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
Email: rz218@cam.ac.uk
http://www.bcmhr-cu.org/
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 were enthusiastic 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
1. http://www.rcpsych.ac.uk/specialtytraining/careersinpsychiatry/careersinfoforugs.aspx
2. http://www.rcpsych.ac.uk/training/studentassociates.aspx
3
Maidment R, Livingstone G, Katona M et al
Carry on shrinking: career intentions and attitudes to psychiatry of prospective medical
students
Psychiatric Bulletin, 27, 30 –32
4
Rajagopal 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