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Ashley L, McDonald I. When the Penny Drops: Understanding how social class influences speciality careers in the UK medical profession. Soc Sci Med 2024; 348:116747. [PMID: 38547804 DOI: 10.1016/j.socscimed.2024.116747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 02/22/2024] [Accepted: 03/01/2024] [Indexed: 04/29/2024]
Abstract
In the UK, the medical profession is socially exclusive and socially stratified as doctors from more advantaged backgrounds are more likely to train for specialities with more competitive entry. However, in research to date the causes and consequences of social stratification have been overlooked. We explore this subject here, drawing on a qualitative study comprising in-depth interviews with 30 medical students and doctors from less advantaged socio-economic backgrounds negotiating medical school and early careers. Using Bourdieu's 'theory of practice' we show how socialisation in the family and at school influences how aspirant medics from less advantaged backgrounds view the world, suggesting some inclination towards more community orientated careers, which may be less competitive. However, these tendencies are encouraged as they lack stocks of social, economic and cultural capital, which are convertible to power and position in the field. While allowing for both choice and constraint our core argument is that speciality outcomes are sometimes inequitable and potentially inefficient, as doctors from more advantaged backgrounds have privileged access to more competitive careers for reasons not solely related to ability or skill. Our main theoretical contribution is to literature in the sociology of medical education where ours is the first study to open-up the 'black box' of causal factors connecting medical students' resources on entering the field of education and training with speciality outcomes, though our findings also have important implications for practitioners, the profession and for patients. We discuss the implications for safe and effective healthcare and how this informs directions for future research.
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Affiliation(s)
- Louise Ashley
- School of Business and Management, Queen Mary University of London, Mile End Road, London, E1 4NS, UK.
| | - Ian McDonald
- School of Business and Management, Royal Holloway University of London, Egham Hill, Egham, TW1 0EX, UK
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Li W, Gillies RM, Liu C, Wu C, Chen J, Zhang X, Cheng B, Dai J, Fu N, Li L, Liu S, Sun H. Specialty preferences of studying-abroad medical students from low- and middle-income countries. BMC MEDICAL EDUCATION 2023; 23:158. [PMID: 36922811 PMCID: PMC10015544 DOI: 10.1186/s12909-023-04123-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND This study explored the specialty preferences of China-educated international medical students (IMSs), who are mainly from low- and middle-income countries (LMICs) and constitute a potential medical workforce both for their home countries and foreign countries, and the influence of migration intentions on their specialty preferences. METHODS A cross-sectional, questionnaire-based survey was conducted at 5 universities in China. The questionnaire link was distributed electronically among the IMSs at the 5 universities via emails. The questionnaire enquired IMSs' demographic information, migration intentions and their specialty preferences. The Chi-square test was applied to determine the influence of the respondent's gender, intention to practise in the home country and intention to practise in a high-income country on their specialty choices. The Chi-square test was also applied to determine the influence of the respondent's gender, year of study and country of origin on their preferences for generalist-orientated or non-generalist orientated specialties. RESULTS Altogether, 452 IMSs returned their responses, yielding a response rate of 64.1%. Approximately half of the IMSs planned to not return to their home country. The most selected specialty was general surgery and the least selected specialty was physical medicine and rehabilitation. No significant differences were evident in most specialty preferences between those who intended to return home and those who intended to stay abroad. Among the IMSs having intentions of returning to their home country, male students tended to choose a generalist-orientated specialty, while female students tended to choose a non-generalist-orientated specialty. CONCLUSION China-educated IMSs could play important roles in the primary care services as well as other shortage specialties both for their home countries or foreign countries. Therefore, it is recommended that governments in these countries plan migration and recruitment policies that cater for these studying-abroad medical students from LMICs, especially in this challenging time during the COVID-19 pandemic.
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Affiliation(s)
- Wen Li
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China
- School of Education, The University of Queensland, 4072, Brisbane, Australia
| | - Robyn M Gillies
- School of Education, The University of Queensland, 4072, Brisbane, Australia
| | - Chang Liu
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China
| | - Changhao Wu
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, GU2 7XH, Guildford, Surrey, UK
| | - Jiayi Chen
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China
| | - Xiaoning Zhang
- School of Management, Xuzhou Medical University, 221004, Xuzhou, China
| | - Bin Cheng
- School of International Education, Weifang Medical University, 261053, Weifang, China
| | - Jing Dai
- College of International Education, Guilin Medical University, 541199, Guilin, China
| | - Ning Fu
- School of International Education, Shandong First Medical University & Shandong Academy of Medical Sciences, 271016, Tai'an, China
| | - Lin Li
- Language and Literature School, Hebei North University, 075000, Zhangjiakou, China
| | - Shenjun Liu
- School of International Education, Xuzhou Medical University, No.209 of Tongshan Road, Yunlong District, 221004, Xuzhou, Jiangsu, China.
| | - Hong Sun
- School of Basic Medicine, Xuzhou Medical University, Xuzhou, China.
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Attracting the next generation of radiologists: a statement by the European Society of Radiology (ESR). Insights Imaging 2022; 13:84. [PMID: 35507198 PMCID: PMC9066129 DOI: 10.1186/s13244-022-01221-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 04/08/2022] [Indexed: 11/23/2022] Open
Abstract
With demand increasing each year for diagnostic imaging and imaging guided interventions, it is important for the radiology workforce to expand in line with need. National and international societies such as the European Society of Radiology have an important role to play in showcasing the diversity of radiology, and highlighting the key role radiologists have in patient care and clinical decision-making to attract the next generation of radiologists. Medical students are an important group to engage with early. Meaningful exposure of undergraduates to radiology with an integrated programme and clinical placements in radiology is essential. Elective courses and dedicated 1-year Bachelor or Masters imaging programmes provide medical students with an opportunity for more in-depth study of radiology practice. Undergraduate radiology societies improve opportunities for engagement and mentorship. Innovations in imaging such as augmented-reality simulation and artificial intelligence and image-guided intervention also offer exciting training opportunities. Through these opportunities, students can gain insight into the wide variety of career opportunities in radiology.
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Sagua N, Pickwick C. Letter Regarding: Effect of Smartphone Laparoscopy Simulator on Laparoscopic Performance in Medical Students. J Surg Res 2021; 270:92-93. [PMID: 34644623 PMCID: PMC8502492 DOI: 10.1016/j.jss.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/05/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Noah Sagua
- Department of Medicine, Cardiff University School of Medicine, University Hospital of Wales Main Building, Heath Park, Cardiff, U.K.
| | - Charlotte Pickwick
- Department of Medicine, Cardiff University School of Medicine, University Hospital of Wales Main Building, Heath Park, Cardiff, U.K
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Lagunes-Cordoba E, Maitra R, Dave S, Matheiken S, Oyebode F, O'Hara J, Tracy DK. International medical graduates: how can UK psychiatry do better? BJPsych Bull 2021; 45:299-304. [PMID: 33263275 PMCID: PMC8477154 DOI: 10.1192/bjb.2020.118] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The National Health Service (NHS) was created 70 years ago to provide universal healthcare to the UK, and over the years it has relied upon international medical graduates (IMGs) to be able to meet its needs. Despite the benefits these professionals bring to the NHS, they often face barriers that hinder their well-being and performance. In this editorial, we discuss some of the most common challenges and the adverse effects these have on IMGs' lives and careers. However, we also propose practical measures to improve IMGs' experiences of working in psychiatry.
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Affiliation(s)
| | - Raka Maitra
- Tavistock and Portman NHS Foundation Trust, UK
| | - Subodh Dave
- Derbyshire Healthcare NHS Foundation Trust, UK
| | | | | | - Jean O'Hara
- South London and Maudsley NHS Foundation Trust, UK
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Johnson J, Al-Ghunaim TA, Biyani CS, Montgomery A, Morley R, O’Connor DB. Burnout in Surgical Trainees: a Narrative Review of Trends, Contributors, Consequences and Possible Interventions. Indian J Surg 2021; 84:35-44. [PMID: 34341627 PMCID: PMC8319710 DOI: 10.1007/s12262-021-03047-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 07/14/2021] [Indexed: 02/03/2023] Open
Abstract
Surgical disciplines are popular and training places are competitive to obtain, but trainees report higher levels of burnout than either their non-surgical peers or attending or consultant surgeons. In this review, we critically summarise evidence on trends and changes in burnout over the past decade, contributors to surgical trainee burnout, the personal and professional consequences of burnout and consider the evidence for interventions. There is no evidence for a linear increase in burnout levels in surgeons over the past decade but the impact of the COVID-19 pandemic has yet to be established and is likely to be significant. Working long hours and experiencing stressful interpersonal interactions at work are associated with higher burnout in trainees but feeling more supported by training programmes and receiving workplace supervision are associated with reduced burnout. Burnout is associated with poorer overall mental and physical well-being in surgical trainees and has also been linked with the delivery of less safe patient care in this group. Useful interventions could include mentorship and improving work conditions, but there is a need for more and higher quality studies.
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Affiliation(s)
- Judith Johnson
- School of Psychology, University of Leeds, Leeds, LS29JT UK
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD96RJ UK
- School of Public Health and Community Medicine, University of New South Wales, Sydney, 2052 Australia
| | | | - Chandra Shekhar Biyani
- Department of Urology, St James’s University Hospital, Beckett Street, Leeds, LS9 7TF UK
- Cadaveric Simulation Programme, Anatomy Department, School of Medicine, University of Leeds, Leeds, LS2 9JT UK
| | - Anthony Montgomery
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
| | - Roland Morley
- Imperial College Healthcare NHS Trust, London, W2 1NY UK
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Sturesson L, Palmgren PJ, Öhlander M, Nilsson GH, Stenfors T. Migrant physicians' choice of employment and the medical specialty general practice: a mixed-methods study. HUMAN RESOURCES FOR HEALTH 2021; 19:63. [PMID: 33980236 PMCID: PMC8114484 DOI: 10.1186/s12960-021-00607-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 05/03/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE In many countries, migrant physicians (MP) tend to fill staff shortages in medical specialties perceived as low status. The aim of this study was to explore aspects that influence MPs', with a medical degree from outside EU/EEA, choice of employment and medical specialty in Sweden, and to explore and understand a potential over-representation in general practice (family medicine), a specialty suffering from staff shortages in Sweden. METHODS A mixed-methods approach was applied. This included questionnaire data from 101 MPs training and working as medical specialists in Sweden and semi-structured interview data from four MPs specializing in general practice. RESULTS Regardless of specialty, the most influential aspects when choosing employment were the ability to combine work with family, to develop one´s competence, and to have highly competent colleagues. Women scored higher on some aspects related to private life and the surroundings. More than half (55%) of the respondents specialized in general practice, and more women than men. The MPs in general practice scored higher on the aspect 'ability to have the same patients for a longer period' than MPs specializing in other specialties. No significant difference between MP general practitioner respondents and MPs in other medical specialties was found in relation to the item 'Was the specialty your first choice?'. Aspects identified in the interviews that influenced the choice to specialize in general practice related to job opportunities, positive experiences of primary health care, working conditions, and family conditions. CONCLUSION Labour market conditions such as high competition, and the time-consuming recertification process, can influence the choice to specialize in general practice as this reduces the time to become a medical specialist. We however did not find any results indicating that MPs' decision to specialize in general practice and to work as general practitioners was any less voluntary than that of MPs who chose other specialties.
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Affiliation(s)
- Linda Sturesson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Per J. Palmgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Magnus Öhlander
- Department of Ethnology, History of Religions and Gender Studies, Stockholm University, 106 91 Stockholm, Sweden
| | - Gunnar H. Nilsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Terese Stenfors
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden
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Rashid MA, Farrukh A, Mayberry JF. International medical graduates from India and Pakistan: an analysis of specialty areas on the UK medical register. Postgrad Med J 2021; 98:e165-e166. [PMID: 33547139 DOI: 10.1136/postgradmedj-2020-139597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/12/2021] [Indexed: 11/03/2022]
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McNicholas F, Sharma S, Oconnor C, Barrett E. Burnout in consultants in child and adolescent mental health services (CAMHS) in Ireland: a cross-sectional study. BMJ Open 2020; 10:e030354. [PMID: 31959602 PMCID: PMC7045151 DOI: 10.1136/bmjopen-2019-030354] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED Physician burnout has reached epidemic levels in many countries, contributing to adverse personal, patient and service outcomes. Adverse socioeconomic conditions, such as the economic downturn in the Ireland post 2008, contribute to a situation of increased demand but inadequate resources. Given a recent unprecedented increase in referrals to Irish child and adolescent mental health services (CAMHS), coupled with a fragmented and poorly resourced service, it is important to reflect on consultant child psychiatrists' well-being. OBJECTIVES To report on the level of burnout among consultants working in CAMHS in Ireland using a cross-sectional design. SETTING Community CAMHS in Ireland. PARTICIPANTS An online questionnaire was sent to all consultant child psychiatrists registered with the Irish Medical Council (n=112). Fifty-two consultants replied (46% response rate). PRIMARY OUTCOME MEASURES Questions assessed demographic and occupational details, career satisfaction and perceived management, government and public support. The Copenhagen Burnout Inventory measured personal, work and patient-related burnout. RESULTS The prevalence of moderate or higher levels of work-related and personal burnout was 75% and 72.3%, respectively. Fewer (n=14, 26.9%) experienced patient-related burnout. There was a strong correlation between work burnout and personal (r=0.851, n=52, p<0.001) and patient-related burnout (r=0.476, n=52, p<0.001). Lack of confidence in government commitment to investment in CAMHS (p<0.001) and perceived ineffective management by health authorities (p=0.002) were associated with higher burnout scores. Few consultants (n=11, 21%) felt valued in their job. The majority (n=36, 69%) had seriously considered changing jobs, and this was positively associated with higher burnout (p<0.001). Higher burnout scores were present in those (n=15, 28.8%) who would not retrain in child psychiatry (p=0.002). CONCLUSION The high level of burnout reported by respondents in this study, and ambivalence about child psychiatry as a career choice has huge professional and service implications. Urgent organisational intervention to support consultant psychiatrists' well-being is required.
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Affiliation(s)
- Fiona McNicholas
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Lucena Clinic, St John of God, Dublin, Ireland
- Our Lady's Hospital for Sick Children, Dublin, Ireland
| | - Sonita Sharma
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Cliodhna Oconnor
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Elizabeth Barrett
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Temple Street University Hospital, Dublin, Ireland
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Qureshi H, Carney S, Iversen A. Narrative review of the impact of clinical psychiatry attachments on attitudes to psychiatry. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/pb.bp.111.037820] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodPsychiatry in the UK has long-standing issues in recruiting UK-trained doctors. A key potential influence on interest in psychiatry during medical school is the clinical attachment. This narrative review investigates how the clinical experience of psychiatry affects medical students' attitudes towards the specialty.ResultsWe identified 107 studies, of which 46 were included. They showed that clinical attachments in psychiatry did result in more positive attitudes towards the specialty and increased career interest. There was inconsistent evidence on whether interest was maintained, with some studies indicating that the increase is transient. Factors which may influence attitudes include attachment setting, duration and student demographics.Clinical implicationsThe results suggest a need to actively maintain interest in psychiatry throughout medical school. Research with long-term follow-up and evaluation of schemes to maintain students' interest is needed.
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Choudry A, Farooq S. Systematic review into factors associated with the recruitment crisis in psychiatry in the UK: students', trainees' and consultants' views. BJPsych Bull 2017; 41:345-352. [PMID: 29234513 PMCID: PMC5709685 DOI: 10.1192/pb.bp.116.055269] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Aims and method To review the literature to examine the factors that may be affecting recruitment into psychiatry in the UK. We systematically searched four databases to identify studies from 1974 to 2016 and identified 27 papers that met the specified inclusion criteria. Results Most papers (n = 24) were based on questionnaire surveys. The population in all studies comprised of 1879 psychiatrists, 6733 students and 220 746 trainees. About 4-7% of students opt for a career in psychiatry. Enrichment activities helped to attract students more towards psychiatry than just total time spent in the specialty. Job content in terms of the lack of scientific basis, poor prognosis and stigma towards psychiatry, work-related stress and problems with training jobs were common barriers highlighted among students and trainees, affecting recruitment. Job satisfaction and family-friendly status of psychiatry was rated highly by students, with lifestyle factors appearing to be important for trainees who tend to choose psychiatry. Clinical implications Negative attitudes and stigma towards psychiatry continue to persist. Teaching and training in psychiatry needs rethinking to improve student experience and recruitment into the specialty.
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Affiliation(s)
| | - Saeed Farooq
- Keele University.,South Staffordshire and Shropshire NHS Foundation Trust
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Rodriguez Santana I, Chalkley M. Getting the right balance? A mixed logit analysis of the relationship between UK training doctors' characteristics and their specialties using the 2013 National Training Survey. BMJ Open 2017; 7:e015219. [PMID: 28801397 PMCID: PMC5724110 DOI: 10.1136/bmjopen-2016-015219] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To analyse how training doctors' demographic and socioeconomic characteristics vary according to the specialty that they are training for. DESIGN Descriptive statistics and mixed logistic regression analysis of cross-sectional survey data to quantify evidence of systematic relationships between doctors' characteristics and their specialty. SETTING Doctors in training in the United Kingdom in 2013. PARTICIPANTS 27 530 doctors in training but not in their foundation year who responded to the National Training Survey 2013. MAIN OUTCOME MEASURES Mixed logit regression estimates and the corresponding odds ratios (calculated separately for all doctors in training and a subsample comprising those educated in the UK), relating gender, age, ethnicity, place of studies, socioeconomic background and parental education to the probability of training for a particular specialty. RESULTS Being female and being white British increase the chances of being in general practice with respect to any other specialty, while coming from a better-off socioeconomic background and having parents with tertiary education have the opposite effect. Mixed results are found for age and place of studies. For example, the difference between men and women is greatest for surgical specialties for which a man is 12.121 times more likely to be training to a surgical specialty (relative to general practice) than a woman (p-value<0.01). Doctors who attended an independent school which is proxy for doctor's socioeconomic background are 1.789 and 1.413 times more likely to be training for surgical or medical specialties (relative to general practice) than those who attended a state school (p-value<0.01). CONCLUSIONS There are systematic and substantial differences between specialties in respect of training doctors' gender, ethnicity, age and socioeconomic background. The persistent underrepresentation in some specialties of women, minority ethnic groups and of those coming from disadvantaged backgrounds will impact on the representativeness of the profession into the future. Further research is needed to understand how the processes of selection and the self-selection of applicants into specialties gives rise to these observed differences.
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Pinto da Costa M, Giurgiuca A, Holmes K, Biskup E, Mogren T, Tomori S, Kilic O, Banjac V, Molina-Ruiz R, Palumbo C, Frydecka D, Kaaja J, El-Higaya E, Kanellopoulos A, Amit BH, Madissoon D, Andreou E, Uleviciute-Belena I, Rakos I, Dragasek J, Feffer K, Farrugia M, Mitkovic-Voncina M, Gargot T, Baessler F, Pantovic-Stefanovic M, De Picker L. To which countries do European psychiatric trainees want to move to and why? Eur Psychiatry 2017; 45:174-181. [PMID: 28957784 DOI: 10.1016/j.eurpsy.2017.06.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/25/2017] [Accepted: 06/26/2017] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country. METHODS Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration. RESULTS A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have 'ever' considered to move to a different country in their future, 53.5% were considering it 'now', at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%). CONCLUSIONS A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.
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Affiliation(s)
- M Pinto da Costa
- Hospital de Magalhães Lemos, Porto, Portugal; Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal; Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom.
| | - A Giurgiuca
- The Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - K Holmes
- Avon and Wiltshire Mental Health Partnership Trust, Bristol, United Kingdom
| | - E Biskup
- University Hospital of Basel, Department of Internal Medicine, Basel, Switzerland; Shanghai University of Medicine and Health Sciences Basic Medical College, Shanghai, China
| | - T Mogren
- Allmänspykiatriska kliniken Falun/Säter, Säter, Sweden
| | - S Tomori
- University Hospital Center Mother Teresa, Department of Pediatrics, Tirana, Albania
| | - O Kilic
- Koc University Hospital, Department of Psychiatry, Istanbul, Turkey
| | - V Banjac
- Clinic of psychiatry, University Clinical Center of the Republic of Srpska, Banjaluka, Bosnia and Herzegovina
| | - R Molina-Ruiz
- CSM de Hospital Universitario Fundación Alcorcón, Psychiatry Department, Madrid, Spain
| | - C Palumbo
- Hospital Papa Giovanni XXIII-Bergamo (BG), Department of Psychiatry, Bergamo, Italy
| | - D Frydecka
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - J Kaaja
- Universiy of Tampere, Tampere, Finland
| | - E El-Higaya
- School of Medicine, National University of Ireland, Galway, Ireland
| | - A Kanellopoulos
- Mental Health Care Unit, Evgenidion Therapeftirion, National & Kapodistrian University of Athens, Greece
| | - B H Amit
- Tel Aviv University, Department of psychiatry, Geha Mental Health Center, Petach Tiqwa, Israel
| | - D Madissoon
- South-Estonian Hospital, Psychiatry Clinic, Võru, Estonia
| | - E Andreou
- Athalassa Mental Health Hospital, Mental Health Services, Nicosia, Cyprus
| | - I Uleviciute-Belena
- Clinical hospital of Vilnius, Office of primary mental health care, Vilnius, Lithuania
| | - I Rakos
- University Hospital Dubrava, Department of Psychiatry, Referral Center for the Stress-Related Disorders, Zagreb, Croatia
| | - J Dragasek
- Pavol Jozef Šafárik University, Faculty of Medicine, 1st Department of Psychiatry, Košice, Slovakia
| | - K Feffer
- Shalvata mental health center, Hod-Hasharon, Israel
| | - M Farrugia
- Mount Carmel Hospital, Triq l-Imdina, Malta
| | - M Mitkovic-Voncina
- Belgrade University School of Medicine, Institute of Mental Health, Belgrade, Serbia
| | - T Gargot
- Service de psychiatrie de l'enfant et de l'adolescent, hôpital de la Pitié-Salpêtrière, Paris, France; Equipe interaction, institut des systèmes intelligents et de la robotique, Paris, France
| | - F Baessler
- Centre for psychosocial medicine and department of general internal medicine and psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - M Pantovic-Stefanovic
- Department for Affective Disorders, University Clinical Center of Serbia, Belgrade, Serbia
| | - L De Picker
- Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
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Shields G, Ng R, Ventriglio A, Castaldelli‐Maia J, Torales J, Bhugra D. WPA Position Statement on Recruitment in Psychiatry. World Psychiatry 2017; 16:113-114. [PMID: 28127914 PMCID: PMC5269505 DOI: 10.1002/wps.20392] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Roger Ng
- Department of PsychiatryKowloon HospitalKowloonHong Kong
| | - Antonio Ventriglio
- Department of Clinical and Experimental MedicineUniversity of FoggiaFoggiaItaly
| | | | - Julio Torales
- Neuroscience DepartmentNational University of AsuncionSan LorenzoParaguay
| | - Dinesh Bhugra
- Institute of Psychiatry, King's College LondonLondonUK
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Khalid U, Thomas E, Ilham MA. Correspondence to: International medical graduates among top US transplant surgeons. Int J Surg 2016; 37:85-86. [PMID: 27998734 DOI: 10.1016/j.ijsu.2016.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 12/11/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Usman Khalid
- Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK.
| | | | - Mohamed Adel Ilham
- Cardiff Transplant Unit, Department of Nephrology & Transplant Surgery, University Hospital of Wales, Cardiff, CF14 4XW, UK
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Abstract
AIMS Psychiatry as science is underpinned by paradigms. Considering whether a social paradigm may help to advance the current state of psychiatry, the review provides a reference to the rich, but fragmented past of related initiatives in the history of psychiatry and a personal view of themes, challenges and perspectives of using a social paradigm in psychiatry. METHODS Major themes are the evidence on social determinants of mental health; the value-based importance of integrating people with mental disorders in society; options to overcome the social isolation and improve the networks of psychiatric patients; utilising a systemic approach for interventions in families and communities; and understanding group and one-to-one treatments in psychiatry primarily as social interactions. Whilst all these themes open up perspectives for future action and/or research, there are also conceptual challenges through the limitations of the current construct of mental disorders and the dominating terminology. RESULTS Initiatives for using a social paradigm in psychiatry may refer to important achievements in the past, but need to go beyond this and consider on-going societal changes. CONCLUSION Innovation may benefit from close collaboration with social sciences and humanities.
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Keynejad R, Garratt E, Adem G, Finlayson A, Whitwell S, Sheriff RS. Improved Attitudes to Psychiatry: A Global Mental Health Peer-to-Peer E-Learning Partnership. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:659-66. [PMID: 25124879 DOI: 10.1007/s40596-014-0206-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Accepted: 07/09/2014] [Indexed: 05/22/2023]
Abstract
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.
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Affiliation(s)
| | | | - Gudon Adem
- Hargeisa Group Hospital, Hargeisa, Somaliland
| | | | | | - Rebecca Syed Sheriff
- King's College London, London, UK
- Australian National University, Canberra, Australia
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Tyrrell E, Keegan C, Humphries N, McAleese S, Thomas S, Normand C, Brugha R. Predictors of career progression and obstacles and opportunities for non-EU hospital doctors to undertake postgraduate training in Ireland. HUMAN RESOURCES FOR HEALTH 2016; 14:23. [PMID: 27381321 PMCID: PMC4943483 DOI: 10.1186/s12960-016-0120-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND The World Health Organization's Global Code on the International Recruitment of Health Personnel urges Member States to observe fair recruitment practices and ensure equality of treatment of migrant and domestically-trained health personnel. However, international medical graduates (IMGs) have experienced difficulties in accessing postgraduate training and in progressing their careers in several destination countries. Ireland is highly dependent on IMGs, but also employs non-European Union (EU) doctors who qualified as doctors in Ireland. However, little is known regarding the career progression of these doctors. In this context, the present study assesses the determinants of career progression of non-EU doctors with particular focus on whether barriers to progression exist for those graduating outside Ireland compared to those who have graduated within. METHODS The study utilises quantitative data from an online survey of non-EU doctors registered with the Medical Council of Ireland undertaken as part of the Doctor Migration Project (2011-2013). Non-EU doctors registered with the Medical Council of Ireland were asked to complete an online survey about their recruitment, training and career experiences in Ireland. Analysis was conducted on the responses of 231 non-EU hospital doctors whose first post in Ireland was not permanent. Career progression was analysed by means of binary logistic regression analysis. RESULTS While some of the IMGs had succeeded in accessing specialist training, many experienced slow or stagnant career progression when compared with Irish-trained non-EU doctors. Key predictors of career progression for non-EU doctors working in Ireland showed that doctors who qualified outside of Ireland were less likely than Irish-trained non-EU doctors to experience career progression. Length of stay as a qualified doctor in Ireland was strongly associated with career progression. Those working in anaesthesia were significantly more likely to experience career progression than those in other specialities. CONCLUSIONS The present study highlights differences in terms of achieving career progression and training for Irish-trained non-EU doctors, compared to those trained elsewhere. However, the findings herein warrant further attention from a workforce planning and policy development perspective regarding Ireland's obligations under the Global Code of hiring, promoting and remunerating migrant health personnel on the basis of equality of treatment with the domestically-trained health workforce.
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Affiliation(s)
- Ella Tyrrell
- Centre for Health Policy and Management, Trinity College Dublin, 3-4 Foster Place, College Green, Dublin 2, Ireland.
| | - Conor Keegan
- Centre for Health Policy and Management, Trinity College Dublin, 3-4 Foster Place, College Green, Dublin 2, Ireland
| | - Niamh Humphries
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland
| | - Sara McAleese
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland
| | - Steve Thomas
- Centre for Health Policy and Management, Trinity College Dublin, 3-4 Foster Place, College Green, Dublin 2, Ireland
| | - Charles Normand
- Centre for Health Policy and Management, Trinity College Dublin, 3-4 Foster Place, College Green, Dublin 2, Ireland
| | - Ruairí Brugha
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons, Dublin, Ireland
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Paheenthararajah K, Ladas T, Gauggel S, Prinz S, Grözinger M. [Medical students' attitude towards electroconvulsive therapy: Impact of patient-oriented training]. DER NERVENARZT 2016; 86:566-70. [PMID: 24943362 DOI: 10.1007/s00115-014-4093-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND As a particular aspect of psychiatric clinical training many students instinctively harbor reservations towards the field of electroconvulsive treatment (ECT). In this context the question arises how controversial issues, such as ECT can be addressed during the placement. The clinical training is predestined to provide basic knowledge concerning ECT for future doctors. As multipliers and potential referrers they then can work to prevent severe mental illness from becoming chronic. MATERIALS AND METHODS Prior to the clinical psychiatric teaching course 158 medical students of the RWTH Aachen University were randomly assigned to three groups. The first actively took part in an ECT therapy session (ECT group), the second was shown an educational video (video group) and the third served as a control group. A questionnaire was filled in before and after the training concerning the knowledge and the attitudes towards ECT. RESULTS In the course of the clinical training the attitudes of the students towards ECT became more positive for all items. The willingness to agree to ECT in the case of patients, family members and friends and themselves increased in the ECT group and the video group but not in the control group. Only the ECT group proved to be superior to the control group in the direct comparisons. In both interventions the knowledge about ECT increased more in comparison to the control group despite the very limited interventions. CONCLUSION Reservations to touch on the controversial issue of ECT during the clinical training do not seem to be justified. Even a single hands-on or video experience can have a relevant impact on knowledge and attitude towards ECT in medical students. This opportunity should be used more intensively.
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Affiliation(s)
- K Paheenthararajah
- Klinik für Strahlentherapie, Klinikum Bielefeld Mitte, Teutoburgerstr. 50, 33604, Bielefeld, Deutschland,
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Kaliyadan F, Amin TT, Qureshi H, Al Wadani F. Specialty preferences of 1(st) year medical students in a Saudi Medical School - Factors affecting these choices and the influence of gender. Avicenna J Med 2015; 5:134-9. [PMID: 26629470 PMCID: PMC4637952 DOI: 10.4103/2231-0770.165120] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and Aims: In recent years there has been a growing appreciation of the issues of career preference in medicine as it affects student learning and academic performance. Various factors influence the specialty choices of medical students. Some specialties tend to attract students more than others. One possible consequence of this would be a mismatch between health needs and specialist numbers in the region. This study investigated the career preferences of 1st year medical students in a Saudi medical school and to assess factors affecting these choices. Materials and Methods: The study was a cross-sectional survey carried out on the 1st year undergraduate students in the college of medicine, King Faisal University, Saudi Arabia. A total of 109 students (57 female and 52 males) responded to the questionnaire which was initially administered to all the students of the 1st year – A total of 120 students (response rate was 90.8%). A mixed method approach was used and qualitative data from open-ended questions were analyzed based on thematic analysis. Results: The top choices were general surgery, internal medicine, and pediatrics. Among female students; the top specialty choices were: General surgery (23%), pediatrics (18%), and dermatology (15%). Among the male students; the top choices were: General surgery (54%) and internal medicine (23%). Of the total, 57% of the students agreed or strongly agreed that primary aptitude was the main factor affecting the choice. Only 31% felt that there was a significant influence of role model, 48% felt that the advice of others – peers and family, would be a factor influencing their choices, and 53% agreed that specialty choice would influence their future learning patterns. Males were more likely to choose a specialty based on actual aptitude for the specialty, financial rewards, and scope for research; and this gender difference was statistically significant. Conclusion: Surgery was the top-choice in both genders. Other popular choices included internal medicine, pediatrics, and dermatology. Important factors affecting these choices included – primary aptitude, advice of peers, reputation, financial rewards, and the challenge involved.
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Affiliation(s)
- Feroze Kaliyadan
- Faculty of Dermatology, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
| | - Tarek Tawfik Amin
- Department of Public Health and Community Medicine, Cairo University, Egypt
| | - Habib Qureshi
- Faculty of Biomedical Sciences, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
| | - Fahad Al Wadani
- Faculty of Ophthalmology, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
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Leung K, Awani T, Chima C, Udo I. What can qualitative studies reveal about recruitment into psychiatry? ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2015; 39:286-292. [PMID: 25800705 DOI: 10.1007/s40596-015-0290-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 01/22/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE Studies examining recruitment problems in psychiatry have been mostly quantitative and limited in their ability to elucidate perceptions and day-to-day influences that may affect recruitment. This review aimed to identify factors on recruitment into psychiatry by appraising available qualitative studies. METHODS The authors searched MEDLINE, PsycINFO, and Embase using Health Database Advanced Search tool on NHS Evidence. Inclusion criteria were qualitative studies and English-language published papers. The authors appraised 10 qualitative studies and identified common themes. RESULTS The ten qualitative studies used thematic analysis, phenomenology, and narrative study methods. Populations studied were medical students, foundation doctors, residents/trainees, psychiatrists, and undergraduate psychiatry teachers from the USA, UK, Australia, Canada, and Ghana. The studies highlighted importance of role models, mentorship, and supervision in improving recruitment. Additional factors included stigmatization in mental illness, satisfaction rates, interactive nature, and academic interest within psychiatry. CONCLUSION The appraised studies were limited in their number and methodology. More qualitative studies are needed to inform policy on recruitment into psychiatry.
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Affiliation(s)
- Kelvin Leung
- South Tees NHS Foundation Trust, Middlesbrough, UK,
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Lau T, Zamani D, Lee EK, Asli KD, Gill J, Brager N, Hawa R, Song WY, Gill E, Fitzpatrick R, Menezes NM, Pham VH, Douglass AB, Allain S, Meterissian GB, Gagnon N, Toeg H, Murphy C. Factors affecting recruitment into psychiatry: a canadian experience. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2015; 39:246-252. [PMID: 25583402 PMCID: PMC4422873 DOI: 10.1007/s40596-014-0269-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Accepted: 11/25/2014] [Indexed: 05/28/2023]
Abstract
OBJECTIVE There is a projected shortage of psychiatrists in Canada in forthcoming years. This study assessed factors in medical school education that are associated with students selecting psychiatry first and matching as a discipline. METHOD The Canadian Organization of Undergraduate Psychiatry Educators (COUPE) conducted telephone interviews and sent e-mail questionnaires to the 17 medical schools across Canada; all schools provided data for 2012. Relevant data were obtained from the Canadian Resident Matching Service. Statistics were performed using v12 STATA program, and significance was set at a p value of <0.05. RESULTS Medical student enrollment ranged from 54 to 266 students (mean = 158 ± 16). Of these students, 4.9 ± 0.6 % ranked psychiatry as their first choice for residency. Final match results yielded similar numbers at 5.0 ± 0.6 %. Ten out of 17 programs filled all psychiatry residency positions, whereas the remaining 7 programs had vacancy rates from 5 to 100 % (mean = 43.4 ± 15.1 %). Medical students were exposed to an average of 2.8 ± 0.5 pre-clerkship psychiatry weeks and 6.2 ± 0.3 clerkship weeks. Linear regression analysis demonstrated that the percentage of graduating medical students entering a psychiatry residency program could be predicted from the number of weeks of pre-clerkship exposure (p = 0.01; R(2) = 0.36) but not from the number of clerkship weeks (p = 0.74). CONCLUSIONS This study indicates that the duration of pre-clerkship exposure to psychiatry predicts the number of students selecting psychiatry as their first choice as a discipline. Thus, increasing the duration of pre-clerkship exposure may increase the enrollment of medical students into psychiatry.
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Affiliation(s)
| | | | | | | | - Jasbir Gill
- Memorial University of Newfoundland, St John’s, NL Canada
| | | | - Raed Hawa
- University of Toronto, Toronto, ON Canada
| | - Wei-Yi Song
- University of British Columbia, Vancouver, BC Canada
| | | | | | | | - Vu H. Pham
- University of Saskatchewan, Saskatoon, SK Canada
| | | | - Suzanne Allain
- Northern Ontario School of Medicine, Greater Sudbury, ON Canada
| | | | | | - Hadi Toeg
- University of Ottawa, Ottawa, ON Canada
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Woolf K, Elton C, Newport M. The specialty choices of graduates from Brighton and Sussex Medical School: a longitudinal cohort study. BMC MEDICAL EDUCATION 2015; 15:46. [PMID: 25889968 PMCID: PMC4365809 DOI: 10.1186/s12909-015-0328-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Accepted: 02/25/2015] [Indexed: 05/25/2023]
Abstract
BACKGROUND Since 2007 junior doctors in the UK have had to make major career decisions at a point when previously many had not yet chosen a specialty. This study examined when doctors in this new system make specialty choices, which factors influence choices, and whether doctors who choose a specialty they were interested in at medical school are more confident in their choice than those doctors whose interests change post-graduation. METHODS Two cohorts of students in their penultimate year at one medical school (n = 227/239) were asked which specialty interested them as a career. Two years later, 210/227 were sent a questionnaire measuring actual specialty chosen, confidence, influence of perceptions of the specialty and experiences on choice, satisfaction with medicine, personality, self-efficacy, and demographics. Medical school and post-graduation choices in the same category were deemed 'stable'. Predictors of stability, and of not having chosen a specialty, were calculated using bootstrapped logistic regression. Differences between specialties on questionnaire factors were analysed. RESULTS 50% responded (n = 105/277; 44% of the 239 Year 4 students). 65% specialty choices were 'stable'. Factors univariately associated with stability were specialty chosen, having enjoyed the specialty at medical school or since starting work, having first considered the specialty earlier. A regression found doctors who chose psychiatry were more likely to have changed choice than those who chose general practice. Confidence in the choice was not associated with stability. Those who chose general practice valued lifestyle factors. A psychiatry choice was associated with needing a job and using one's intellect to help others. The decision to choose surgical training tended to be made early. Not having applied for specialty training was associated with being lower on agreeableness and conscientiousness. CONCLUSION Medical school experiences are important in specialty choice but experiences post-graduation remain significant, particularly in some specialties (psychiatry in our sample). Career guidance is important at medical school and should be continued post-graduation, with senior clinicians supported in advising juniors. Careers advice in the first year post-graduation may be particularly important, especially for specialties which have difficulty recruiting or are poorly represented at medical school.
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Affiliation(s)
- Katherine Woolf
- University College London Medical School (UCLMS), Room GF/664, Royal Free Hospital, London, NW3 2PF, UK.
| | - Caroline Elton
- London Deanery, The Careers Unit, Room ST201, Stewart House, 32 Russell Square, London, WC1B 5DN, UK.
| | - Melanie Newport
- Brighton & Sussex Medical School, BSMS Teaching Building, University of Sussex, Brighton, East Sussex BN1 9PX, UK.
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Affiliation(s)
- Guy M Goodwin
- Department of Psychiatry, University of Oxford, Warneford HospitalOxford OX3 7JX, UK
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Cleland JA, Johnston PW, Anthony M, Khan N, Scott NW. A survey of factors influencing career preference in new-entrant and exiting medical students from four UK medical schools. BMC MEDICAL EDUCATION 2014; 14:151. [PMID: 25056270 PMCID: PMC4131477 DOI: 10.1186/1472-6920-14-151] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 07/10/2014] [Indexed: 05/21/2023]
Abstract
BACKGROUND Workforce planning is a central issue for service provision and has consequences for medical education. Much work has been examined the career intentions, career preferences and career destinations of UK medical graduates but there is little published about medical students career intentions. How soon do medical students formulate careers intentions? How much do these intentions and preferences change during medical school? If they do change, what are the determining factors? Our aim was to compare medical students' career preferences upon entry into and exit from undergraduate medical degree programmes. METHODS This was a cross-sectional questionnaire survey. Two cohorts [2009-10, 2010-11] of first and final year medical students at the four Scottish graduating medical schools took part in career preference questionnaire surveys. Questions were asked about demographic factors, career preferences and influencing factors. RESULTS The response rate was 80.9% [2682/3285]. Significant differences were found across the four schools, most obviously in terms of student origin [Scotland, rest of UK or overseas], age group, and specialty preferences in Year 1 and Year 5. Year 1 and Year 5 students' specialty preferences also differed within each school and, while there were some common patterns, each medical school had a different profile of students' career preferences on exit. When the analysis was adjusted for demographic and job-related preferences, specialty preferences differed by gender, and wish for work-life balance and intellectual satisfaction. CONCLUSIONS This is the first multi-centre study exploring students' career preferences and preference influences upon entry into and exit from undergraduate medical degree programmes. We found various factors influenced career preference, confirming prior findings. What this study adds is that, while acknowledging student intake differs by medical school, medical school itself seems to influence career preference. Comparisons across medical school populations must therefore control for differences in input [the students] as well as context and process [the medical school] when looking at output [e.g., performance]. A robust, longitudinal study is required to explore how medical students' career preferences change as they progress through medical school and training to understand the influence of the learning environment on training choice and outcomes.
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Affiliation(s)
- Jennifer A Cleland
- Division of Medical and Dental Education, University of Aberdeen, Polwarth Building, West Wing, Foresterhill, Aberdeen AB25 2AZ, UK
| | - Peter W Johnston
- NHS Education for Scotland, North Deanery, Forest Grove House, Foresterhill, Aberdeen, UK
| | - Micheal Anthony
- Division of Medical and Dental Education, University of Aberdeen, Polwarth Building, West Wing, Foresterhill, Aberdeen AB25 2AZ, UK
| | - Nadir Khan
- Division of Medical and Dental Education, University of Aberdeen, Polwarth Building, West Wing, Foresterhill, Aberdeen AB25 2AZ, UK
| | - Neil W Scott
- Medical Statistics Team, Division of Applied Health Sciences, University of Aberdeen, Foresterhill, Aberdeen, UK
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Williams JA, Liu N, Afzal K, Cooper B, Sherer R, Morgan I, Dong H. Positive attitudes towards psychiatry among Chinese medical students. Int J Soc Psychiatry 2014; 60:21-9. [PMID: 23283749 DOI: 10.1177/0020764012467259] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND AIMS Increasingly positive attitudes have been reported among young people in China towards mental illness, but little is known about Chinese medical students' attitudes towards psychiatry, psychiatric services and patients. METHODS We administered a bilingual survey to Wuhan University medical students in the final years of their clinical training. Primary outcomes were composite scores on a 21-item attitudes toward psychiatry (ATP) survey and the number of correct responses to diagnostic questions following a series of three clinical case vignettes. RESULTS Mean composite score on the ATP items was 78/105 (SD = 9.6), representing overall positive attitudes among the students. Female gender and having learned about more psychiatric disorders were positively associated with a higher mean ATP score and remained so after adjustment for relevant covariates. CONCLUSIONS Chinese medical students reported positive attitudes towards psychiatry, openness with regard to psychiatric services, and respect for psychiatric patients. Learning about a broad spectrum of psychiatric diagnoses and greater clinical contact with patients may improve overall attitudes of Chinese medical students towards psychiatry and their ability to make accurate diagnoses.
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Affiliation(s)
- Joshua A Williams
- 1Psychiatry Resident at Harvard Longwood Psychiatry Residency Training Program, Harvard Medical School, Boston, MA, USA
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Farooq K, Lydall GJ, Bhugra D. What attracts medical students towards psychiatry? A review of factors before and during medical school. Int Rev Psychiatry 2013; 25:371-7. [PMID: 24032490 DOI: 10.3109/09540261.2013.823855] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Potential psychiatrists decide on their careers before, during or after medical school. This article summarises the literature focusing on the first two groups. Pre-medical school factors associated with choosing psychiatry include gender, academic aptitude, ethnicity and migration, exposure to mental illness, economic considerations and medical school route and selection. Factors involved in influencing career choice at medical school level include attitudes towards psychiatry, teaching methods, quality and length of clinical exposure, electives and enrichment activities, and personality factors. Considering these factors may improve recruitment to psychiatry and address shortages in the speciality.
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Affiliation(s)
- Kitty Farooq
- Oxleas NHS Foundation Trust, Greenwich Recovery Service , London
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Halder N, Hadjidemetriou C, Pearson R, Farooq K, Lydall GJ, Malik A, Bhugra D. Student career choice in psychiatry: findings from 18 UK medical schools. Int Rev Psychiatry 2013; 25:438-44. [PMID: 24032499 DOI: 10.3109/09540261.2013.824414] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Psychiatry recruitment continues to be a problem in the UK and large-scale studies are required to understand the factors surrounding this. A quantitative, cross-sectional online survey, incorporating demographics, career choices, teaching exposure, attitudes to psychiatry and personality factors, was administered to final-year UK medical students. A total of 484 students from 18 medical schools responded (66% women). Sixteen (16%) had chosen psychiatry at medical school entry. By final year, 15 respondents (3%) had decided to pursue a career in psychiatry, while another 78 (17%) were seriously considering it. There was little difference in the quality ratings of lectures and small group teaching between those interested in psychiatry and those not. Experience of 'enrichment activities' (psychiatry special study modules or components, psychiatric research, university psychiatry clubs, and psychiatry electives) were significantly more likely to take up psychiatry. Causality cannot, however, be determined in this study. The study identified several distinct groups of UK students: those deciding on psychiatry before medical school and maintaining that career choice, those deciding on psychiatry during medical school, and those interested in other fields. Addressing psychiatry teaching and exposure may improve recruitment into the speciality.
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Affiliation(s)
- Neel Halder
- Alpha Hospital, Bury, and Senior Honorary Lecturer, Manchester University
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Goldacre MJ, Fazel S, Smith F, Lambert T. Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009. Br J Psychiatry 2013; 202:228-34. [PMID: 23099446 PMCID: PMC3585421 DOI: 10.1192/bjp.bp.112.111153] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND Recruitment of adequate numbers of doctors to psychiatry is difficult. AIMS To report on career choice for psychiatry, comparing intending psychiatrists with doctors who chose other clinical careers. METHOD Questionnaire studies of all newly qualified doctors from all UK medical schools in 12 qualification years between 1974 and 2009 (33 974 respondent doctors). RESULTS One, three and five years after graduation, 4-5% of doctors specified psychiatry as their first choice of future career. This was largely unchanged across the 35 years. Comparing intending psychiatrists with doctors who chose other careers, factors with a greater influence on psychiatrists' choice included their experience of the subject at medical school, self-appraisal of their own skills, and inclinations before medical school. In a substudy of doctors who initially considered but then did not pursue specialty choices, 72% of those who did not pursue psychiatry gave 'job content' as their reason compared with 33% of doctors who considered but did not pursue other specialties. Historically, more women than men have chosen psychiatry, but the gap has closed over the past decade. CONCLUSIONS Junior doctors' views about psychiatry as a possible career range from high levels of enthusiasm to antipathy, and are more polarised than views about other specialties. Shortening of working hours and improvements to working practices in other hospital-based specialties in the UK may have reduced the relative attractiveness of psychiatry to women doctors. The extent to which views of newly qualified doctors about psychiatry can be modified by medical school education, and by greater exposure to psychiatry during student and early postgraduate years, needs investigation.
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Mair G, Ewing F, Murchison JT. Survey of UK radiology trainees in the aftermath of 'Modernising Medical Careers'. BMC MEDICAL EDUCATION 2012; 12:93. [PMID: 23031228 PMCID: PMC3579711 DOI: 10.1186/1472-6920-12-93] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 09/25/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Following implementation of Modernising Medical Careers (MMC) in the UK, potential radiology trainees must decide on their career and apply sooner than ever before. We aimed to determine whether current trainees were sufficiently informed to make an earlier career decision by comparing the early radiology experiences of Traditional and Foundation Trainees. METHODS 344 radiology trainees were appointed through MMC in 2007/08. This cohort was surveyed online. RESULTS Response rate was 174/344 (51%). Traditional Trainees made their career decision 2.6 years after graduation compared with 1.2 years for Foundation Trainees (57/167, 34%). Nearly half of responders (79/169, 47%) experienced no formal radiology teaching as undergraduates. Most trainees regularly attended radiology meetings, spent time in a radiology department and/or performed radiology research. Many trainees received no career advice specific to radiology (69/163, 42%) at any point prior to entering the specialty; this includes both formal and informal advice. Junior doctor experiences were more frequently cited as influencing career choice (98/164, 60%). An earlier career decision was associated with; undergraduate radiology projects (-0.72 years, p = 0.018), career advice (-0.63 years, p = 0.009) and regular attendance at radiology meetings (-0.65 years, p = 0.014). CONCLUSION Early experience of radiology enables trainees to make an earlier career decision, however current radiology trainees were not always afforded relevant experiences prior to entering training. Radiologists need to be more proactive in encouraging the next generation of trainees.
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Affiliation(s)
- Grant Mair
- Department of Radiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
| | - Fiona Ewing
- Department of Radiology, Western General Hospital, Edinburgh, UK
| | - John T Murchison
- Department of Radiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh, EH16 4SA, UK
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Affiliation(s)
- Brian Lunn
- School of Medical Sciences Education Development, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom
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Tan SSY. The surgical route remains overcompetitive for junior doctors in the United kingdom. JOURNAL OF SURGICAL EDUCATION 2011; 68:97. [PMID: 21338961 DOI: 10.1016/j.jsurg.2010.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2010] [Accepted: 11/29/2010] [Indexed: 05/30/2023]
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