Background: Medical students consistently report low rates of interest in psychiatry as a career over time with negative perceptions of the specialty. Only 3-6% of students enter the specialty. Aim: To explore medical students' current career choices and attitudes to psychiatry and factors affecting these. Methods: Medical students at four UK medical schools completed a questionnaire related to career specialty choices and psychiatry and their psychiatry placement experiences. Results: A total of 905 questionnaires were returned. Psychiatry was first career specialty choice in 4% but in the top three choices in 14%. The students in this group who had undertaken clinical placements were more positively inclined towards psychiatry, given more opportunities to practice and receive feedback on psychiatric skills, and more inclined to practice psychiatry later. Conclusion: One in seven students is interested in psychiatry. Psychiatrists need to find ways to identify these students and target them with individually tailored interventions to help recruitment into the specialty.

This study examined the prevalence of diagnosed diabetes mellitus in a defined population over 13 years by undertaking cross-sectional surveys on 3 occasions between 1983 and 1996. The study population consisted of all the people registered with 10 general (primary care) practices at the time of each survey; 90660 in 1983/4; 97122 in 1988/9; and 86287 in 1996. Ascertainment of cases was by a surveillance programme in general practice and the hospital diabetes department. The number of diabetic patients increased significantly over the study period: in 1983/4, there were 917 patients, crude prevalence 1.01% (95% CI 0.95-1.08%); in 1988/9, 1150 patients, crude prevalence 1.17% (1.12-1.25%); and in 1996, 1604 patients, crude prevalence 1.86% (1.77-1.95%). The prevalence adjusted to the age and sex distribution of the UK was 0.97% (95% CI 0.90-1.03%) in 1983/4, 1.05% (0.99-1.11%) in 1988/9 and 1.55% (1.48-1.63%) in 1996. The main increase in prevalence was due to Type 2 diabetes mellitus, crude prevalence 0.75% (95% CI 0.69-0.81%) in 1983/4, 0.92% (0.86-0.98%) in 1988/9 and 1.52% (1.44-1.60%) in 1996 rather than Type 1 diabetes mellitus, crude prevalence 0.25% (0.21-0.28%) in 1983/4, 0.25% (0.22-0.28%) in 1988/9 and 0.34% (0.30-0.38%) in 1996. During the study period, the crude prevalence of diagnosed diabetes was significantly greater in men than women; in 1983/4 men 1.1% (95% CI 1.00-1.20%) versus women 0.93% (0.84-1.02%); in 1988/9, men 1.31% (1.21-1.41%) versus women 1.07% (0.98-1.16%); and in 1996, men 2.13% (2.00-2.27%) versus women 1.60% (1.49-1.72%). This difference was statistically significant in the 1988/9 and 1996 surveys. In conclusion, over 13 years there was a significant increase of 83.6% in the prevalence of diagnosed diabetes mellitus in the Poole area, with the UK age and sex adjusted prevalence increasing by 60.7%.

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Psychiatry in the UK and in many other countries is facing a fundamental crisis in attracting new graduates. This poorly understood problem may be related to negative undergraduate experiences. Many clinicians have learnt through an ‘apprenticeship’ model and few are formally taught how to teach students in a modern clinical setting. Learning theory provides useful models for learning and teaching that can improve undergraduate clinical experiences. A variety of means are available to help teaching clinicians apply these theories, including self-help using published literature and gaining teaching qualifications. As the majority of modern undergraduate psychiatry teaching occurs during clinical placements, the incorporated techniques will need to be sensitive to the teaching environment. Application of these principles to day-to-day teaching practice may help to reverse the current staff shortages.

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