Pre-registration house officers' psychiatric knowledge in practice

Abstract

Psychiatric distress is commonly found in general hospital patients and is associated with a poorer outcome and increased complexity of care. It is important for non-psychiatric hospital doctors to possess skills of assessment and treatment of common psychiatric problems. Thissurvey of all house officers in their first pre-registration posts in three large teaching hospitals found that junior doctors rarely ask about or consider the presence of psychiatric problems in their patients. Where psychiatric problems are found, house officers often feel they lack the appropriate skills of assessment and management.This has important implications for medical school course content and emphasis.

Impact of medical school teaching on preregistration house officers' confidence in assessing and managing common psychological morbidity: three centre study

“…We found that newly qualified doctors rarely assessed or had confidence in treating common psychiatric conditions, and our findings may even underestimate the extent of these problems 3 4. Two different postgraduate teaching interventions failed to improve these results.…”

Experiences from psychiatric rotation for pre-registration house officers: contributions to subjective learning

“…One study of PRHOs in medical and surgical settings found that they rarely ask about, or consider the presence of, psychiatric problems in general hospital patients. When psychiatric problems are found, the PRHOs reported that they often feel they lack the appropriate skills of assessment and management 16 . Although meeting patients with psychiatric disorders could well represent a greater personal challenge than that presented by somatic medicine, we did not find studies focusing specially on learning in psychiatry during the pre‐registration period.…”

“…These are important practical fields of psychiatry, in which all doctors, working in hospitals or in general practice, need competence and practical experience. It is known that there is a lack of practical skills in psychiatry among PRHOs 16 …”

Teaching general psychiatry to medical undergraduates

“…is asked, thus making sense of these apparently diverse symptoms. The student should be encouraged to begin to ask routine screening questions for psychiatric morbidity in their other medical placements (Williams & Wilson, 1996). The example of the teacher is the most powerful influence upon the standards of conduct and practice of every trainee (General Medical Council, 1993), and psychiatrists have an important role to play in promoting an integrated biopsychosocial assessment of patients.…”