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Original papers: Tom M. Brown, Karen Addie, and John M. Eagles Recruitment into psychiatry: views of consultants in Scotland Psychiatr Bull 2007; 31: 411-413 [Abstract] [Full text] [PDF]

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Recruitment and Retention in Psychiatry in Developing Countries

Prof K.A.L.A. Kuruppuarachchi MD,FRCPsych(UK)   (15 February 2008)

Stigma & less rewarding

AK Al-Sheikhli   (28 February 2008)

Recruitment and Retention in Psychiatry in Developing Countries 15 February 2008
Prof K.A.L.A. Kuruppuarachchi MD,FRCPsych(UK), Professor of Psychiatry Faculty of Medicine, University of Kelaniya,Ragama,Sri Lanka Send letter to journal: Re: Recruitment and Retention in Psychiatry in Developing Countries lalithkuruppu{at}lycos.com Prof K.A.L.A. Kuruppuarachchi MD,FRCPsych(UK)	I have read the article on Recruitment into psychiatry: views of consultants in Scotland by Tom M. Brown, Karen Addie and John M. Eagles (Psychiatric Bulletin, November 2007, 31 , 411-413 ) with great enthusiasm as it’s contents appear to be very relevant to the developing countries as well. This seems to be a global issue. In addition to problems in recruitment, many psychiatrists and psychiatric trainees leave the developing countries in order to find out more lucrative jobs in developed countries. For instance in Sri Lanka, Postgraduate Institute of Medicine, University of Colombo has trained a reasonable number of psychiatrists over the last few decades. However there are about 35 psychiatrists who are working in the country at present ( about 2 psychiatrists per million population). Obviously this figure is grossly inadequate. Shortage of other professionals in the multidisciplinary team add to the problem further. As a result of concentration of most of the psychiatrists in the cities peripheries are poorly served. In the MD (Psychiatry) training programme in Sri Lanka there is a component of overseas training after completion of MD (Psychiatry) part 2 examination. A survey amongst the trainees revealed that the majority preferred U.K. centres for their overseas training and all indicated that they would like to return to Sri Lanka after their overseas training ( more details are available from the author upon request). However it seems that once exposed to the overseas training and the western lifestyle many are reluctant to return. These issues were discussed at length at the recently held South Asian Federation of Psychiatric Association’s Annual Academic Sessions in Kalutara , Sri Lanka.. We believe that there are a few options to reduce this crisis. One option is to enhance the recruitment of more doctors to do psychiatry whereas another option may be to improve the knowledge of psychiatry amongst the primary care doctors. Already some medical schools in Sri Lanka (eg. University of Kelaniya and University of Colombo) have addressed this issue and increased the psychiatry training component in their undergraduate curricula. Psychiatry is assessed as a separate subject in the Final MBBS Examination in Colombo Medical School at present. Faculty of Medicine , University of Kelaniya will incorporate psychiatry as a separate subject at the final year assessment soon. It has been emphasized the importance of improving the quality of undergraduate teaching in order to enhance the recruitment of medical graduates to the field of psychiatry (Sierles). When the medical students are more knowledgeable , fear and stigma which seems to be more prevalent in developing countries such as Sri Lanka become less. A recent survey done amongst the undergraduates in Medical Schools in the Western Province of Sri Lanka demonstrated that the carrier choice in psychiatry is about 2 % which is less than the west(more details are available from the author upon request). A study done in Spain has shown that the carrier choice for psychiatry was 6 % compared with 4.5% in the United States(Guillem Pailhez, Antonio Bulbena and Richard Balon).Psychiatry seems to be a less attractive field globally. Overworked psychiatrists with minimum rewards for their work tend to lose their interest, which can adversely influence the quality of care and teaching. Psychiatrists should be aware of factors which will maintain their interest . As medical teachers and practicing psychiatrists we should be aware of this important area to enhance the recruitment and retention of psychiatrists. References Brown,T.M. Addie,K. & Eagles,J.M.(2007) Recruitment into psychiatry : views of consultants in Scotland , Psychiatric Bulletin , 31, 411-413. Sierles,F.S. Yager,J. Weissman,S.H.(2003) Recruitment of U.S. Medical Graduates Into Psychiatry; Reasons for Optimism , Sources of Concern, Academic Psychiatry ,27, 252-259. Pailhez,G. Bulbena,A. Balon,R.(2005) Attitudes to psychiatry :a comparison of Spanish and US medical students, International Psychiatry . 10, 6-8.
Stigma & less rewarding 28 February 2008
AK Al-Sheikhli, Cosultant Psychiatrist CRHT,Gambier House,West Hill Road,St.Leonards on Sea,TN38 0NG Send letter to journal: Re: Stigma & less rewarding aalsheikhli{at}aol.com AK Al-Sheikhli	I have taught psychiatry in Iraq, Jordan and UK to medical students in different medical schools. My impression is that medical students do not choose psychiatry because: 1. They think that working in psychiatry carries a stigma. 2. Psychiatry is less rewarding, not only regarding the diagnosis and treatment, but also financially. Which is more rewarding in the private sector at national and international level: is it psychiatry or other branches of medicine? 3. I have had excellent students in the past. After they finish medical school, they choose other branches of surgery and medicine but not psychiatry. 4. Pressure from family and others can affect which branch of medicine or surgery to choose. When I told a well known professor of surgery in Baghdad College of Medicine from which I graduated that I had chosen psychiatry, he said that we are losing good graduates to go to other branches like psychiatry!