Choosing a Career in Psychiatry: Factors Associated With a Career Interest in Psychiatry Among Canadian Students on Entry to Medical School

Objective: To report the proportion of Canadian medical students interested in a career in psychiatry at medical school entry and to describe the unique demographics and career influences associated with this early interest. Methods: From 2001 to 2004, during the first 2 weeks of medical school, a 41-item survey of career choice, demographics, and attitudes toward various aspects of medical practice was distributed to all students in 18 classes at 8 Canadian medical schools. Associations between early career interest, demographics, and career influences were explored. Results: Of the 2096 completed surveys, 3.2% of students named psychiatry as their first career choice. While 34% of students considered psychiatry a possible career option, 54.9% stated mat they had not considered this option. Students interested in psychiatry were more likely than other students to have an undergraduate education in the arts, to have close family or friends practicing medicine, and to have worked voluntarily with people with mental illness. Students interested in psychiatry had a lesser social orientation than students interested in family medicine but had a greater social orientation and lesser hospital orientation than students interested in other specialties. Conclusions: Enhanced psychiatric care may be aided by the selective recruitment into medical school of students with a demonstrated empathy toward people with mental illness, an educational background in the arts, and a strong social orientation. As career influences change throughout medical school, participants in this study will be re-surveyed at graduation to better understand the evolution of career choice decision-making throughout medical school. Can J Psychiatry. 2009;54(8):557-564. Clinical Implications * Our study provides a contemporary Canadian perspective of the types of students interested in a career in psychiatry on entry to medical school. * Only 3.2% of students expressed an interest in a career in psychiatry at medical school entry, which is far below the current percentage of physicians practicing psychiatry. * Students who reported empathy toward people with mental illness, had an educational background that included the arts, and expressed a strong social orientation were most likely to be interested in a career in psychiatry. Limitations * A larger sample may have allowed us to discern more subtle associations between some of the variables and early student interest in psychiatry. * While our study was carried out at 8 medical schools, there are regions of Canada that it does not represent. * Our study does not provide associations with students' final career residency choices, which may differ significantly from their early career interests. Key Words: education, medical, undergraduate, career choice, specialties, psychiatry Before the work of Freud in the early 20th century, little was understood about normal mental processes and even less was understood about mental disorders.1 Since then, with the recognition of multiple psychiatric disease states and a developing awareness of their impact on people, families, and society, the diagnosis of mental illness has risen steadily. Recent figures state that about 20% of Canadians personally experience mental illness in any 1-year period.2 The true prevalence would be even higher if undiagnosed cases could be added to this figure. According to Health Canada, estimated costs related to mental health problems totalled $14.4 billion in 1998, placing mental illness among the most costly of all health conditions in Canada.3 Unfortunately, the availability of, and access to, mental health professionals in Canada is limited.4 Only 6.6% of practising physicians in Canada are psychiatrists,5 equating to 8.0% of full-time equivalent physicians.6 While in part a reflection of the low number of residency positions available in psychiatry, student interest is also low with between 5. …