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

A cross-sectional study of opinion about mental illness among undergraduate medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training

Background

A positive attitude toward mental illness is a prerequisite for the provision of holistic care. Thus, a study was undertaken to know the opinion about mental illness among medical students with and without exposure to the psychiatry clinical rotation/postings during their undergraduate training.

Materials and Methods

This is a descriptive, cross-sectional study conducted at Adichunchanagiri Institute of Medical Sciences (AIMS), Karnataka. The sample comprised medical undergraduate students with and without exposure to psychiatry clinical postings, respectively. Self-administered socio-demographic and opinion about mental illness (OMI) questionnaires were used to collect the data.

Result

Medical undergraduates from 1st and 2nd years who were unexposed to psychiatry and students from 3rd and 4th years who had exposure to psychiatry constituted about 52.17% (n = 252) and 47.83% (n = 231) of the overall sample size. A positive opinion toward mental illness was seen across various subsections of OMI questionnaire, especially in students who had attended psychiatry clinical posting.

Conclusion

Opinions can change based on one's experiences. A positive opinion toward mental illness was seen across medical undergraduate students who had completed psychiatry clinical postings in our study. The study provides valuable insights across various domains or areas wherein a teacher can focus and adjust the teaching methodologies accordingly. In the long run, it might have a positive influence on medical students to understand mental disorders, diagnose them, and manage patients with mental illness.

Elements of an Excellent Psychiatry Clerkship Experience: A Survey Study of Graduating Medical Students

OBJECTIVE

One possible factor associated with choosing psychiatry as a career is students rating their psychiatry clerkship as excellent. Although this suggests that an excellent clerkship may improve recruitment into psychiatry, to our knowledge there has never been a multi-site survey study of graduating medical students that identify what factors lead to an excellent clerkship rating. The purpose of this study was to determine factors that medical student find important for an excellent psychiatry clerkship experience.

METHODS

A total of 1457 graduating medical students at eight institutions were sent a 22-item Likert-type survey about what clinical and administrative factors they considered when rating their psychiatry clerkship via email in the fall of their last year. 357 (24.5%) responded and Z-test, t-tests, and multiple regression analyses were carried out.

RESULTS

The factors which students rated higher than the mean included planned application to psychiatry residency, clear expectations, a transparent grading process, feeling part of a team, timely feedback by faculty, and a competent clerkship coordinator and director. Lectures, active learning, and self-study were rated as less pertinent, and the overall clerkship rating did differ between students going into psychiatry versus other specialties.

CONCLUSIONS

Although the low response undermines the validity of findings, by improving the administration of the clerkship with clear expectations, grading, feedback, and by encouraging clinical teams to fully integrate students clerkship ratings might improve which could potentially improve recruitment. Future research could further quantify and qualify these parameters and compare psychiatric clerkships to other clerkships.

Factors influencing medical students and psychiatry residents in Ghana to consider psychiatry as a career option - a qualitative study

BACKGROUND

Currently, Ghana has 14 actively practicing psychiatrists and about 26 psychiatric residents for a population of over 28 million people. Previous research suggests a lack of interest by Ghanaian medical students and medical graduates in considering psychiatry as a career option.

OBJECTIVES

To examine the perception of medical students and psychiatry residents in Ghana about the barriers which hinder Ghanaian medical graduates from choosing careers in psychiatry and how these barriers could be overcome.

METHODS

This was a cross-sectional qualitative study with data gathered using focus group discussion. Twenty clinical year medical students were selected through block randomization from the four public medical schools in Ghana and invited to participate in one of two focus group discussions. Also, four psychiatric residents were invited to participate in the focus group discussions.

RESULTS

The main barriers identified by participants could be grouped under four main themes, namely: (a) myths and stigma surrounding mental health and patients, (b) negative perceptions of psychiatrists, (c) infrastructure and funding issues, (d) lack of exposure and education. To address the barriers presented, participants discussed potential solutions that could be categorized into five main themes, namely: (a) stigma reduction, (b) educating professionals, (c) addressing deficient infrastructure, (d) risk management, and (e) incentivizing the pursuit of psychiatry among students.

CONCLUSION

Health policy planners and medical training institutions could consider implementing proposed solutions to identify barriers as part of efforts to improve the psychiatrist to patient ratio in Ghana.

Attitudes towards psychiatry amongst medical and nursing students in Singapore

BACKGROUND

A shortage of specialists in psychiatry, both in terms of psychiatrists and psychiatric nurses is evident worldwide. While there are multiple factors leading to an individual's decision to specialize in psychiatry, the individual's perceptions and attitudes towards psychiatry tend to play an essential role. This study thus aimed to explore attitudes towards psychiatry amongst medical and nursing students in Singapore and examine factors associated with these attitudes.

METHODS

The present cross-sectional study used an online web survey tool to assess attitudes towards psychiatry amongst 502 medical and 500 nursing students in Singapore using the Attitudes towards Psychiatry (ATP-18) scale. Descriptive statistics and multiple linear regressions were used to examine associated factors (sociodemographic and education).

RESULTS

The majority of students in this population endorsed favourable attitudes towards the following aspects of psychiatry: challenges within psychiatry, importance of psychiatry and psychiatric skills, treatment efficacy and view towards psychiatrists, but had generally unfavourable attitudes towards psychiatric patients. Male participants (compared to female; β = - 1.190, p < 0.05), participants in the middle income group (compared to higher income group; β = - 0.945, p < 0.05), participants who rated average for psychiatry lecture course and psychiatry clinical placement course (compared to above average; β = - 1.654, p < 0.05; β = - 1.181, p < 0.05) had a less favourable attitude to psychiatry. Not surprisingly, participants who were more likely to specialize in psychiatry (β = 2.053, p < 0.001) had a more favourable attitude towards psychiatry compared to those who were less likely to specialize in psychiatry.

CONCLUSIONS

The majority of students in this study endorsed unfavourable attitudes towards patients in the psychiatric setting. The present psychiatry curriculum could be improved to nurture the development of empathetic attitudes towards people with mental illness. De-stigmatization strategies could also be integrated into other curricula besides psychiatry.

Stigma perpetuation at the interface of mental health care: a review to compare patient and clinician perspectives of stigma and borderline personality disorder

BACKGROUND

People with borderline personality disorder (BPD) experience significant stigma, particularly at the interface of care delivery.

AIMS

To compare and contrast what stigma looks like within mental health care contexts, from the perspective of patients and mental health professionals (MHPs) and how it is perpetuated at the interface of care.

METHOD

A review of the literature was undertaken to compare the experiences of stigma towards BPD from the patient and MHP perspective by thematically analysing the results from empirical studies exploring their experiences.

RESULTS

Thirty studies were found; 12 on patients perspectives and 18 on clinicians perspectives. Six themes arose from the thematic synthesis: (1) stigma related to diagnosis and disclosure; (2) perceived un-treatability; (3) stigma as a response to feeling powerless; (4) stigma due to preconceptions of patients; (5) low BPD health literacy and (6) overcoming stigma through enhanced empathy. A conceptual framework for explaining the perpetuation of stigma and BPD is proposed.

CONCLUSION

Stigma towards people with BPD is perpetuated through poor BPD health literacy by patients and MHPs that stalls effective treatment and engagement, and disempowers all concerned, deferring responsibility to others. Addressing this stigma requires multiple strategies that include more targeted education, advocacy and leadership.

Narrative review of the impact of clinical psychiatry attachments on attitudes to psychiatry

Aims and method

Psychiatry 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.

Results

We 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 implications

The 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.

Strategies to reduce the stigma toward people with mental disorders in Iran: stakeholders' perspectives

BACKGROUND

Stigma affects all aspects of mental disorders, and is the most important risk factor for promoting mental health. The aim of this study was to explore strategies effective in reducing the stigma toward people with mental disorders in Iran.

METHODS

This qualitative study was conducted from 2013 to 2016. All participants were recruited by purposive sampling method. The majority of them were stakeholders of mental health in Iran. Data were collected through eight individual interviews, two focus groups, and six written narratives. The data were collected, coded and analyzed simultaneously. Content analysis was employed to analyze the qualitative interview data.

RESULTS

The major themes that emerged were: "Emphasis on education and changing attitudes", "Changing the culture", "Promoting supportive services", "Role of various organizations and institutions", "Integrated reform of structures and policies to improve the performance of custodians", and "Evidence-based actions".

CONCLUSIONS

This study did not investigate the extent of stigma or its origins, rather it examines strategies appropriate for implementation in Iran. Additional studies are needed to evaluate the effectiveness of strategies for reducing the stigma attached to patients with mental disorders.

Attitude of interns towards mental illness and psychiatry: A study from two medical colleges in South India

OBJECTIVE

This study aims to assess the intern's beliefs about mental illness, their attitude towards psychiatry and psychiatry as a career choice.

METHODS

In a cross-sectional design, one hundred and seventy six interns from the two medical colleges completed the Belief about Mental illness scale and Attitudes Towards Psychiatry (ATP-29) scale.

RESULTS

Majority of the interns considered mentally ill patients as dangerous, unpredictable, cannot take up major responsibilities, cannot be a good parent, have poor interpersonal or social skills. The attitude towards psychiatry overall, functioning of a psychiatrist, efficacy of psychiatry treatment was found to be good in over 90% of the interns. The attitude towards career and reward aspect of psychiatry was not favorable in about 40%. About 13% considered psychiatry as a career choice.

CONCLUSIONS

Beliefs about mental illness continue to be negative. Though the attitude towards psychiatry, psychiatrist and treatment efficacy is good, the social and reward aspects of psychiatry are not encouraging. Steps for changes in undergraduate medical education policies are required.

Dynamics of career choice among students in undergraduate medical courses. A BEME systematic review: BEME Guide No. 33

INTRODUCTION

Due to the lack of a theoretically embedded overview of the recent literature on medical career decision-making, this study provides an outline of these dynamics. Since differences in educational routes to the medical degree likely affect career choice dynamics, this study focuses on medical career decision-making in educational systems with a Western European curriculum structure.

METHODS

A systematic search of electronic databases (Medline, Embase) was conducted from January 2008 to November 2014. A panel of seven independent reviewers performed the data extraction, quality assessment and data synthesis using the Bland-Meurer model of medical specialty choice as a reference.

RESULTS

Fifty-seven studies met the inclusion criteria for the review. Factors associated with specialty preference or career choice can be classified in five main categories: (1) medical school characteristics (e.g., curriculum structure), (2) student characteristics (e.g., age, personality), (3) student values (e.g., personal preference), (4) career needs to be satisfied (e.g., expected income, status, and work-life balance), and (5) perception of specialty characteristics (e.g., extracurricular or curricular experiences). Especially career needs and perceptions of specialty characteristics are often associated with medical career decision-making.

CONCLUSION

Our results support that medical career decisions are formed by a matching of perceptions of specialty characteristics with personal needs. However, the process of medical career decision-making is not yet fully understood. Besides identifying possible predictors, future research should focus on detecting interrelations between hypothesized predictors and identify the determinants and interrelations at the various stages of the medical career decision-making process.

Attitudes toward people with mental illness among medical students

Background:

Globally, people with mental illness frequently encounter stigma, prejudice, and discrimination by public and health care professionals. Research related to medical students’ attitudes toward people with mental illness is limited from India.

Aim:

The aim was to assess and compare the attitudes toward people with mental illness among medical students’.

Materials and Methods:

A cross-sectional descriptive study design was carried out among medical students, who were exposed (n = 115) and not exposed (n = 61) to psychiatry training using self-reporting questionnaire.

Results:

Our findings showed improvement in students’ attitudes after exposure to psychiatry in benevolent (t = 2.510, P < 0.013) and stigmatization (t = 2.656, P < 0.009) domains. Further, gender, residence, and contact with mental illness were the factors that found to be influencing students’ attitudes toward mental illness.

Conclusion:

The findings of the present study suggest that psychiatric education proved to be effective in changing the attitudes of medical students toward mental illness to a certain extent. However, there is an urgent need to review the current curriculum to prepare undergraduate medical students to provide holistic care to the people with mental health problems.

What can qualitative studies reveal about recruitment into psychiatry?

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.

Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice

BACKGROUND

Mental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students' attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from considering a career in psychiatry. The aim of this study was to assess the impact of an eight week psychiatry clerkship on i) student knowledge and interest in psychiatry; ii) psychiatry as a career choice; iii) attitudes towards psychiatry; and iv) perceptions of stigma towards mental illness.

METHOD

Year 4 medical students at the University of Western Australia completed two questionnaires, the Balon Attitudes Towards Psychiatry and the Mental Illness Clinicians Attitudes (MICA), at the beginning and end of the psychiatry clerkship. Interest in, knowledge of, and consideration of psychiatry as a career were also assessed. Non-parametric tests were used to compare baseline and follow-up differences on the Balon and MICA. Unpaired t-tests compared mean differences for interest, knowledge and psychiatry as a career.

RESULTS

Attitudes towards psychiatry were positive at the beginning of the clerkship. Overall, there was a significant decrease in negative and stigmatising views towards mental illness post clerkship measured by the MICA, but the follow-up mean score remained close to the neutral value with views in some areas becoming more negative. There was no significant improvement in students' interest in psychiatry post clerkship, however, knowledge of psychiatry improved significantly. Numbers of students 'definitely considering' psychiatry as a career increased significantly from 7 (4.6%) students at baseline to 17 (10.5%) at follow-up.

CONCLUSION

The clerkship made a modest impact on students' attitudes to psychiatry, stigma and consideration of psychiatry as a career. Integration of strategies to overcome stigma towards mental illness and the mental health profession into pre-clinical teaching may provide students with skills to prepare them for the clerkship. This may assist in improving attitudes towards psychiatry and encourage more students towards a psychiatry career.

Impact of the psychiatry clerkship on medical student attitudes towards psychiatry and to psychiatry as a career

OBJECTIVE

The psychiatry clerkship forms part of the core curriculum of medical schools worldwide and provides psychiatric educators with an ideal opportunity to positively influence students. The aim of this paper is to systematically review literature on the impact of the psychiatry clerkship to determine the effect on attitudes towards psychiatry and to psychiatry as a career.

METHOD

A systematic review was undertaken. The following key search words were used to search a number of electronic databases: medical student/s, attitude/s, psychiatry and clerkship. Studies published in the English language from 1990 to the present were included. Studies were included if they were based on a pre-/post-design, i.e. the same students must have participated in the study both before and after the clerkship.

RESULTS

Twenty-six studies from 19 countries were identified for the review. Sixteen studies reported an overall improvement in attitudes towards psychiatry post-clerkship, and ten found no change in attitudes. In terms of career choice, nine studies reported an increase in the number of students interested in psychiatry as a career post-clerkship, nine found no impact on career choice and, in eight studies, it was not assessed. A number of positive and negative factors regarding the clerkship were identified.

CONCLUSION

Overall, the psychiatry clerkship has a positive impact on students' attitudes towards psychiatry, but does not improve interest in psychiatry as a career option. For those students particularly interested in psychiatry, the challenge is to maintain their enthusiasm post-clerkship. Charismatic teachers, mentorship and stigma reduction may be effective strategies. Future research needs to more clearly identify specific components of the clerkship that are viewed favorably by students.

Why medical students choose psychiatry - a 20 country cross-sectional survey

BACKGROUND

Recruitment to psychiatry is insufficient to meet projected mental health service needs world-wide. We report on the career plans of final year medical students from 20 countries, investigating factors identified from the literature which influence psychiatric career choice.

METHODS

Cross sectional electronic or paper survey. Subjects were final year medical students at 46 medical schools in participating countries. We assessed students' career intentions, motivations, medical school teaching and exposure to psychiatry. We assessed students' attitudes and personality factors. The main outcome measure was likelihood of specializing in psychiatry. Multilevel logistic regression was used to examine the joint effect of factors upon the main outcome.

RESULTS

2198 of 9135 (24%) of students responded (range 4 to 91%) across the countries. Internationally 4.5% of students definitely considered psychiatry as a career (range 1 to 12%). 19% of students (range 0 to 33%) were "quite likely", and 25% were "definitely not" considering psychiatry. Female gender, experience of mental/physical illness, media portrayal of doctors, and positive attitudes to psychiatry, but not personality factors, were associated with choosing psychiatry. Quality of psychiatric placement (correlation coefficient = 0.22, p < 0.001) and number of placements (correlation coefficient =0.21, p < 0.001) were associated with higher ATP scores. During medical school, experience of psychiatric enrichment activities (special studies modules and university psychiatry clubs), experience of acutely unwell patients and perceived clinical responsibility were all associated with choice of psychiatry.Multilevel logistic regression revealed six factors associated with students choosing psychiatry: importance of own vocation, odds ratio (OR) 3.01, 95% CI 1.61 to 5.91, p < 0.001); interest in psychiatry before medical school, OR 10.8 (5.38 to 21.8, p < 0.001); undertaking a psychiatry special study module, OR 1.45 (1.05 to 2.01, p = 0.03) or elective OR 4.28 (2.87- 6.38, p < 0.001); membership of a university psychiatry club, OR 3.25 (2.87 to 6.38, p < 0.001); and exposure to didactic teaching, OR 0.54 (0.40 to 0.72, p < 0.001).

CONCLUSIONS

We report factors relevant to medical student selection and psychiatry teaching which affect career choice. Addressing these factors may improve recruitment to psychiatry internationally.

The role of trainees as clinical teachers of medical students in psychiatry

OBJECTIVE

To consider the role of specialty trainees as clinical teachers of medical students in psychiatry.

METHOD

We discuss the role of specialty trainees as teachers and approaches to improving their skills and capacity, giving examples from the local and international literature and our own experience as psychiatry medical educators.

RESULTS

Good clinical teaching is crucial for medical students' learning but sharp increases in numbers combined with economic and workforce pressures have stretched capacity. Specialty trainees do much of the medical student teaching during their clinical placements but infrequently receive instruction on how to teach. The two common approaches to increasing capacity are, first, establishing education rotations for individual trainees and, second, providing workshops to improve trainees' confidence and skill. Psychiatry trainees surveyed in New South Wales welcomed the role of teacher and the opportunity to improve their teaching capacity. Further support from supervisors, health services and medical schools is needed to assist trainees in their teaching role.

CONCLUSION

The role that trainees play as clinical teachers should be acknowledged and supported. Further development of research and scholarship in medical education is needed to determine how best to teach trainees to teach.

Non-graduate and graduate entry medical students attitudes to psychiatry

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Recruiting medical students into psychiatry in lower income countries

There is a serious shortage of psychiatrists and poor recruitment of new psychiatry trainees worldwide. Low and middle income countries suffer disproportionately on many accounts. A negative attitude towards psychiatry is thought to contribute to poor recruitment of psychiatry trainees. Previous reviews have focused on the attitudes of medical students in high income countries, but factors relevant to attitude and recruitment may be different in lower income countries. Here we review studies of medical students' attitudes towards psychiatry from low and lower-middle income countries, summarize key themes which negatively influence attitudes, and suggest strategies for overcoming them. Major themes include stigma, perceived status of psychiatry, lack of psychiatric trainers, local cultural beliefs, poor working conditions, and quality of patient care.

[Perception of Psychiatry among Undergraduate Students of a School of Medicine]

OBJECTIVE

Learn about perceptions and beliefs regarding psychiatry among undergraduate medicine students and compare their conceptions and appreciations concerning positive and negative aspects, before and after specific training in psychiatry.

METHODS

Observational, cross-sectional study; qualitative and quantitative research with application of a survey for undergraduate medicine students of the Universidad de La Sabana, before and after a specific psychiatry course. 90 students answered the survey in two groups: one of them before the course, and the other one afterwards;

RESULTS

52,2% corresponded to semesters prior to the course of psychiatry; 25.5% expressed the purpose to specialize in Psychiatry before the course, and such percentage decreased to 13.4% after the course. Association was found between the purpose of not specializing in Psychiatry with the fact of having taken said course (Fisher's exact test, p=0,042). Most students would not specialize in psychiatry because they are interested in other areas. Before the course, students made emphasis on the biological aspects of mental disease. After the course, they also directed their attention to other factors. The two groups believe that the management of these patients is mainly pharmacological. The incurable character of mental illness was also highlighted together with the risk of getting ill and the stigma it entails.

CONCLUSIONS

Psychiatry is perceived as a medical specialization with emphasis on pharmacological treatment. There is a low frequency of students interested in this area. The course of psychiatry is associated with reduction of this frequency and limits the variability of the psychiatric concept.

Impact of psychiatric education and training on attitude of medical students towards mentally ill: A comparative analysis

BACKGROUND

A number of studies from the western world have explored the negative beliefs held by individuals towards people with mental illness. The knowledge of attitude and awareness of undergraduate medical students towards psychiatry, mental health and mental disorders is of utmost importance.

OBJECTIVE

The current study aims at assessment of attitudes of medical students towards mental illness and mentally ill.

MATERIALS AND METHODS

The study used a cross-sectional survey design. The instruments used included Beliefs toward Mental Illness (BMI) scale, Attitudes to Mental Illness Questionnaire (AMIQ). ANOVA was carried out to compare the in between group differences for the four study groups. Additionally Bonferroni correction was used to conduct the post hoc analysis.

RESULTS

The interns were significantly more likely to agree with the statement that the mental disorders are recurrent; less likely to be of thought that the behavior of people with mental disorders is unpredictable; more likely to disagree with the fact that diagnosis of depression as described in the case vignette was going to damage the career of the individual; more likely to agree with the option of inviting a depressed person to a party; more likely to believe in fact that mentally ill individuals are more likely to be criminals as compared to medical students in different professional years.

CONCLUSIONS

Adequate modifications to existing medical curriculum would help improve attitude of medical students towards mentally ill.

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

OBJECTIVES

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

METHOD

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

RESULTS

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

CONCLUSIONS

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

A controlled trial of mental illness related stigma training for medical students

BACKGROUND

The evidence base for mental illness related stigma interventions in health care professionals and trainees is underdeveloped. This study aimed to examine the impact of mental illness related stigma training on third year medical students' knowledge, attitudes and behaviour related to people with mental illness.

METHODS

A non-randomised controlled trial was conducted with 110 third year medical students at a medical school in England to determine the effectiveness of a mental illness related stigma training package that targeted their knowledge, attitudes and behaviour.

RESULTS

We detected a significant positive effect of factual content and personal testimonies training upon an improvement in knowledge, F(1, 61) = 16.3, p = 0.0002. No such difference was determined with attitudes or for behaviour.

CONCLUSIONS

Knowledge, attitudes and behaviour may need to be separately targeted in stigma reduction interventions, and separately assessed. The inter-relationships between these components in mental health promotion and medical education warrant further research. The study next needs to be replicated with larger, representative samples using appropriate evaluation instruments. More intensive training for medical students may also be required.

Up close and personal: medical students prefer face-to-face teaching in psychiatry

OBJECTIVE

The aim of this paper was to determine the teaching activities most valued by medical students in the psychiatry rotation and to examine whether this varies with age, gender or stage of training.

METHOD

Medical students at Sydney Medical School were surveyed following an 8-week clinical attachment in psychiatry. Differences in ratings between activities were examined by means of ANOVA and post hoc contrasts.

RESULTS

The learning activities involving face-to-face teaching received the highest ratings. The most valued tutorial was that given weekly by a dedicated academic clinician. No differences were seen with respect to age and gender. Inconsistent differences were seen between stages of training for skills sessions, but no other learning activities.

CONCLUSIONS

Face-to-face clinical teaching should be a priority in clinical attachments in psychiatry as it is highly valued by students and contributes to positive attitudes towards psychiatry.