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Mirror mirror on the wall, why is ours the least desired speciality of them all?”
Concerns about training of medical students
Promoting Psychiatry to Medical Students
Professionalism and integration of quality research are key factors
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Aditya Joshi, Staff grade South Warwickshire PCT ,NHS Trust, Suraj Pal Singh,Senior House Officer(Forensic Psyhciatry),Birmingham and Solihull Mental Health Trust
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dr_adityajoshi{at}yahoo.com Aditya Joshi, et al.
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Sir, The article by El-Sayeh, Budd, Waller & Holmes in the May 2006 edition of APT describes in admirable detail how improvements in under-graduate teaching in psychiatry may well entice more medical students into our speciality. However we feel there are other issues of equal importance which do not get mentioned often enough. We are referring in particular to the image problem which our field tends to suffer from and which we suspect is responsible for a majority of medical students discounting psychiatry as a future career choice. We are certain most of us working as psychiatrists have often been reminded by colleagues in medical and surgical fields that we work in a Cinderella speciality ( that they tend to forget that Cinderella had two evil sisters is a different matter altogether ! ) . Most people entering medical school, be it in the UK or abroad, do tend to have a stereotypical picture in their minds of life in the fast lane with plenty of cardiac arrests and adrenaline surges thrown in for good measure. So one can well imagine the culture shock most students experience when they walk onto Psychiatric wards, into a land far far away where strange people calling themselves doctors do not wield stethoscopes nor carry out daring life saving procedures and where ward rounds are often punctuated by tea/coffee breaks! In short in this age of Hello and Heat magazines our speciality is not considered titillating enough. We do not claim to know the answer to this conundrum but we suspect that there are many incredibly bright people out there who do. The authors have produced a fine article which will surely be of great help in improving the standard of undergraduate teaching. Indeed the post graduate training programme in psychiatry is an excellent one and perhaps the only one of its kind which places emphasis on trainee supervision and the provision of a great deal of protected teaching time for trainee senior house officers. Unfortunately, until the Royal College of Psychiatrists packages and promotes its brand in the most aggressive manner, psychiatry will remain the poor cousin to its more glamorous relatives. The College has worked incredibly hard to erase stigma associated with mental illness. Perhaps it is time for it to focus its attention on the stigma surrounding psychiatry itself. Until such time we will continue to have difficulties in attracting recruits to what is still unfortunately perceived in certain quarters as the “Dark Side “ Aditya Joshi is currently a Staff Grade Psychiatrist in Substance Misuse based at the Woodleigh Beeches Centre, Lakin Road, Warwick e-mail: dr_adityajoshi@yahoo.com. Suraj Pal Singh is a Senior House Officer in the Coventry and Warwickshire Rotational Training Scheme in Psychiatry and is currently based at Reaside Clinic, Birmingham.e-mail: crazy_suraj@yahoo.com Both have recently passed the membership exam.This letter was conceived in a euphoric state in the aftermath of the recent MRCPsych results ! |
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Vincent O. Udenze, Psychiatrist nil
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vudenze{at}yahoo.com Vincent O. Udenze
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This is a very important article. I believe every doctor should reflect on the image they portray to medical students about our unique speciality. We have a duty and moral obligation to teach students. I wish to draw attention to some concerns about medical students training. First, it is a requirement that all psychiatrists receive training in breakaway techniques. In my Trust, all new doctors have mandatory training at induction. However medical students do not, as a mandatory requirement, have this training. Yet, they walk our wards and have contact with patients regularly without these skills and often not even carrying alarms. Risks can be unpredictable. Second, the practice of psychiatry involves a holistic approach. We seek information to enable us understand our patients symptoms and psychopathology. The contents may be disturbing to the untrained mind. I wonder what measures are in place to prepare medical students for such impacts, and more importantly to support them if they become traumatised psychologically. |
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Christopher James McAloon, Final Year Medical Student University of Birmingham, Feroz Nainar, Consultant Psychiatrist , South Birmingham PCT
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cjm232{at}bham.ac.uk Christopher James McAloon, et al.
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El-Sayeh, Budd, Walker & Holmes in May 2006 wrote a very poignant article regarding psychiatry not attracting many medical students to the speciality. As a final year medical student I found this quite surprising. I have had two psychiatry placements during my training. Both have been engaging and challenging placements, which have inspired me into a potential psychiatric career. However I am sad to say that this is not always the case in my personal experience, many of my colleagues have been less than inspired by their placements and this is in particular due to the lack motivation of their clinical leads to engage with them. The article provides many excellent points and strategies for psychiatrists to engage with students, and ideally provide the ‘modelling’ learning style the article highlights, which in my opinion facilitates ‘deep’ learning, which is the most beneficial and inspiring. However this can only occur if the ‘role model’ to the student has a particular passion for teaching students. Unfortunately with the ever increasing pool of medical students, every psychiatrist, whether a natural teacher or not may be required to supervise and teach a student. Whether the psychiatrist is a good teacher is ultimately the factor which will inspire a student into considering a career in psychiatry. Psychiatry as a speciality must compete against all the others for the ‘hearts and minds’ of students. This can be incredibly difficult considering that other specialities (e.g. general practice) have more opportunities to influence students who more often than not are exposed to several clinicians in that field, whereas with psychiatry there may only be one. Therefore that individual can make or break the student’s interest in psychiatry. Thus, I feel this article may offer much needed advice and practical strategies to allow psychiatrists to engage with medical students on placement with them, allowing a more beneficial clinical experience and the possibility of a future psychiatrist. |
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Dumindu Witharana, SHO Worcestershire basic specialist training scheme for psychiatry, Amalsh Vithanaarachchi, SHO , Worcestershire basic specialist scheme
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duminduwitharana{at}doctors.net.uk Dumindu Witharana, et al.
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Dear Editor, We read the article ‘How to win the hearts and minds of students in psychiatry’ by El-sayeh and others with interest (El-Sayeh et.al. 2006). We would like to contribute some of our experiences as junior staff members in a University Medical College Psychiatry Department a few years ago in Sri Lanka, and as basic specialist trainees in psychiatry in the UK at present. The authors make the interesting observation that sixth form students often express their desire for psychiatry as a career where as most medical students do not. What might be the reason for the change of choice? Psychiatry is an inherently interesting subject, in view of the fact it deals with the human mind, the as yet elusive domain for humankind. Joshi and Singh (Joshi and Singh, 2006) quite rightly point to stigma as one of the major factors contributing to a change. Many people view psychiatry as a ‘non scientific’ subject which is based on the hypothetical assumptions of a few individuals. Unfortunately only a few psychiatrists try to change this view by integrating quality research and a true professionalism into the subject. Psychiatry, if practised properly has vast scope for development, be it in research or in improving the mental health of an entire nation. Unfortunately, some clinicians take the easier approach of doing less, not being up to date with new developments and generally not being professional. Such conduct causes damage to the speciality. However, our experiences with students during teaching sessions have been mostly rewarding. This is mainly due to the fact that we have been able to talk to students directly and listen to their views on ways of improving the curriculum. One such issue that came up from the students was to integrate more practical sessions into psychiatry in ways such as role playing to improve the awareness of students rather than monotonous lecturer delivered teaching sessions (Kathriarachchi and Witharana, 2000). We do not agree completely with the authors' opinion on students participating in ward reviews. Our experience is that most students enjoy ward reviews and they benefit immensely by observational learning. It may be the only time in which students are exposed to the multi disciplinary team approach, the delicate art of eliciting a psychiatric history and, more importantly, the risk assessment. References El-Sayeh, H.G., Budd S., Waller R., and Holmes J. (2006) How to win the hearts and minds of students in psychiatry. Advances in Psychiatric Treatment, vol.12,182-192 Joshi, A., and Singh S. P.,(2006) Mirror mirror on the wall, why is ours the least desired specialty of them all? Website http://apt.rcpsych.org/cgi/eletters/12/3/182 20th August 2006 Kathriarachchi, S.T., and Witharana, D. (2000) Study of the Psychiatric curriculum of the University of Sri Jayawardanapura using student feedback. Colombo :Annual academic sessions, Sri Lanka Psychiatric Association. Paper 5. |
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