The psychiatry experience from a medical student perspective

I am a third-year medical student in the last week of psychiatry rotation. Although many positives emerged from this experience of psychiatry, it is clearly useful to identify areas of weakness, as a good undergraduate experience is crucial to encouraging recruitment into the profession.

The first challenge facing my curriculum is from sharing timetable space with neurology in a ‘brain-and-mind’ rotation. It is perhaps an indictment of attitudes towards mental health that psychiatry is found in this position, something which is not required of my other third-year rotations. The very title ‘brain and mind’ is fatally misleading, insidiously suggesting that neurology is the ‘brain’ (i.e. the challenging, scientific area), whereas psychiatry is relegated to the ‘mind’ (and by association, the opposite) by medical school and students alike. I have observed the damage to the attitudes of students previously sanguine towards psychiatry originating from this false and simplified dichotomy.

With psychiatry being the Cinderella of the ‘brain and mind’ rotation, the contrast with the ‘brain’ of neurology is stark. Neurology lectures are delivered by a locally eminent neurologist, whereas a majority of the psychiatry lecture curriculum is delegated to nurses trained in medical education. I cannot be alone in suspecting that it would be considered unthinkable for the neurology component to be delivered by nurses, yet somehow this attitude is acceptable and pervasive in psychiatric undergraduate education. Part of a wider stigma, perhaps? That, of course, is not a criticism of the teaching delivered by the psychiatric nurses (and the multidisciplinarian approach is vital in psychiatry), but if attitudes (and therefore recruitment) are to improve among medical students, then it is essential that psychiatrists lead the taught curriculum. Not only would this potentially raise standards, but also provide students with psychiatric role models. Most can recall doctors or professors from their undergraduate years who were near idolised by students. To create this culture in psychiatry would give students considering a career in psychiatry a template of how they can progress. At present, however, psychiatrists are seldom found on the ward, or delivering lectures (a common issue raised by other schools). There is great difficulty even finding psychiatrists to facilitate the psychiatry problem-based learning. The blame for these problems is not confined to one organisation and progress is being made.

Nevertheless, I have enjoyed my psychiatry rotation and have been steeled towards the specialty as a career. It is encouraging to see a more evangelical approach to recruitment being propagated by the Royal College of Psychiatrists, and I look forward to the debate continuing.