Recruitment into Psychiatry: An International Challenge

Abstract

Recruitment into psychiatry is an issue that has exercised our profession over many years with multiple publications in educational and professional journals addressing the professions concerns internationally [1 -6].In this journal Malhi et al [7] studied the personality, preferences and perceptions of medical students and whether these correlated with consideration of psychiatry as a career. Like many others, they found negative perceptions of psychiatry as being " unscientifi c " and "...somehow different to mainstream medicine in terms of training and outcomes". Interestingly they also noted that there was little different with respect to personality in those students choosing psychiatry in comparison to their peers, apart, that is, from an increased tendency to be "open" i.e. "intellectually curious, emotionally aware and independent in judgement". The Recruitment CrisisThe Royal College of Psychiatrists ' annual census has, over many years, demonstrated vacancies in UK consultant psychiatrist posts as being stable in the 10 -15% range [8]. At the same time the interest in psychiatry amongst UK medical students has remained static at around 4 -5% which is insuffi cient to meet demand. This is despite changes in the demographics of recruitment to undergraduate medical courses, with more female students, and changes in the ways in which the speciality is taught. Brockington and Mumford [9] pointed out that standard selection criteria for medical schools emphasises competency in physical and biological sciences over social sciences and the humanities. Indeed it has been the case for some time that passes in physics and chemistry are rated more highly that biology itself in many medical schools. It may be the case that our courses actually reinforce this as illustrated by Silvermann et al [10] in the US showed that when patients with chest or abdominal pain were assessed by Boston medical students they were unlikely to consider possible psychosocial factors in the patients ' presentation.Prem Shah et al [11] in a study looking at Scottish doctors in the fi rst two years after qualifi cation identifi ed three broad areas that they felt impacted positively on choice of psychiatry as a career. The fi rst was early medical school experience; the second the infl uence of seniors and the third aspects related to the working environment. Many authors have considered the fi rst of these areas and Shah et al's fi ndings are not unique in this regard. In a study looking at the views of Scottish consultant psychiatrists about recruitment into psychiatry Brown et al [12] identifi ed fi ve main areas which this group felt had infl uenced their career choice. Fifth amongst these was undergraduate medical experience (the others were, in descending order; interest in, and concern for, the mentally ill; being more interested in people than diseases; a greater interest in social aspects of medicine; an ability to tolerate ambiguity) which has been highlighted by a number of authors as affecting interest in our speciality....

Medical Students Attitude Toward Psychiatry in Umm Al-Qura University: A Cross-Sectional Study.

“…In part 2: The majority of students and intern had a 1366 neutral attitude toward psychiatric knowledge, 62.38%, and 83.28% showed a neutral to negative attitude toward the scientific knowledge of psychiatry, and that most facts in psychiatry are just vague speculations, respectively. These results show that medical students and interns have anegative perception of psychiatry as an unscientific discipline and somehow different from other medical disciplines in term of training and outcome [24], similar results were reported in an Australian study [25]. The emphasis on the biological aspects of psychiatric disorders has been proposed to play a positive role to enhance the attitude toward psychiatry [9,32], as well as the integration of psychiatry into the general hospital settings [33].…”

Changes in attitudes toward psychiatry with introduction of a new curriculum: experiences of a Sri Lankan medical school

“…Interest in psychiatry among medical undergraduates has remained low despite recent developments in the discipline (1)(2)(3)(4)(5)(6). The declining interest in psychiatry among medical students and junior doctors has been of concern in both developed and developing countries (1)(2)(3)(4)(5)(6)(7). The percentage of medical students pursuing psychiatry as post-graduates has been gradually declining over the past 50 years and psychiatry remains one of the least favoured medical specialties (8).…”

Research into recruitment: Critical gaps in the literature

“…There have been several key literature reviews (although none employing systematic methodology), in the area since the 1950s (Brockington & Mumford, 2002;Eagle & Marcos, 1980;Sierles, 1982), and numerous editorials and other reviews (Brown et al, 2009;Buckley & Madaan, 2008;Eagles et al, 2007;El-Sayeh et al, 2006;Feldmann, 2005;Lunn, 2011;Newton & Grayson, 2003;Sierles et al, 2003;Stoudemire, 2000;Tamaskar & McGinnis, 2002;Thompson & Sims, 1999). The WPA and WHO produced a joint atlas of training report in 2005 (WHO, 2005a) illustrating wide variations in training opportunities worldwide.…”