P02-118 - Student Career Choice in Psychiatry - Phase 1 - a Systematic Review

Abstract

Introduction

The chronic worldwide shortage of psychiatrists has impaired the delivery of first class mental health care (WHO 2008). This international project funded by a World Psychiatric Association grant proposes to examine and compare the effects of country-specific undergraduate and postgraduate factors involved in medical student choice of a psychiatric career. Phase 1 focussed on identifying published proven and novel modifiable factors to improve psychiatric recruitment.

Method

We searched EMBASE, PsychInfo and Medline using the keywords ‘career psychiatry’, ‘medical education’, and ‘career choice’. All 206 papers retrieved using the combined search were reviewed and categorized thematically.

Results

Findings are summarised under three themes:

1. · Pre-medical school factors: arts & social sciences qualifications, attitudes towards mental illness, high uncertainty tolerance, liberal political views, gender and life goals.

2. · Medical school factors: availability of psychology/sociology/special-studies modules, electives; length of clinical placement; exposure to motivated patients and effective treatment; quality of teaching and good role models; and conversely negative attitudes from other specialities.

3. · Post-graduate factors: availability of early clinical posts in psychiatry, work-life balance, remuneration.

Conclusions

1. · Studies have been limited by small sample sizes, unicentricity, and datedness, given the major reorganisations of mental health services and postgraduate training in many countries.

2. · During the next stage we will generate the first multicountry comparison, with sufficient power to detect differences in factors influencing a psychiatric career choice at personal, institutional and national level. We will focus on factors that may be modifiable by policy to positively influence career choice towards psychiatry.