Psychiatry why choose

Psychiatry is a specialized field of medicine because of its focus on mental health. Currently, there is a national shortage of psychiatrists, and the demand is big. Psychiatry—like other medical specialties—is evidence-based. You can help patients who were once institutionalized indefinitely by treating them so that they can live at home even partially , work, and have relationships with people. As a psychiatrist, you have the unique opportunity to improve the mental health of your patients and improve their quality of life.

You can weigh and treat the impact of mental illness on your patients—and help them function in society. Scientists are beginning to understand the complicated systems of our brains—and how they affect our behavior. However, interestingly, the proportion of future psychiatrists choosing to specialise in psychiatry before medical school remains unchanged over time, perhaps reflecting the handful of individuals with an innate interest in psychological aspects of medicine who enter medical school with the intent to take up psychiatry.

The percentage of UK graduates entering psychiatry has remained consistent over time, confirming the extent to which international medical graduates continue to disguise the long-standing under-recruitment of UK graduates to psychiatry. This study has demonstrated that 5 of the 48 factors associated with choosing to specialise in psychiatry significantly differ in importance between core trainees and consultant psychiatrists Table 2.

All of the five factors were scored as more important by the core trainee population than by the consultant population. It is of note that four of the five factors are lifestyle factors and relate to quality of life. One possible interpretation of these results is that working hours, salary and quality of life have become of increasing importance over the past 20 years.

It may be that the simultaneous rise in the numbers of female psychiatrists over the years 13 is responsible for the demonstrated differences in the importance of lifestyle factors. Additionally, perhaps a cultural shift in family roles has led to a growth in the number of men who consider work—family balance an important factor when choosing a career. This is possibly what separates psychiatry from other medical specialties except general practice.

They are likely to represent key drivers into psychiatry which have remained significant over the years. However, the rank in which the factors appear in the top ten has altered.

There appears to be a greater vocational drive operating within the core trainees to work with the underprivileged, with empathy and concern for people with mental illness and mental health being considered an area of need ranking joint second.

This study was carried out among consultant psychiatrists and core trainees within a single area of the UK. A retrospective survey of this nature may lead to systematic recall bias which is likely to be greater for the consultant group than for the core trainees.

Direct questioning may not always reveal true motivations behind career choice. This study highlights a change in the stage of career in which doctors choose to embark on a career in psychiatry. It would be interesting to compare these results to those of core trainees in other specialties to investigate whether this finding indicates a global trend or is isolated and particular to psychiatry. Additionally, this study has identified a growing importance of lifestyle factors when choosing a career and it would be useful to discover whether this trend also appears across other specialties.

This study establishes that the reasons for choosing to specialise in psychiatry differ between core trainees and consultant psychiatrists. Numerous key driving factors for psychiatry have remained important over time, whereas other previously important factors have been displaced: academic factors seem to have been replaced by more domestic matters work—life balance, salary and quality of life.

The results of this study confirm that it is not appropriate to generalise the consultants' reasons for choosing to specialise in psychiatry to today's prospective psychiatrists. Today's recruitment strategies may be improved by promoting the likely quality of life benefits that choosing a career in psychiatry can offer in an attempt to boost psychiatry recruitment. I thank Sara Prosser for allowing me to distribute questionnaires to the psychiatrists and Professor Gill Livingston of University College London who allowed me to access a questionnaire used in a previous study.

Declaration of interests None. National Center for Biotechnology Information , U. BJPsych Bull. Author information Article notes Copyright and License information Disclaimer. Correspondence to Melissa Denman ku. In-depth qualitative interviews with a range of purposively sampled London based psychiatry trainees, aiming to explore their experiences of being taught psychiatry at medical school and how these may have affected their career choice.

Psychiatry trainees working within the London deanery were invited to complete an online survey in an email sent through the Royal College of Psychiatrists email database results reported separately [ 17 ].

On completion of the survey trainees were asked to provide their details if they agreed to be considered for an in-depth interview. Those who agreed were sent an information sheet and further brief demographic questionnaire to assist in purposive sampling for the qualitative interviews, which was based on age, gender, ethnicity, stage of training and medical school attended.

Interested trainees who had been purposively selected were sent an information sheet and consent form prior to the in-depth interviews arranged at a convenient London site.

Reflection and ongoing discussions with a colleague MB took place between interviews to ensure standardization of interview style and minimize bias. Interviews were digitally recorded, anonymised and transcribed by AA. At least two members of the study team reviewed each transcript independently. AA coded all the data. The participants did not provide feedback on the transcripts due to concerns this could alter the findings. A thematic framework was developed and agreed by consensus after the research group had reviewed all the transcripts and identified key themes.

Interview data was organised using Microsoft Excel charts and distributed amongst the research team AA, MB, NE and SS for familiarization and detection of themes, which were then finalised at a meeting attended by all members. The Framework approach was selected as it allowed the qualitative data to be organized in a transparent and systematic way [ 18 ]. Framework is a method for analyzing qualitative data, and allows both a case and theme based approach to the analysis, which helps reduce data by summarization [ 19 ] whilst still allowing researchers to compare data across and between cases [ 20 ].

It ensures links are retained to the original data which provides a comprehensive and transparent form of data analysis [ 19 ] useful when working in research teams.

The results have been reported as per the criteria from the COREQ checklist for reporting qualitative research [ 21 ].

Twenty-one psychiatry trainees working in London who had qualified from 17 different UK medical schools were interviewed see Table 1. Interview length ranged from to 22 to 50 min and interviews continued until data saturation was reached which was defined in our study as when no new themes were emerging from the final five interviews.

The themes extracted from the interviews are summarized in Table 2 and described in detail below:. Many psychiatry trainees interviewed had taken some time after qualification to come to their decision to pursue a career in psychiatry, with both positive factors and potential barriers having an influential role. A recurrent theme was the quality of their exposure to psychiatry at medical school , which was very important for some in influencing their attitudes and awareness of mental illness.

I think out of all my clinical attachments, it was the one in which I'd felt most involved… my attitude…toward psychiatrists themselves became more positive. Some trainees identified how having a reasonable time on such a placement i. Several also suggested the benefit from having sufficient time to get involved in the team, which was considered important in creating a positive teaching environment and experience. A few trainees felt that as students they were valued members of the team during their psychiatry placements, which positively impacted on their attitudes and career choice and was not necessarily the case with teaching received in other specialties.

Some recommended earlier placements in psychiatry, in order to encourage students to consider psychiatry as a viable career path earlier in their time at medical school. Some trainees suggested that all students should have exposure to both inpatient and outpatient psychiatric experiences. Some trainees suggested there might be particular personality traits, which were helpful in psychiatry:.

Several trainees recalled positive experiences of their undergraduate psychiatry teachers showing a particular interest in the students as individuals and doctors-to-be. Some trainees recalled how getting detailed personal feedback improved their confidence and skills.

In addition some trainees had identified their own role models through undertaking special study modules in psychiatry or attending career talks with inspiring speakers who helped nurture their interest. Most of the trainees had been taught in a block of psychiatry teaching, before curricula integrating teaching about mental health with physical health were introduced.

Many of those interviewed favoured the idea of integration provided it did not detract from or dilute core psychiatry teaching to ensure its recognition as a specialty in its own right. Some trainees suggested that the integration of psychiatry could be improved through increasing access to liaison psychiatry and primary care mental health placements. Some respondents suggested this would also help future psychiatrists to feel more confident with managing co-existent physical health problems and raise awareness of the overlap between physical and mental health disorders amongst all future doctors.

There were three main pathways that trainees had followed when deciding to enter into a career in psychiatry. Those who already had a prior interest and had decided to choose psychiatry before entering medical school. Those whose medical school experiences encouraged them to choose psychiatry, of whom, several had undertaken additional activities to explore their interest, such as special study modules, or specific career talks. Those who had been interested in the possibility of psychiatry as a career, but did not firmly decide until after completing a Foundation year job in psychiatry.

However, several respondents commented on how choosing psychiatry was often a decision made later in their career path, which has implications as Foundation doctors are expected to select their specialty of choice within a year of graduating from medical school.

Many of the respondents found the opportunity to have more time with patients and involvement in the psychosocial aspects of their care appealing and said this had contributed to their decision. Several trainees described a healthy work-life balance as having influenced their choice of psychiatry:. Respondents tended to rate either the psychosocial aspects or the scientific aspects of a career in psychiatry, but not both as factors that appealed to them.

A few described the research potential of psychiatry as an attraction:. Most trainees described having had negative experiences during their medical student and Foundation training and all suggested that some stigma towards working with people with mental health difficulties remains prevalent. Many described having to overcome negative attitudes from family members, peers, and senior medical clinicians as barriers along their path to choosing a career in psychiatry.

In my medicine F2 post They wanted me to be the type of doctor who was highly regarded. And they felt psychiatrists were not highly regarded The physical isolation from the rest of medicine was also considered a deterrent by some of the trainees. Several trainees also identified emotional stress as a barrier and described how this could be precipitated by the responsibility of making decisions based on clinical assessments conducted by the psychiatric team together with their individual clinical judgment rather than also being able to rely on investigations, as in most other medical specialties.

Buddy schemes, mentoring and shadowing opportunities for medical students and Foundation year doctors were all suggested as potentially helpful for those considering applying for psychiatry.

Balint groups for medical students during psychiatry placements were also suggested. There were several suggestions to improve the image of psychiatry in the media and with the public, as well as raising awareness at secondary school through outreach projects and work experience placements in psychiatry. We should be trying to I think demystify it bit, make it more human really.

Several respondents described the importance of challenging negative attitudes towards mental health amongst all clinical staff, particularly those involved in both undergraduate and postgraduate teaching. To avoid students possibly picking up a stigmatized approach to psychiatry, staff who are directly involved in medical education, should be targeted as a group who need to have their awareness raised… and should demonstrate a respect for mental health care.

This is the first study exploring the detailed views of psychiatry trainees regarding the factors, which helped or hindered their final choice of career pathway.

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