed the worst attitudes. The personality factors 'openness to experience' and 'agreeableness' correlated significantly with positive attitudes towards psychiatry. PBL-students showed significantly more 'openness to experience'.

CONCLUSION

Educational programs might play a role for the development of attitudes towards psychiatry, especially in male students. Factors influencing enrollment into special educational programs should also have been taken into account. An independent study with a larger number of participants will be required to support these findings.

Mental health treatment needs for medical students: a national longitudinal study

Purpose

We aimed to study the occurrence and predictors of medical students' mental health problems that required treatment.

Subjects and methods

Medical students from all Norwegian universities (N = 421) were surveyed in their first term (T1), and 3 (T2) and 6 (T3) years later. The dependent variable was “Mental health problems in need of treatment”. Predictor variables included personality traits, medical school stress and negative life events.

Results

The lifetime prevalence of mental health problems was 15% at T1. At T2, of the 31% who reported problems during the first 3 years, a majority had not sought help. At T3, 14% reported problems during the preceding year. Adjusted predictors of problems at T2 were previous mental health problems (p < .001), low level of intensity personality trait (extraversion) (p < .01), reality weakness personality trait (p < .01), perceived medical school stress (p < .05) and negative life events (p < .05).

Discussion

Mental health problems during the first 3 years were predicted by previous problems, personality, medical school stress and negative life events.

Conclusion

A third of the students reported mental health problems during the first 3 years. Intervention should focus on both individual problems and contextual stress.

Current issues in undergraduate psychiatry education: the findings of a qualitative study

BACKGROUND

Recruitment into psychiatry is correlated with the quality of undergraduate medical school teaching programmes and with a commitment of major resources to teaching students. There is an extensive literature related to attitudes towards psychiatry but less on the learning and teaching of psychiatry.

AIMS

To identify the current issues in undergraduate psychiatric education in the UK for lead teachers at UK medical schools.

METHOD

Semi-structured telephone interviews with psychiatric leads at UK medical schools. A total of 26 participants were interviewed from 23 different medical schools.

RESULTS

Three key areas of problems were identified: issues related to teaching personnel (e.g. conflict of time), teaching resources and impact of teaching on recruitment (e.g. role models; stigma). Eight potential solutions to address the problems were identified and these included improving the quality of teaching, improving the perceived value of the discipline and recruiting teachers.

CONCLUSION

There are several problems facing teachers in psychiatry but the teachers are also able to identify solutions which need support from both education and health if they are to be implemented.

Prestige and its significance for medical specialties and diseases

AIMS

The aim of this paper is to review the literature concerning the existence of prestige hierarchies for medical specialities and diseases. Moreover, the implications of prestige for priority setting in healthcare systems are discussed.

METHODS

The study is based on a review of the literature. Papers were obtained through the National Library of Medicine, PubMed. The search was conducted on 14 July 2005, and included articles from 1950 until that date. The medical subject headings "disease", "illness", and "medical specialities" were combined with the search word "prestige". A total of 183 papers were found. Only studies focusing on prestige hierarchies for medical specialities and diseases were included. The final search identified 20 articles, six of which specifically established hierarchies for medical specialities and diseases.

RESULTS

The review documented prestige hierarchies for medical specialities and diseases. Explanatory characteristics behind the distribution of prestige were identified. It was demonstrated that active, specialized, biomedical, and high-technological types of medicine practised on organs in the upper part of the bodies of young or middle-aged people were accorded high levels of prestige. Medicine with the opposite characteristics had low levels of prestige.

CONCLUSIONS

Medical specialities and diseases differ with regard to prestige. Characteristics related to specialties and diseases determine their prestige. The authors suggest that differences in prestige bear consequences for actual priority setting in healthcare systems, and contend that this should be further investigated.