Electronic Letters to:
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eLetters: Electronic letters published:
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The Abandoned Career Choice
- Lena Palaniyappan, Denmark Hill, London SE5 8AZ (14 December 2004)
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Changing medical students' attitudes to psychiatry
- Clare E Oakley (20 December 2004)
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Lena Palaniyappan, Senior House Officer The Maudsley Hospital, Denmark Hill, London SE5 8AZ
Send letter to journal:
L.Palaniyappan{at}iop.kcl.ac.uk Lena Palaniyappan, et al.
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The fact that Psychiatry is looked down upon by medical students is disturbing though not surprising (Rajagopal S,2004). It is important to note that many students did not enjoy the rotation in Psychiatry.However, we all know that most of us are in a speciality because of some good teachers or models we had in the speciality during training and we did enjoy our clinical postings atleast to some degree. Studying the results carefully, we see that the negative attitudes are mainly because Psychiatry is ‘boring’ and ‘unscientific’.Is psychiatry really boring and unscientific? If not why this distortion? I think it is time to acknowledge that we, as specialist practitioners, have faltered in erecting proper foundations for our future lot. The picture we present to an average medical student is of a long ward round where mostly social issues are discussed, difficult patients who are reluctant to be interviewed, narratives that are challenging and time consuming to organise for a case presentation and absence of immediate rewarding sensation when you make a diagnosis in General Medicine or Neurology (This may be because we deal with syndromes rather than diseases). All the above said qualities are characteristic of our speciality and I do not appeal to change them. But what we can do is providing more supervision to students, employing a 'guarded release' system into clinical activities instead of ' clerk the patient and present to me tomorrow', changing the goal of clinical placements from 'getting signed off in the log book' to 'getting facts about the speciality'. This is the only way to make students understand that Psychiatry is not unscientific, of course it is more scientific than all other medical specialities. Most importantly, we cannot follow the streamlined education models used for other specialities; Now it is time for us to wake up and resuscitate Psychiatry! Reference: Rajagopal S, Rehill K, Godfrey E (2004).Psychiatry as a career choice compared with other specialties: a survey of medical students, Psychiatric Bulletin (2004) 28: 444-446 |
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Clare E Oakley, SHO Queen Elizabeth Psychiatric Hospital, Edgbaston, Birmingham
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clareoakley{at}doctors.org.uk Clare E Oakley
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The finding by Rajagopal et al. (2004) that psychiatry was the least popular clinical specialty amongst medical students is unsurprising but is clearly an issue that needs addressing. The authors suggested that the Royal College of Psychiatrists should undertake a campaign similar to the ‘Changing Minds’ initiative to destigmatise psychiatry in the eyes of medical students. I agree that it is important to try to change medical students’ attitudes to psychiatry but believe it can be achieved by improving their experiences during their placements. This issue was explored by McParland et al. (2003). They found that an improvement in students’ attitudes to psychiatry, following their placement, was predicted by factors such as receiving encouragement from consultants, seeing patients respond well to treatment and having direct involvement in patient care. This is consistent with my personal experience. Prior to my psychiatric attachment at medical school I had many misconceptions about psychiatry and it was certainly not a career I was contemplating. However, during my placement I received excellent teaching and encouragement from my consultant and other members of the team. I was able to see patients improve and feel that I had a direct, if small, role to play in their care. This positive experience caused me to reassess my opinions about psychiatry and to decide it was a fascinating and challenging career choice. It is clear that medical students’ attitudes to psychiatry are dependent on the actions of clinical teachers. An improvement in these attitudes will lead to more medical students considering a career in psychiatry. Therefore, it is my belief that more effective training to produce dynamic undergraduate clinical teachers will significantly improve recruitment to psychiatry. Rajagopal, S., Rehill, K. S. & Godfrey E. (2004) Psychiatry as a career choice compared with other specialties: a survey of medical students. Psychiatric Bulletin, 28, 444-446. McParland, M., Noble, L.M., et al (2003) The effect of a psychiatric attachment on students’ attitudes to and intention to pursue psychiatry as a career. Medical Education, 37 (5), 447-454. |
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