A Week Long “PEP” Talk – Initial and 2-3 Year Longitudinal Data on the Ottawa Psychiatry Enrichment Program (OPEP)

Abstract

Background: Recruitment to psychiatry has been challenging in Canada and abroad. Historically 4-6% of medical students match to psychiatry in Canada. Novel and innovative measures to increase interest in psychiatry among medical students are needed to meet the increasing demand for psychiatrists given the increasing burden of mental health issues globally. Common barriers include negative attitudes and stigma towards psychiatry and a paucity of knowledge about the field. The study goal was to evaluate the efficacy of the Ottawa Psychiatry Enrichment Program (OPEP), a one-week extracurricular program about psychiatry as a career, developed for 1st and 2nd year medical students to improve medical students’ attitudes towards psychiatry, and increase recruitment.Methods: 1st and 2nd year medical students from Canada applied to OPEP. Attendees completed the Attitudes Towards Psychiatry Questionnaire (ATP-30) before OPEP (PreOPEP), after OPEP (PostOPEP) and after their Canadian Residency Matching Service (CaRMs) match 2-3 years later. OPEP ATP-30 scores were compared to third-year student ATP-30 scores before and after their psychiatry rotation. Data were analysed using Friedman non-parametric ANOVA and post hoc testing by either Wilcoxon rank sum test, Wilcoxon matched pairs signed rank test, or parametric Welch independent t-test as appropriate. Effect sizes of group mean differences were calculated using Cohen’s “d”. Results: 29 students were selected for OPEP from 2017-2018 from across Canada. 100%, 93.1% and 75.8% of students completed the PreOPEP, PostOPEP, and CaRMs ATP-30 surveys respectively. 43% of OPEP attendees matched to psychiatry. PostOPEP ATP-30 scores (mean=133, median=137, SD=10.6) were significantly higher than PreOPEP ATP-30 (mean score=121, median=122, SD=9.3, p < 0.001) and CaRMS ATP-30 (mean=126, median=127, SD=12.3, p < 0.02) scores. OPEP effect size on ATP-30 scores was large (d=1.2) but decreased 2-3 years later (p=0.078, d=0.44). 97/202 students completed the ATP-30 before and after their psychiatry rotation (clerkship). Clerkship effect size on improvement in ATP-30 was moderate (d=0.39). There was a non significant difference between OPEP CaRMS ATP-30 and post clerkship ATP-30 scores (median 127 vs 121, p=0.056). Conclusions: OPEP ameliorated attitudes toward Psychiatry, but improvement deteriorated longitudinally. Additional strategies to boost/retain these improvements during clerkship years may be beneficial.