Pilot study of current factors influencing the choice of psychiatry as a specialty

Attitudes Toward Psychiatry Among Medical Students With a Psychiatric Major at Chongqing Medical University

OBJECTIVES

To understand the attitudes of medical students with a psychiatry major toward psychiatry at Chongqing medical university in China and to find out factors influencing students' career choice.

METHODS

The present study used an online web survey tool to assess the attitudes toward psychiatry amongst 422 students majoring in psychiatry at Chongqing medical university in China using sociodemographic and Attitudes Toward Psychiatry-30 items (ATP-30) scales. Descriptive statistics and logistic regression analysis were used to examine associated factors.

RESULTS

Three hundred and sixty-nine students (87%) answered the questionnaire. Nearly 54.5% of participants had overall positive attitudes to psychiatry and 80.8% thought psychiatrist could be a career choice. Of the students, 5.1% showed that they did not want to be a psychiatrist while the remaining 14.1% were undecided. The first and fifth year students showed less desire to be a psychiatrist (74.3 and 69.8%, respectively); the highest percentage recorded is of the third year (90.6%). Female participants, in contact with patients suffering from mental illness, were willing to study psychiatry as a master degree and see good prospects were positive factors in choosing psychiatry as a career.

CONCLUSIONS

Students generally have good expectations toward psychiatry, but different opinions are also held and the field is still faced with various challenges in order to provide more psychiatrists.

Attitudes Towards Psychiatry in Lebanese Medical Students: What Are the Factors that Could Lead to a More Favorable Outlook?

OBJECTIVE

The authors aimed to assess the attitudes towards psychiatry of all Lebanese medical students, as well as the factors that could have led to these attitudes, whether favorable or not.

METHODS

In this cross-sectional study, the authors ran a questionnaire among a sample of Lebanese medical students from all medical faculties, regions in Lebanon, and years of medical school, using the ATP-30 scale and the WHO-5 well-being index. The answers from the 607 participants were statistically analyzed on SPSS version 23.0.

RESULTS

Among participants, 95.1% had a positive attitude towards psychiatry, reflecting a favorable outlook among Lebanese medical students overall. The average ATP-30 score in our sample was 111.95 out of 150 (SD = 12.55), which is in the range of countries of higher socio-economic level such as Germany and Switzerland. Also, 26.5% of participants reported that they consider psychiatry as a potential career choice. No demographic factor had any influence on the ATP-30 score. In the multivariate analysis, only two factors resulted in favorable attitudes: exposure to a patient with a diagnosed psychiatric illness in the student's surroundings and a lower WHO-5 well-being index.

CONCLUSION

This study's results do not fit into the traditional "developed vs. developing countries" paradigm. However, Lebanon still has a lot of challenges to face in order to provide quality mental healthcare.

Who wants to do psychiatry?

Aims and Method

The study aimed to determine whether medical students who participated in a student psychotherapy scheme aimed at helping them learn about the doctor-patient relationship were more likely to choose psychiatry as a career than a control group who did not participate. One hundred and ninety-eight medical students who participated in the University College and Middlesex School of Medicine (UCMSM) Psychotherapy Scheme between 1982 and 1992, and 200 randomly selected students of the same period who did not, were sent a questionnaire asking about career choice.

Results

Seventy-seven of 163 participants in the scheme who sent back the questionnaire had not thought about doing psychiatry before entering the scheme. Of these, 11 became psychiatrists (14.3%), compared with only two (1.6%) of the 128 controls (of 152 respondents) who had not considered psychiatry as a career at the same stage. This difference is highly significant (P<0.001). Many of the participants, including those who did not specialise in psychiatry, emphasised how the scheme had helped them understand the doctor-patient relationship.

Implications

Participating in the Student Psychotherapy Scheme encouraged medical students to choose psychiatry as a career. This knowledge is important, particularly in view of the current recruitment crisis in psychiatry.

Attitudes to psychiatry: a comparison of Spanish and US medical students

There is a growing concern in many countries over the low recruitment into psychiatry among medical graduates. This has led to studies that aim: (1) to study the attitudes of medical students towards psychiatry, (2) to determine factors that influence such attitudes, (3) to assess the possible causes of this low recruitment and (4) to try to change students’ views of psychiatry during their medical education to improve recruitment.

Factors Affecting the Choice of Psychiatry as a Specialty and Satisfaction among Turkish Psychiatry Residents

OBJECTIVE

This study aimed to investigate the factors affecting the choice of psychiatry among psychiatry residents, identify the fulfillment of expectations, and assess their satisfaction level.

METHODS

Anonymous questionnaires were administered to 98 psychiatry residents, and sociodemographic and professional data were collected.

RESULTS

Among the reasons for choosing psychiatry, the opportunity to cultivate interest in humanities, importance of social and relational issues, and intellectual challenge were most frequently selected. The opportunity for complete use of medical training, salary, and opportunity to practice psychotherapy were the expectations least met. The largest group of participants was satisfied to have chosen psychiatry (41.5%), decided on psychiatry training after medical school (35.4%), and attached importance to becoming a clinician (70.7%).

CONCLUSIONS

Although the satisfaction level was high in this study, addressing the areas in which expectations were not met may increase the satisfaction of psychiatry residents and the selection of psychiatry as a specialty.

Undergraduate medical students' attitudes towards psychiatry: an international cross-sectional survey between India and Japan

Undergraduate psychiatric education has an important role in developing psychiatric knowledge, decreasing stigma towards mental illness, and promoting psychiatry as a career choice. The attitudes and beliefs of medical students towards psychiatry have not been well understood, especially in non-western countries. To clarify this aspect, we have conducted a cross-sectional study between India and Japan. This study, conducted at two centres, one each in India and Japan, used a semi-structured questionnaire to evaluate the attitudes and beliefs of third-year medical students towards mental illness and psychiatry; such as emotions experienced dealing with psychiatric patients, aetiology and treatment of psychiatric disorders, and psychiatry as a career choice. A total of 79 medical students from India and 77 from Japan participated in the present study. Significant differences were observed in the emotions experienced by the medical students while dealing with psychiatric patients. Most medical students (> 90%) from both study sites favoured psychiatrists for treatment of psychiatric illness. Psychiatry as a carrier choice was significantly related to the nationality of the medical students. The findings of the current study provide insight in to the attitudes of third-year medical students from India and Japan towards psychiatric patients.

Hunter New England Training (HNET): how to effect culture change in a psychiatry medical workforce

OBJECTIVE

It is now recognized that education and training are at the core of quality systems in health care. In this paper we discuss the processes and drivers that underpinned the development of high quality education and training programs and placements for all junior doctors. The early identification and development of doctors interested in psychiatry as a career, engagement and co-operation with the broader junior doctor network and the creation of teaching opportunities for trainees that was linked to their stage of development were identified as key to the success of the program.

CONCLUSIONS

Targeted, high quality education programs and clinical placements coupled with strategic development of workforce has reduced staff turn over, led to the stabilization of the medical workforce and created a culture where learning and supervision are highly valued.

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.

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.

Evaluation of the Claassen Institute of Psychiatry for Medical Students

OBJECTIVE

Psychiatric educators need to develop innovative strategies to attract more medical students to psychiatry. In 2008, the University of Western Australia held the inaugural Claassen Institute of Psychiatry for Medical Students. This novel program aimed to increase students' level of interest in psychiatry as a career opportunity.

METHOD

Students completed baseline and follow-up questionnaires. Questions were rated on a scale of 1 to 10.

RESULTS

Thirty students participated. The average age was 25.5 years and 11 were male. The mean interest and knowledge in psychiatry from baseline to follow-up increased from 7.8 to 8.9 and 5.8 to 7.3, respectively. Mean interest and knowledge in neurosciences increased from 6.9 to 7.7 and 4.3 to 6.2, respectively. Paired t sample tests were significant (p<0.001). Students 'definitely considering' a career in psychiatry increased by 20% overall from baseline to follow-up. Enjoyment and organization of the week were rated highly.

CONCLUSIONS

The Institute is an innovative teaching strategy targeted towards medical students. The program increased the level of interest shown by students in psychiatry as a career. The Institute may positively contribute to recruitment of students to psychiatry training programs and it is planned to run it annually.

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.

The impact of contact with psychiatry on senior medical students' attitudes toward psychiatry

OBJECTIVE

To investigate the attitudes of Danish medical students as to the attractiveness of psychiatry as a career possibility and to asses the impact on such attitudes of actual contact with psychiatry.

METHOD

A base-line survey included 222 senior medical students, of whom 160 were also surveyed subsequent to a 4-week psychiatric affiliation.

RESULTS

The base-line survey shows that psychiatry is rated as less attractive than other specialization groups, and that working as health assistants in psychiatric wards contributes to the problematic image. However, a 4-week psychiatric affiliation resolves a number of image issues, and following such an affiliation more medical students were considering specializing in psychiatry.

CONCLUSION

The findings of this study suggest that psychiatric affiliations can influence students' attitudes to psychiatry. The observed changes in attitudes lead to the presumption that some aspects of the image problem of psychiatry stem from inadequate knowledge of psychiatry as a specialty and the actual work psychiatrists perform.

Attitudes toward psychiatry among students entering medical school

OBJECTIVE

To survey the attitudes of Australian medical students to determine their views about the relative attractiveness of psychiatry as a career compared with other specialties, and against findings from a North American study.

METHOD

We surveyed 655 first-year medical students attending six Australian Universities.

RESULTS

Responses indicated that Australian medical students view psychiatry as distinctly less 'attractive' than other career options, as reported in the North American sample. In comparison with other disciplines, psychiatry was regarded as more interesting and intellectually challenging, but also as lacking a scientific foundation, not being enjoyable and failing to draw on training experiences.

CONCLUSION

Our findings suggest that psychiatry has an image problem that is widespread, reflecting community perceptions and the specialist interests of medical students on recruitment. If psychiatry is to improve its 'attractiveness' as a career option, identified image problems need to be corrected and medical student selection processes re-considered.

Shrinking away from psychiatry? A survey of Australian medical students' interest in psychiatry

OBJECTIVE

We sought to examine the attitudes of newly recruited medical students towards psychiatry and other specialties to determine what factors influence their career choice options.

METHOD

We surveyed the attitudes of 655 medical students using a 31-item self-report questionnaire.

RESULTS

Australian medical students rated the ability to help patients as the most important aspect of a specialty in determining their choice. Attraction to psychiatry was based on the specialty being interesting and intellectually challenging,and providing a career that promised job satisfaction with good prospects and enjoyable work. Females expressed a greater interest in psychiatry and were more likely to consider pursuing it as a career, principally due to a greater interest in the subject matter and a stronger desire for interaction with patients. The least attractive aspects of psychiatry were its lack of prestige among the medical community and a perceived absence of a scientific foundation.

CONCLUSION

The attitudes of medical students can perhaps be modified and recruitment into psychiatry enhanced by presenting the reality of psychiatry today - namely the wide range of available therapeutic processes, the predominantly positive outcomes, the interesting and intellectually challenging nature of the subject and its nurturing and accommodating work environment.

What factors contribute to senior psychiatry residents' interest in geriatric psychiatry? a Delphi study

OBJECTIVE

To generate hypotheses regarding factors that influence senior psychiatric residents, to consider treating geriatric patients in their future practices.

METHOD

Using the Delphi technique, designed to generate ideas and consensus, we asked psychiatry residents at the University of Toronto who had completed, or were completing, their geriatric rotation about the factors they thought might influence residents in devoting some of their practice to geriatric patients. Residents then rated the degree of influence of these factors which had been synthesized into a questionnaire.

RESULTS

Twenty-six items were rated according to their degree of influence. The most influential item was positive clinical experiences with seniors. This was followed closely by supervisor characteristics such as enthusiasm, role modeling, competence, and mentoring. Interest in and comfort with the medical psychiatric and neuropsychiatric nature of the field were also felt to be influential.

CONCLUSIONS

The factors that influence senior psychiatry resident interest in the practice of geriatric psychiatry are primarily educational and result from exposure to the field under optimal educational circumstances (positive clinical experiences and excellent supervisors). The medical and neuropsychiatric nature of the field also likely exerts a unique influence and should be considered in stimulating interest in this population.

Medical students' attitudes toward psychiatry in Greece : an eight-year comparison

This study is a comparative investigation of the attitudes toward psychiatry of two medical student groups who did their undergraduate training in psychiatry in 1985 and 1993. Attitude assessments were carried out by using the Libertarian Mental Health Ideology Scale (LMHIS). The students completed the questionnaire twice, at the beginning and at the end of their clerkship. The LMHIS was also completed by the teaching staff. Both medical student groups showed a significant change in their attitudes toward psychiatry after the end of the training. The change consisted of a shift to a more medical orientation. However, the 1993 group manifested a significantly higher medical orientation both before and after their undergraduate training in psychiatry compared with the 1985 group. Furthermore, the former group's opinions at the end of their education were similar to those of their teaching staff, whereas the 1985 students continued to have a lower medical orientation compared with the teaching staff. These findings indicate that 1) psychiatric education during medical school may significantly mold students' attitudes toward psychiatry and 2) if these medical student groups represent the larger Greek society, then significant changes may be occurring in the Greek society about attitudes toward psychiatry.