What will really persuade UK graduates to consider psychiatry as a career?
Dr Rashid Zaman
BSc (Hons) MBBChir (Cantab) DGM MRCGP MRCPsych
Consultant Psychiatrist & Director BCMHR-CU
Hon. Visiting Fellow, University of Cambridge
SEPT & Dept of Psychiatry
University of Cambridge
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The current unpopularity of psychiatry as a specialty option by UK medical students and graduates fresh out of the medical school is well known and is reflected by estimates of medical students wanting to become psychiatrists being as low as 3%. Indeed, it has been reported by the Royal College of Psychiatrists that only 6% of people who took the exam for the membership of the College (MRCPsych) were UK graduates.
Clearly a worrying phenomenon, and given that many restrictions have been placed on overseas graduates entering UK, the manpower situation with regards to the availability of trained psychiatry specialist could soon become dire.
What is being done, what will help?
The Royal College of Psychiatrist on its website has very useful information for medical students who may be considering a career in psychiatry (1). Indeed, students are encouraged to become student associates of the college (2).
The encouragement for medical students has come from those holding eminent positions within the Royal College of Psychiatrists such as Prof. Bhugra (College President) and Prof. Howard (College Dean). Prof. Howard also organised a successful free Summer school at the Institute of Psychiatry during July 2009 for medical students.
Additional activities of the College include the offer of prizes and bursaries and support for student associates newsletter and for the psychiatry students’ societies affiliated with various medical schools through out UK.
All this is will certainly help to address the current worrying situation. However, from my experience (as a consultant psychiatrist and student tutor for Cambridge University medical students for 6 years) of having been successfully involved in active encouragement and recruitment into psychiatry of a significant number medical students and foundation house officers, I do believe the work at grass root level needs to be not only supported but also given recognition.
The research suggests that 49% of sixth formers found psychiatry an attractive career option (3). Yet a drastic drop appears to occur as medical students go through their training with only 3% of medical students wanting to pursue a career in psychiatry (4). Could the rather negative attitude of non-psychiatric doctors be one of many significant factors keeping medical students and young doctors away from psychiatry?
My experience suggests that encouragement of medical students at the start of their studies, with continuous support and encouragement throughout their training, well in to the foundation years (yes psychiatry foundation jobs do help) is essential. Furthermore, education of non-psychiatric doctors (in order to dispel negative ideas), provision of excellent psychiatry attachments (run by interested psychiatrists), as well as involving students in small research and audit projects (which could lead to publications) along with having good role models (psychiatrists), will also go a long way to address the dire future our profession faces.
Below are few quotes from senior Cambridge University clinical students who are considering psychiatry as a career.
“Almost all psychiatrists I have met have been positive role models. I found that most were interested in their patients as individuals, an attitude I did not find in many of my other hospital attachments. Many opportunities have been opened up to me by psychiatrists whom wereenthusiastic in helping me get into audits/research. This has allowed me to explore my psychiatry interest and develop skills that will be useful to any career I end up doing.” Sophie Butler
“If I say that I am thinking about being a psychiatrist the usual reaction is "why would you want to do that?!" Generally it seems that there is a perception among non-psych doctors that psychiatry is rather depressing and a bit "woolly" - not "real medicine". While I have tried not to be influenced this negative attitude towards psychiatry, I can imagine that it might serve to put some other students off.” Clare Holt
“Perhaps it would be possible to collaborate with other specialities in designing projects for medical students (known as special study modules at my medical school). In this way, students might realise that psychiatry is more interesting than they had ever imagined!” Clare Holt
“I think my 6-week placement with psychiatry has dispelled many of the negative notions associated with the speciality. In particular, I realised that we do not only work with 'crazy people', but rather we care for the general mental health of the population - something which has often been neglected.” Kenrick K.H. Ng
References
3Maidment R, Livingstone G, Katona M et al
Carry on shrinking: career intentions and attitudes to psychiatry ofprospective medical students
Psychiatric Bulletin, 27, 30 –32
4Rajagopal S, Rehill K S & Godfrey E
Psychiatry as a career choice compared with other specialties: A survey of medical students
Psychiatric Bulletin, 28, 444 –446