Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

Abstract

BackgroundGiven the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option.MethodsTwo self-report questionnaires were administered to all 6th year students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests.Results153 students (60.8% female) filled in both questionnaires (no dropouts). After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry.However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students.ConclusionsThe results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment.

Attitudes Toward Psychiatry as a Prospective Career among Medical Students in Their Pre-Clinical Year in China- A Pilot Study

“…According to the existing literature on the subject, education can produce some changes to medical students’ attitudes toward psychiatry [22,30]. We suggest that all medical schools should consider supplying appropriate education or counseling about career choices to enhance the image of psychiatry (or any other specialty), which would help modify students’ attitudes and opinions toward different specialties and allow a less biased career choice.…”

Medical Students Attitude Toward Psychiatry in Umm Al-Qura University: A Cross-Sectional Study.

“…The scale consisted of 30 statements, 15 of them were negatively stated with the other 15 were positively stated. The positively stated items (i.e., questions 4,5,9,12,14,15,18,20,23,25,[27][28][29] were reversed by subtracting the score from 6. The instrument showed good internal consistency for this study (Cronbach's alpha = 0.810).…”

“…Only 48.35 % acknowledged psychiatry as an important part of the curriculum, with the majority (62.38 %) didn't consider their undergraduate psychiatric training to be valuable, which may be due to the fact that 74.62 % believe that psychiatry is so amorphous that it cannot be taught effectively. Although not examined in this study, several studies have pointed to the positive effect of psychiatric clerkship or attachment among medical students and interns [27,28,29]. In a study done in Saudi Arabia [6], the students showed a favorable attitude after they have had some experience in psychiatry.…”

Medical students’ experience and perceptions of their final rotation in psychiatry

“…The higher number of female respondents in our study correlates with the national and international 'feminisation' trend of increased female enrolments for medical studies. [10,13,23,24] There were fewer junior 5th-year respondents than senior respondents, which reflects the spread of clinical rotations over a period of 18 months, starting in the middle of the 5th year. The absence of significant differences between the different scores for male and female, junior and senior students, or for the rotations at different times of the year is indicative of the common exposure that would be expected in a psychiatry training setting.…”

“…[8,9] Most other reported surveys among psychiatry students relate to final-year students' attitudes to psychiatry or psychiatric illness, or to psychiatry as a career choice. [10][11][12][13][14][15][16][17] One study conducted among 85 preregistration house officers in Norway had more similar objectives to those of our study, namely getting a sense of the learning benefits and learning environment of a psychiatry rotation. [18] This article reports on the findings of undergraduate medical students' evaluation of the final psychiatry rotation at the University of…”