1
|
Munir K, Oner O, Kerala C, Rustamov I, Boztas H, Juszkiewicz K, Wloszczak-Szubzda A, Kalmatayeva Z, Iskandarova A, Zeynalli S, Cibrev D, Kosherbayeva L, Miriyeva N, Jarosz MJ, Kurakbayev K, Soroka E, Mancevska S, Novruzova N, Emin M, Olajossy M, Bajraktarov S, Raleva M, Roy A, Waqar Azeem M, Bertelli M, Salvador-Carulla L, Javed A. Social distance and stigma towards persons with serious mental illness among medical students in five European Central Asia countries. Psychiatry Res 2022; 309:114409. [PMID: 35121341 DOI: 10.1016/j.psychres.2022.114409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 02/02/2023]
Abstract
The study investigated behavioral measures of social distance (i.e., desired proximity between self and others in social contexts) as an index of stigma against those with mental illness among medical students in the Republic of North Macedonia, Turkey, Azerbaijan, Kazakhstan, and Poland, using the Reported and Intended Behavior Scale (RIBS), a standardized, self-administered behavioral measure based on the Star Social Distance Scale. The students' responses to standardized clinical vignettes on schizophrenia, and depression with suicidal ideation, were also assessed. A total of 257 North Macedonian (females, 31.5%; 1-4 grades, 189; 5-6 grades, 68); 268 Turkish (females, 43.3%; 1-4 grades, 90; 5-6 grades, 178); 450 Kazakh (females, 28.4%, 71.6%; 1-4 grades, 312; 5-6 grades, 138); 512 Azerbaijani (females, 24%; 1-4 grades, 468; 5-6 grades, 44; females, 24%), and 317 Polish (females, 59.0%; 1-4 grades, 208; 5-6 grades, 109) students were surveyed. The responses on the RIBS social distance behavior measures did not improve with advancing medical school grade, but students across all sites viewed schizophrenia and depression as real medical illnesses. The results support the development of enhanced range of integrated training opportunities for medical student to socially interact with persons with mental illness sharing their experiences with them.
Collapse
Affiliation(s)
- Kerim Munir
- Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA; World Psychiatric Association, Geneva, Switzerland.
| | - Ozgur Oner
- World Psychiatric Association, Geneva, Switzerland; Bahcesehir University School of Medicine, Istanbul, Turkey
| | - Coskun Kerala
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | | | | | - Konrad Juszkiewicz
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan; Al-Farabi Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | | | - Dragan Cibrev
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | - Lyazzat Kosherbayeva
- Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan; Al-Farabi Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | | | | | - Sanja Mancevska
- Faculty of Human Sciences, University of Economics and Innovation, Lublin, Poland
| | | | - Melda Emin
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | | | - Stojan Bajraktarov
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | - Marija Raleva
- Faculty of Medicine, Ss. Cyril and Methodius University, Skopje, Republic of North Macedonia
| | - Ashok Roy
- World Psychiatric Association, Geneva, Switzerland; Coventry and Warwickshire Partnership NHS Trust, Birmingham, UK
| | - Muhammad Waqar Azeem
- World Psychiatric Association, Geneva, Switzerland; Department of Psychiatry, Sidra Medicine, Weill Cornell Medicine, Doha, Qatar
| | - Marco Bertelli
- World Psychiatric Association, Geneva, Switzerland; CREA (Centro Ricerca E Ambulatori), Fondazione San Sebastiano, Florence, Italy
| | - Luis Salvador-Carulla
- World Psychiatric Association, Geneva, Switzerland; Health Research Institute, Faculty of Health, University of Canberra, Australia
| | - Afzal Javed
- World Psychiatric Association, Geneva, Switzerland; Warwick Medical School, University of Warwick, UK
| |
Collapse
|
2
|
Samari E, Seow E, Chua BY, Ong HL, Lau YW, Mahendran R, Verma SK, Xie H, Wang J, Chong SA, Subramaniam M. Attitudes towards psychiatry amongst medical and nursing students in Singapore. BMC MEDICAL EDUCATION 2019; 19:91. [PMID: 30917834 PMCID: PMC6437870 DOI: 10.1186/s12909-019-1518-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 03/12/2019] [Indexed: 05/28/2023]
Abstract
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.
Collapse
Affiliation(s)
- Ellaisha Samari
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Esmond Seow
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Boon Yiang Chua
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Hui Lin Ong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Ying Wen Lau
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Rathi Mahendran
- Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Swapna Kamal Verma
- Clinical and Faculty Affairs, Duke-NUS Graduate Medical School, Singapore, Singapore
- Clinical Departments, East Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - Huiting Xie
- Department of Nursing Administration, Institute of Mental Health, Singapore, Singapore
| | - Jia Wang
- Department of Nursing Administration, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| |
Collapse
|
3
|
Taş Hİ, Ertekin H. Evaluation of attitudes and thoughts of fifth grade medical faculty students towards psychiatry before and after psychiatry internship. FAMILY PRACTICE AND PALLIATIVE CARE 2018. [DOI: 10.22391/fppc.378917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
|
4
|
Curtis-Barton MT, Eagles JM. Factors that discourage medical students from pursuing a career in psychiatry. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/pb.bp.110.032532] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aims and methodThis cross-sectional study investigated the evolution of intentions among medical students to pursue a career in psychiatry and the factors that might discourage them from becoming a psychiatrist. A questionnaire survey was sent to medical students in years 1–5 at Aberdeen University.ResultsFrom 918 students, 467 (51%) returned useable responses. Proportions of students across the 5-year groups who definitely or probably intended to become psychiatrists remained fairly stable at 4–7%. In their final year, psychiatry remained a possible career option for a further 17% of students. The most potent discouraging factor was the perception of poor prognoses among psychiatric patients. Perceptions of a lack of scientific/evidence base reduced enthusiasm for becoming a psychiatrist. Issues relating to the prestige of the specialty were also important.ImplicationsIf recruitment to the specialty is to improve, these negative perceptions among students should be addressed by their teachers and more widely within psychiatry.
Collapse
|
5
|
Jilowa CS, Meena PS, Jain M, Dhanda G, Sharma KK, Kumawat AK, Dosodiya Y, Moond S. Attitude of undergraduate medical students toward psychiatry: A cross-sectional comparative study. Ind Psychiatry J 2018; 27:124-130. [PMID: 30416303 PMCID: PMC6198587 DOI: 10.4103/ipj.ipj_82_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
CONTEXT Both psychiatry as a specialty and mental illnesses carry a lot of stigmatizing attitudes. Even medical professionals are not immune to prevailing stigma. Psychiatrists are perceived to have less scientific attitude, earn less money, to be less respected, and to have less prestige. AIMS The present study was designed to know the attitude of medical students with different years of exposure to medical education, toward psychiatry as a specialty. SETTINGS AND DESIGN The study was conducted at JLN medical College, Ajmer. The participants were divided into two groups, undergraduate and interns, respectively. It was a cross-sectional descriptive study. MATERIALS AND METHODS Self-administered sociodemographic and Attitude Toward Psychiatry-30 items questionnaires were given to the second-year and medical intern and the scores were analyzed using appropriate statistical tools. STATISTICAL ANALYSIS USED Student's t-test and Chi-square test using SPSS version 21. RESULTS Nearly 84% of second-year medical students and 52% of interns had positive attitude toward psychiatry (P = 0.001). Only five second-year (5%) and two intern (1.8%) students affirmatively indicated to choose psychiatry as a career choice, while 73% denied choosing psychiatry as a specialty. CONCLUSIONS Second-year medical students showed more positive attitude than the intern group. Increasing negative attitude in higher classes might be due to poor teaching of psychiatry in under graduate training, ridiculous stereotypic comments and remarks by medical teachers and practitioners belonging to other specialty branches.
Collapse
Affiliation(s)
- Charan Singh Jilowa
- Department of Psychiatry, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Parth Singh Meena
- Department of Psychiatry, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Mahendra Jain
- Department of Psychiatry, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Gaurav Dhanda
- Department of Psychiatry, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Krishan Kumar Sharma
- Department of Psychiatry, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Anil Kumar Kumawat
- Department of Psychiatry, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Yogesh Dosodiya
- Department of Psychiatry, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Sunil Moond
- Department of Psychiatry, JLN Medical College, Ajmer, Rajasthan, India
| |
Collapse
|
6
|
Patra S, Patro BK, Nebhinani N. Images of psychiatry: Attitude survey of teaching medical specialists of India. Ind Psychiatry J 2017; 26:52-55. [PMID: 29456322 PMCID: PMC5810168 DOI: 10.4103/ipj.ipj_36_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
CONTEXT Attitude of teaching medical specialists shapes those of future doctors. Region-specific data on teaching medical specialists' attitudes toward psychiatry (ATP) are lacking from India. AIMS This study aimed to assess the attitudes of teaching medical specialists toward psychiatry and its association with sociodemographic profile and career stage. SETTINGS AND DESIGN This is a cross-sectional descriptive survey. MATERIALS AND METHODS Attitude towards psychiatry (ATP) was assessed from 188 specialists from All India Institute of Medical Sciences (AIIMS) Bhubaneswar and AIIMS Jodhpur using modified ATP scale-30. STATISTICAL ANALYSIS Descriptive statistical analysis was done using SPSS version 16.0. Associations of ATP with sociodemographic status, career stage, and family history of psychiatric illness were done using logistic regression analysis. RESULTS Overall response rate was 81.68%, and gender (confidence interval [C.I.]: 2.026-7.410, P = 0.000) and super-specialization (C.I.: 2.167-19.479, P = 0.021) were independent significant predictors for difference in attitudes. Female gender and super-specialization were associated with better attitudes. Ninety percent of participants had favorable attitude toward psychiatric illness. Four-fifth felt psychiatric patients to be as human as other patients and found psychiatric treatments effective. More than half felt that psychiatry does not stand among the three most exciting specialties and psychiatrists get less work satisfaction. Only one third said that they would have liked to be a psychiatrist. CONCLUSIONS Attitudes were favorable toward patients and psychiatric interventions whereas unfavorable toward psychiatry as a discipline.
Collapse
Affiliation(s)
- Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Binod Kumar Patro
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Naresh Nebhinani
- Department of Psychiatry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
| |
Collapse
|
7
|
Thomas SA, Dobbins MI, Hill-Jordan J, Thomas MC, Lee S, Albers J. Beginning the Work of Integration: An Investigation of Primary Care Physicians' Attitudes Toward Psychiatry. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:604-607. [PMID: 26626789 DOI: 10.1007/s40596-015-0433-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 09/18/2015] [Indexed: 06/05/2023]
Abstract
OBJECTIVE The authors sought to better understand the attitudes of primary care physicians toward psychiatrists in order to assess their receptivity for further psychiatric education. METHODS A survey about attitudes toward psychiatrists in comparison to other specialties was distributed among four family medicine residency programs at Southern Illinois University. RESULTS Respondents rated psychiatry lower than other specialties in the areas measured. However, family medicine physicians expressed a desire to work with psychiatrists and receive further education in psychiatry. CONCLUSION Favorable attitudes toward psychiatrists and education in psychiatry suggest the potential for additional family medicine training in psychiatry.
Collapse
Affiliation(s)
| | | | | | | | - Stacy Lee
- Southern Illinois University, Springfield, IL, USA
| | - Janet Albers
- Southern Illinois University, Springfield, IL, USA
| |
Collapse
|
8
|
Shalaby AS. Attitude of an Egyptian Sample of Medical Students Toward Psychiatry in Comparison to Previous Studies Using the Attitudes Towards Psychiatry (ATP-30) Questionnaire. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:213-217. [PMID: 25788335 DOI: 10.1007/s40596-015-0295-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 01/23/2015] [Indexed: 05/28/2023]
Abstract
OBJECTIVE This study aims to determine the attitude of medical students toward psychiatry at the College of Medicine, Menoufia University, Egypt, and to compare it with previous similar studies in other countries. METHODS Four hundred medical students, randomly selected from four different years, completed the Attitudes Towards Psychiatry (ATP-30) in a cross-sectional study. RESULTS The mean ATP score was 99.31; 76.3% of the students had favorable attitudes toward psychiatry and 29.5% considered psychiatry as a potential career choice. CONCLUSIONS A generally positive attitude toward psychiatry was found among medical students in Menoufia University. Consistent with this positive attitude was the relatively high percentage of students who considered psychiatry as a potential career.
Collapse
|
9
|
Stigmatization of psychiatrists and general practitioners: results of an international survey. Eur Arch Psychiatry Clin Neurosci 2015; 265:189-97. [PMID: 25190351 DOI: 10.1007/s00406-014-0530-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 08/25/2014] [Indexed: 12/17/2022]
Abstract
The stigma of mental illness affects psychiatry as a medical profession and psychiatrists. The present study aimed to compare the extent and correlation patterns of perceived stigma in psychiatrists and general practitioners. An international multicenter survey was conducted in psychiatrists and general practitioners from twelve countries. Responses were received from N = 1,893 psychiatrists and N = 1,238 general practitioners. Aspects of stigma assessed in the questionnaire included perceived stigma, self-stigma (stereotype agreement), attitudes toward the other profession, and experiences of discrimination. Psychiatrists reported significantly higher perceived stigma and discrimination experiences than general practitioners. Separate multiple regression analyses showed different predictor patterns of perceived stigma in the two groups. Hence, in the psychiatrists group, perceived stigma correlated best with discrimination experiences and self-stigma, while in the general practitioners group it correlated best with self-stigma. About 17% of the psychiatrists perceive stigma as a serious problem, with a higher rate in younger respondents. Against this background, psychiatry as a medical profession should set a high priority on improving the training of young graduates. Despite the number of existing antistigma interventions targeting mental health professionals and medical students, further measures to improve the image of psychiatry and psychiatrists are warranted, in particular improving the training of young graduates with respect to raising awareness of own stigmatizing attitudes and to develop a better profession-related self-assertiveness.
Collapse
|
10
|
Lyons Z, Janca A. Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice. BMC MEDICAL EDUCATION 2015; 15:34. [PMID: 25888984 PMCID: PMC4357197 DOI: 10.1186/s12909-015-0307-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 02/12/2015] [Indexed: 05/17/2023]
Abstract
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.
Collapse
Affiliation(s)
- Zaza Lyons
- School of Psychiatry and Clinical Neurosciences, M521, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Western Australia, Australia.
| | - Aleksandar Janca
- School of Psychiatry and Clinical Neurosciences, M521, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Western Australia, Australia.
| |
Collapse
|
11
|
Giasuddin NA, Levav I, Gal G. Mental health stigma and attitudes to psychiatry among Bangladeshi medical students. Int J Soc Psychiatry 2015; 61:137-47. [PMID: 24913265 DOI: 10.1177/0020764014537237] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND The shortage of specialized human resources in mental health in Bangladesh requires active recruitment of psychiatric residents. In addition, the involvement of positively inclined health personnel, for example, medical doctors, emerges as an immediate priority. AIM To explore stigma among medical students toward persons with mental disorders (PMDs) and their attitudes toward psychiatry. METHOD A cross-sectional study was conducted at Faridpur Medical College in Bangladesh before (First year) and following psychiatric rotation (Fifth year). Students (N = 200) filled anonymous questionnaires measuring stigma toward PMDs and attitudes to psychiatry. RESULTS Upper medical school year (p = .028), older age (p = .005), mother's lower academic level (p = .043), upper and lower socioeconomic level affiliation (p = .008) and self-consultation for mental or neurological complaints (p = .032) were associated with increased stigma toward PMDs. More favorable attitudes toward psychiatry were found in upper medical school year (p = .073) and were significantly associated with female gender (p = .018) and middle socioeconomic level affiliation (p = .013). CONCLUSION The relative improvement in attitudes toward psychiatry in the upper medical school year is overshadowed by the increased stigma toward PMDs. Specific anti-stigma program in the curriculum and strategies to improve the attitudes are required.
Collapse
Affiliation(s)
| | - Itzhak Levav
- Department of Community Mental Health, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Gilad Gal
- School of Behavioral Sciences, Tel Aviv-Yaffo Academic College, Tel Aviv, Israel
| |
Collapse
|
12
|
Abstract
OBJECTIVE This study surveyed medical teaching faculty to determine their attitudes toward psychiatry and psychiatrists. METHOD We conducted a multisite survey of a probability sample of 1057 teaching medical faculty members from 15 academic teaching centers in the United Kingdom, Europe, and Asia stratified by early, middle, and late career stage. The average response rate across countries was 65%. RESULTS The outstanding findings were that 90% of respondents considered that psychiatrists were not good role models for medical students, 84% thought psychiatric patients were unsuitable to be treated outside of specialized facilities, and 73% thought psychiatric patients were emotionally draining. We noted statistically significant differences by country, gender, career stage, and specialty. CONCLUSION These results highlight why recruitment into psychiatry is problematic in many countries and suggest that greater attention should be given to improving the perception of psychiatrists as good role models and the efficacy of psychiatric treatments.
Collapse
Affiliation(s)
- H Stuart
- Public Health Sciences, Queen's University, Kingston, ON, Canada
| | | | | |
Collapse
|
13
|
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.
Collapse
Affiliation(s)
- Joshua A Williams
- 1Psychiatry Resident at Harvard Longwood Psychiatry Residency Training Program, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | |
Collapse
|
14
|
Lyons Z. Impact of the psychiatry clerkship on medical student attitudes towards psychiatry and to psychiatry as a career. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2014; 38:35-42. [PMID: 24464416 DOI: 10.1007/s40596-013-0017-3] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 04/26/2013] [Indexed: 05/04/2023]
Abstract
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.
Collapse
Affiliation(s)
- Zaza Lyons
- University of Western Australia, Crawley, WA, Australia,
| |
Collapse
|
15
|
Abstract
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.
Collapse
|
16
|
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.
Collapse
Affiliation(s)
- Kitty Farooq
- Oxleas NHS Foundation Trust, Greenwich Recovery Service , London
| | | | | |
Collapse
|
17
|
Dvoracek B, Nawka A, Nawkova L, Vevera J, Lydall G, Malik A, Farooq K, Bhugra D. Recruitment to psychiatry in the Czech Republic: 'waiting for resuscitation'? Int Rev Psychiatry 2013; 25:466-71. [PMID: 24032503 DOI: 10.3109/09540261.2013.821405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recruitment to psychiatry is becoming a serious obstacle in providing first-class mental health treatment in many countries worldwide. We attempt to address this burning issue by examining medical student's attitudes towards psychiatry and factors influencing their career choice in the Czech Republic. In 2010, 71 students in their last year of medical school at the First Faculty of Medicine, Charles University, Prague were recruited in this quantitative cross-sectional online study. From the sample, 16% (n = 11) of students were considering psychiatry as a career path. An important factor in choosing psychiatry as a career path was personal/family presence of mental illness. Longer experience with psychiatry placement also contributed to the choice of psychiatry, as well as participation in elective courses or psychiatric research projects. Students considering psychiatry were less systematic compared to the group not considering psychiatry. Low reported levels of recruitment to psychiatry present a problematic issue in the Czech Republic. To make psychiatry more appealing to medical students, proactive steps by the relevant stakeholders need to be implemented. These strategies should include steps such as allocating more time for psychiatry in the medical curriculum, better quality of lectures, and the inclusion of additional elective courses.
Collapse
Affiliation(s)
- Boris Dvoracek
- Department of Psychiatry, First Faculty of Medicine, Charles University , Prague , Czech Republic
| | | | | | | | | | | | | | | |
Collapse
|
18
|
Sakarya D, Camsari UM, Coskun B. Motivations of medical students towards psychiatry: a perspective from Turkey. Int Rev Psychiatry 2013; 25:399-405. [PMID: 24032493 DOI: 10.3109/09540261.2013.804403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Recruitment in psychiatry has been an ongoing challenge worldwide; Turkey is no exception. In this article we have reviewed the issue from multiple aspects. Negative opinions on psychiatry among medical students have been associated with various matters, such as problems with scientific soundness, stigma, prestige and financial incentives. It has been reported that these negative opinions could be reversed by clinical exposure, improved knowledge base and increased affiliation with the field. Unfortunately, reversed attitudes do not have permanency. Considering that there has not been any study focusing on recruitment problems in Turkey, we attempted to provide a perspective by reporting the results of our study conducted with Turkish medical students. Attractive qualities of psychiatry were of particular interest. We found that brain research, neuroscience, philosophy, psychotherapy and academics are main areas of interest in psychiatry. We attempt to discuss our findings in view of current literature while noting current setbacks of psychiatry residency training in Turkey. We conclude that there exists a great need for working strategies in order to improve recruitment in psychiatry, addressing the stigma and correcting false beliefs such as treatment inefficacy or compromised scientific solidity.
Collapse
|
19
|
Aggarwal R, Guanci N, Caracci G, Concepcion E. Medical students and psychiatry: an attitude change? MEDICAL EDUCATION ONLINE 2013; 18:1-2. [PMID: 23551891 PMCID: PMC3616257 DOI: 10.3402/meo.v18i0.20676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 02/22/2013] [Indexed: 05/21/2023]
Affiliation(s)
- Rashi Aggarwal
- Department of Psychiatry, UMDNJ–New Jersey Medical School, Newark, NJ, USA
- Rashi Aggarwal, Department of Psychiatry, UMDNJ–New Jersey Medical School, BHSB F-1542, 183 S Orange Ave, Newark, NJ 07101, USA.
| | - Nicole Guanci
- Department of Psychiatry, UMDNJ–New Jersey Medical School, Newark, NJ, USA
| | - Giovanni Caracci
- Department of Psychiatry, UMDNJ–New Jersey Medical School, Newark, NJ, USA
| | - Erika Concepcion
- Department of Psychiatry, Beth Israel Medical Center, New York, NY, USA
| |
Collapse
|
20
|
Affiliation(s)
- Brian Lunn
- School of Medical Sciences Education Development, The Medical School, Newcastle University, Newcastle upon Tyne, NE2 4HH, United Kingdom
| |
Collapse
|
21
|
Gowans MC, Wright BJ, Brenneis FR, Scott IM. Which students will choose a career in psychiatry? CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2011; 56:605-13. [PMID: 22014693 DOI: 10.1177/070674371105601006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In Canada, availability of and access to mental health professionals is limited. Only 6.6% of practising physicians are psychiatrists, a situation unlikely to improve in the foreseeable future. Identifying student characteristics present at medical school entry that predict a subsequent psychiatry residency choice could allow targeted recruiting or support to students early on in their careers, in turn creating a supply of psychiatry-oriented residency applicants. METHOD Between 2002 and 2004, data were collected from students in 15 Canadian medical school classes within 2 weeks of commencement of their medical studies. Surveys included questions on career preferences, attitudes, and demographics. Students were followed through to graduation and entry data linked anonymously with residency choice data. Logistic regression was used to identify early predictors of a psychiatry residency choice. RESULTS Students (n = 1502) (77.4% of those eligible) contributed to the final analysis, with 5.3% naming psychiatry as their preferred residency career. When stated career interest in psychiatry at medical school entry was not included in a regression model, an exit career choice in psychiatry was predicted by a student's desire for prestige, lesser interest in medical compared with social problems, low hospital orientation, and not volunteering in sports. When an entry career interest in psychiatry was included in the model, this variable became the only predictor of an exit career choice in psychiatry. CONCLUSION While experience and attitudes at medical school entry can predict whether students will chose a psychiatry career, the strongest predictor is an early career interest in psychiatry.
Collapse
Affiliation(s)
- Margot C Gowans
- Department of Family Practice, University of British Columbia, Vancouver
| | | | | | | |
Collapse
|
22
|
Kahl KG, Alte C, Sipos V, Kordon A, Hohagen F, Schweiger U. A randomized study of iterative hypothesis testing in undergraduate psychiatric education. Acta Psychiatr Scand 2010; 122:334-8. [PMID: 20491718 DOI: 10.1111/j.1600-0447.2010.01567.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Iterative hypothesis testing (IHT) or related strategies of diagnostic decision making have been taught in many curricula for medical students but not in psychiatry. We therefore asked whether the addition of training in IHT may add to the quality of the psychiatry course. METHOD Seventy-two medical students were randomized to four weeks problem-based learning or to IHT. Knowledge and skills of the students were tested using a multiple choice exam and simulated patients. RESULTS Iterative hypothesis testing-trained students recognized more diagnostic items and more often identified comorbid psychiatric disorders and acute suicidal tendencies. Acquisition of general psychiatric knowledge and global satisfaction with the course were similar in both groups. CONCLUSION We conclude that teaching IHT to medical students may enhance their clinical ability to recognize complex disease patterns. Further studies are required concerning the enhancement of clinical skills in the psychiatric specialty.
Collapse
Affiliation(s)
- Kai G Kahl
- Department for Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.
| | | | | | | | | | | |
Collapse
|
23
|
Sartorius N, Gaebel W, Cleveland HR, Stuart H, Akiyama T, Arboleda-Flórez J, Baumann AE, Gureje O, Jorge MR, Kastrup M, Suzuki Y, Tasman A. WPA guidance on how to combat stigmatization of psychiatry and psychiatrists. World Psychiatry 2010; 9:131-44. [PMID: 20975855 PMCID: PMC2948719 DOI: 10.1002/j.2051-5545.2010.tb00296.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
In 2009 the WPA President established a Task Force that was to examine available evidence about the stigmatization of psychiatry and psychiatrists and to make recommendations about action that national psychiatric societies and psychiatrists as professionals could do to reduce or prevent the stigmatization of their discipline as well as to prevent its nefarious consequences. This paper presents a summary of the Task Force's findings and recommendations. The Task Force reviewed the literature concerning the image of psychiatry and psychiatrists in the media and the opinions about psychiatry and psychiatrists of the general public, of students of medicine, of health professionals other than psychiatrists and of persons with mental illness and their families. It also reviewed the evidence about the interventions that have been undertaken to combat stigma and consequent discrimination and made a series of recommendations to the national psychiatric societies and to individual psychiatrists. The Task Force laid emphasis on the formulation of best practices of psychiatry and their application in health services and on the revision of curricula for the training of health personnel. It also recommended that national psychiatric societies establish links with other professional associations, with organizations of patients and their relatives and with the media in order to approach the problems of stigma on a broad front. The Task Force also underlined the role that psychiatrists can play in the prevention of stigmatization of psychiatry, stressing the need to develop a respectful relationship with patients, to strictly observe ethical rules in the practice of psychiatry and to maintain professional competence.
Collapse
Affiliation(s)
- Norman Sartorius
- Association for the Improvement of Mental Health Programmes, Geneva, Switzerland
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Kato TA, Suzuki Y, Sato R, Fujisawa D, Uehara K, Hashimoto N, Sawayama Y, Hayashi J, Kanba S, Otsuka K. Development of 2-hour suicide intervention program among medical residents: first pilot trial. Psychiatry Clin Neurosci 2010; 64:531-40. [PMID: 20727109 DOI: 10.1111/j.1440-1819.2010.02114.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Suicide is associated not only with primary psychiatric disorders but also with physical disorders. Physicians' education on suicide prevention contributes to reducing suicide. Therefore, medical residents, who contact patients daily and who eventually become primary physicians in each specialty, might be the most appropriate candidates for intervention. In this article, we introduce our newly developed suicide intervention program among medical residents. METHODS We developed a 2-hour suicide intervention program among medical residents, based on the Mental Health First Aid (MHFA), which had originally been developed for the public. The program contains a 1-hour lecture and a 1-hour role-play session. As the first pilot trial, we conducted the program among 44 first-year medical residents at a university hospital and evaluated its effectiveness. Changes in confidence, attitudes and behavior toward suicidal people were evaluated using self-reported questionnaires before, immediately after, and 6 months after the program. RESULTS Participants' confidence and attitudes significantly improved after the program. The total mean score (standard deviation) of the Suicide Intervention Response Inventory improved from 18.4 (2.0) before the intervention to 19.4 (2.0) immediately after the intervention. However, the effectiveness was limited after 6 months. In the course of 6 months, the participants learned to apply the MHFA principles in their daily clinical practice. CONCLUSION Our newly developed brief suicide intervention program demonstrating its effectiveness among medical residents should be modified in order to be more effective in the long term. The next trial with a control group ought to be conducted to evaluate our developed program.
Collapse
Affiliation(s)
- Takahiro A Kato
- Department of Neuropsychiatry, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Lampe L, Coulston C, Walter G, Malhi G. Familiarity breeds respect: attitudes of medical students towards psychiatry following a clinical attachment. Australas Psychiatry 2010; 18:348-53. [PMID: 20645902 DOI: 10.3109/10398561003739612] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this paper was to examine the influence of a clinical attachment in psychiatry on medical students' attitudes to psychiatry as a specialty and potential career. METHOD Medical students at Sydney Medical School were surveyed following an 8-week clinical attachment in psychiatry. Secondary analyses sought to identify associations with variables such as age, gender and level of clinical experience as a medical student. RESULTS Following a clinical attachment in psychiatry, 80% of students rated their attitude to psychiatry as more positive. Approximately 32% rated themselves as likely or very likely to choose a career in psychiatry. No differences were seen with respect to gender, age or stage of training. The quality of the teaching, enthusiasm of the clinical teachers, the holistic approach and scientific basis of psychiatry were cited by students as factors influencing attitudes. CONCLUSIONS The clinical rotation in psychiatry is a significant factor influencing medical student attitudes towards psychiatry.
Collapse
Affiliation(s)
- Lisa Lampe
- Discipline of Psychiatry, University of Sydney, NSW, Australia.
| | | | | | | |
Collapse
|
26
|
Katschnig H. Are psychiatrists an endangered species? Observations on internal and external challenges to the profession. World Psychiatry 2010; 9:21-8. [PMID: 20148149 PMCID: PMC2816922 DOI: 10.1002/j.2051-5545.2010.tb00257.x] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Based on recently voiced concerns about a crisis in psychiatry, six challenges to our profession are identified and discussed. As we approach the revisions of ICD-10 and DSM-IV, the validity of psychiatry's diagnostic definitions and classification systems is increasingly questioned also from inside psychiatry. In addition, confidence in the results of therapeutic intervention studies is waning. A further challenge is the existence of de facto subgroups with opposing ideologies, a situation which is responsible for an unclear role profile of the psychiatrist. Challenges from outside include mounting patient and carer criticism, intrusion of other professions into psychiatry's traditional field of competence, and psychiatry's low status within medicine and in society in general. Studies suggest that the decline of the recruitment into psychiatry, as it is observed in many countries, might be related to problems arising from these challenges. It is unclear whether psychiatry will survive as a unitary medical discipline or whether those segments which are more rewarding, both financially and in status, will break away, leaving the unattractive tasks to carry out by what remains of psychiatry. The demise of the generalist and the rise of the specialist in modern society may contribute to this development. Attempts are underway by professional bodies to define the profile of a "general psychiatrist". Such discussions should be complemented by an analysis of the incentives which contribute to the centrifugal tendencies in psychiatry.
Collapse
Affiliation(s)
- Heinz Katschnig
- Medical University of Vienna and Ludwig Boltzmann Institute for Social Psychiatry, Lazarettgasse 14A-912, A-1090 Vienna, Austria
| |
Collapse
|
27
|
Fazel S, Ebmeier KP. Specialty choice in UK junior doctors: is psychiatry the least popular specialty for UK and international medical graduates? BMC MEDICAL EDUCATION 2009; 9:77. [PMID: 20034389 PMCID: PMC2805648 DOI: 10.1186/1472-6920-9-77] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2009] [Accepted: 12/24/2009] [Indexed: 05/13/2023]
Abstract
BACKGROUND In the UK and many other countries, many specialties have had longstanding problems with recruitment and have increasingly relied on international medical graduates to fill junior and senior posts. We aimed to determine what specialties were the most popular and desirable among candidates for training posts, and whether this differed by country of undergraduate training. METHODS We conducted a database analysis of applications to Modernising Medical Careers for all training posts in England in 2008. Total number of applications (as an index of popularity) and applications per vacancy (as an index of desirability) were analysed for ten different specialties. We tested whether mean consultant incomes correlated with specialty choice. RESULTS In, 2008, there were 80,949 applications for specialty training in England, of which 31,434 were UK graduates (39%). Among UK medical graduates, psychiatry was the sixth most popular specialty (999 applicants) out of 10 specialty groups, while it was fourth for international graduates (5,953 applicants). Among UK graduates, surgery (9.4 applicants per vacancy) and radiology (8.0) had the highest number of applicants per vacancy and paediatrics (1.2) and psychiatry (1.1) the lowest. Among international medical graduates, psychiatry had the fourth highest number of applicants per place (6.3). Specialty popularity for UK graduates was correlated with predicted income (p = 0.006). CONCLUSION Based on the number of applicants per place, there was some consistency in the most popular specialties for both UK and international medical graduates, but there were differences in the popularity of psychiatry. With anticipated decreases in the number of new international medical graduates training in the UK, university departments and professional associations may need to review strategies to attract more UK medical graduates into certain specialties, particularly psychiatry and paediatrics.
Collapse
Affiliation(s)
- Seena Fazel
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
| | - Klaus P Ebmeier
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford OX3 7JX, UK
| |
Collapse
|
28
|
|