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

Abstract

BackgroundRecruitment 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.MethodsCross 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.Results2198 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).ConclusionsWe report factors relevant to medical student selection and psychiatry teaching which affect career choice. Addressing these factors may improve recruitment to psychiatry internationally.

Burnout syndrome among psychiatric trainees in 22 countries: Risk increased by long working hours, lack of supervision, and psychiatry not being first career choice

“…A -all trainees in the country, B -statistically rigorous randomised sample of all trainees in the country that controls for possible sources of bias, C -randomised sample consisting of a significant proportion of all trainees in the country but without clear controls for possible sources of bias, D -all trainees from more than one training institution in the country, E -trainees from more than one training institution in the country, F -all trainees from the largest training institution in the country. 2 Number of participants who fully completed the MBI-GS and were included in the final analysis presented in this paper. 3 Percentage of trainees who fully completed the MBI-GS out of all approached trainees in each country.…”

“…1 Severe burnout was a dichotomous outcome, defined as mean sum scores ≥ 2.20 on the emotional exhaustion (MBI-EX) and ≥ 2.00 on the cynicism (MBI-CY). 2 Total weekly working hours are sum of time spent doing work assignments at one's workplace (mean 48.1, SD 14.3) and at home (mean 5.9, SD 7.1). Two participants did not provide data on their weekly working hours.…”

The choice of psychiatry as a specialty: why do we need to pay attention?

“…The main factors studied include style and quality of life, financial rewards, social prestige, as well as personality characteristics and psychological profiles 1 . Besides these factors, the choice of psychiatry as a specialty is motivated by aspects that include: quality of education in the area during medical graduation, interest even before entering graduation, intellectual challenge, importance of doctor-patient relationship, integration opportunity with other areas, and experience from personal or family experiences of psychological and/or psychiatric problems [2][3][4] .…”

“…Table 1 shows that there is a greater chance of choosing Psychiatry among students who have or had psychiatric symptoms/ disorder and/or are doing or have done psychiatric treatment. Specific studies to evaluate the medical specialty choice had already shown the association between the choice of psychiatry and the experience of personal, familiar or close people psychological/ psychiatric problems 2,3 . Our study pointed to the same direction.…”

Los especialistas en psiquiatría en México: año 2016

“…Algunos de los factores que se han visto asociados con esta preferencia incluyen: gé-nero femenino, experiencia personal y/o familiar de enfermedad mental e interés en la psiquiatría previo a estudiar medicina y que se mantiene durante la carrera. 14 En nuestro país, las plazas ofertadas para realizar la especialidad en psiquiatría no se han incrementado desde el 2007, año en el que se ofertaron 150 plazas. 15 Para el año 2015 se ofertaron 144 plazas, seis lugares menos que los disponibles ocho años atrás.…”