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Recruitment into psychiatry: views of consultants in Scotland

  • Tom M. Brown (a1), Karen Addie (a2) and John M. Eagles (a3)
Abstract
AIMS AND METHOD

By use of a postal survey we sought to determine attitudes and beliefs about recruitment to psychiatry. Members of the Scottish Division of the Royal College of Psychiatrists were asked to complete a questionnaire asking their views on the importance of various factors in relation to recruitment (n=387).

RESULTS

Response rates were low from non-consultants and we focused on the views of the 212 consultants (55%) who responded. The perceived low status of psychiatry among other doctors and the belief that individuals with psychiatric disorders are difficult to deal with emerged as the two most important factors seen to affect recruitment. Improving undergraduate teaching in psychiatry was deemed important in enhancing recruitment.

CLINICAL IMPLICATIONS

Dealing with stigma, within and out with the profession, and improving undergraduate exposure to psychiatry may be important in recruiting doctors to psychiatry.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
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Recruitment into psychiatry: views of consultants in Scotland

  • Tom M. Brown (a1), Karen Addie (a2) and John M. Eagles (a3)
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eLetters

Stigma & less rewarding

AK Al-Sheikhli, Cosultant Psychiatrist
28 February 2008

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 brancheslike psychiatry!
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Conflict of interest: None Declared

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Recruitment and Retention in Psychiatry in Developing Countries

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

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 enthusiasmas it’s contents appear to be very relevant to the developing countries aswell. This seems to be a global issue. In addition to problems in recruitment, many psychiatrists and psychiatric trainees leave the developing countriesin 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 seemsthat once exposed to the overseas training and the western lifestyle manyare 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. MedicalGraduates 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.
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