Psychiatry recruitment continues to be a problem in the UK and large-scale studies are required to understand the factors surrounding this. A quantitative, cross-sectional online survey, incorporating demographics, career choices, teaching exposure, attitudes to psychiatry and personality factors, was administered to final-year UK medical students. A total of 484 students from 18 medical schools responded (66% women). Sixteen (16%) had chosen psychiatry at medical school entry. By final year, 15 respondents (3%) had decided to pursue a career in psychiatry, while another 78 (17%) were seriously considering it. There was little difference in the quality ratings of lectures and small group teaching between those interested in psychiatry and those not. Experience of 'enrichment activities' (psychiatry special study modules or components, psychiatric research, university psychiatry clubs, and psychiatry electives) were significantly more likely to take up psychiatry. Causality cannot, however, be determined in this study. The study identified several distinct groups of UK students: those deciding on psychiatry before medical school and maintaining that career choice, those deciding on psychiatry during medical school, and those interested in other fields. Addressing psychiatry teaching and exposure may improve recruitment into the speciality.
Traumatic brain injury causes significant morbidity in youth, and headache is the most common postconcussive symptom. No established guidelines exist for pediatric post-traumatic headache management. We aimed to characterize common clinical practices of child neurologists. Of 95 practitioners who completed our survey, most evaluate <50 pediatric concussion patients per year, and 38.9% of practitioners consistently use International Classification of Headache Disorders criteria to diagnose post-traumatic headache. Most recommend nonsteroidal anti-inflammatory drugs as abortive therapy, though timing after injury and frequency of use varies, as does the time when providers begin prophylactic medications. Amitriptyline, topiramate, and vitamins/supplements are most commonly used for prophylaxis. Approach to rest and return to activities varies; one-third recommend rest for 1 to 3 days and then progressive return, consistent with current best practice. With no established guidelines for pediatric post-traumatic headache management, it is not surprising that practices vary considerably. Further studies are needed to define the best, evidence-based management for pediatric post-traumatic headache.
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