Changing undergraduate attitudes to mental illness

Undergraduate learning in psychiatry: can we prepare our future medical graduates better?

Irish medical schools attract an increasingly diverse student population and produce graduates who will practise in many parts of the world. There are particular implications in this for the planning and delivery of the undergraduate psychiatry curriculum. In all countries, mental health services struggle for equitable resourcing, and mental health care within general medical services remains relatively neglected. The traditional undergraduate psychiatry offering has been justifiably criticised for being excessively oriented towards secondary care when the vast majority of medical graduates will pursue careers in primary care or in specialties other than psychiatry. Recently published articles in the Irish Journal of Psychological Medicine address the current challenges and opportunities in providing an undergraduate experience that better prepares students for the mental health aspects of medical practice in a global context. We summarise and discuss these contributions and the recent Royal College of Psychiatrists publication Choose Psychiatry: Guidance for Medical Schools.

Changing attitudes to psychiatry and interest in the specialty as a career choice during clinical undergraduate years at a medical school in Penang, Malaysia

BACKGROUND

Studies have suggested that the undergraduate clinical clerkship improves medical students' attitudes to psychiatry and career interest in the specialty, but few studies have explored the sustainability of these changes.

AIMS

To explore changes in students' attitudes to psychiatry and career preference for psychiatry during the course of their senior clinical years at RCSI & UCD Malaysia Campus (RUMC).

METHODS

All year 3 students (n = 111) at RUMC were invited to complete the Attitudes towards Psychiatry questionnaire (ATP-30) and a separate questionnaire seeking opinions on career preferences. The questionnaires were administered at 3 points in time: in year 3 before the 8-week psychiatry posting, following completion of the posting in year 4, and at the end of year 5. Quantitative data analysis was performed using SPSS version 18, and free-text responses were thematically analysed.

RESULTS

One hundred completed questionnaires (90.1%) were returned. There was a significant improvement in students' ATP scores after their psychiatry rotation and this was sustained into year 5. Psychiatry as a career choice had highest preference levels following completion of the clerkship but declined in year 5 to below pre-clerkship preference levels. Qualitative analysis of factors influencing a career in psychiatry revealed themes of job satisfaction, lifestyle factors, perceived image of psychiatry, and self-appraisal.

CONCLUSIONS

Our findings suggest that an enriched undergraduate clinical clerkship experience can help to sustain improved attitudes to psychiatry into the final medical year. However, declining interest in the specialty a career choice prior to graduation presents an enduring challenge.