Which students will choose a career in psychiatry

Objective: In Canada, availability of and access to mental health professionals is limited. Only 6.6% of practising physicians are psychiatrists, a situation unlikely to improve in the foreseeable future. Identifying student characteristics present at medical school entry that predict a subsequent psychiatry residency choice could allow targeted recruiting or support to students early on in their careers, in turn creating a supply of psychiatry-oriented residency applicants. Method: Between 2002 and 2004, data were collected from students in 15 Canadian medical school classes within 2 weeks of commencement of their medical studies. Surveys included questions on career preferences, attitudes, and demographics. Students were followed through to graduation and entry data linked anonymously with residency choice data. Logistic regression was used to identify early predictors of a psychiatry residency choice. Results: Students (n = 1502) (77.4% of those eligible) contributed to the final analysis, with 5.3% naming psychiatry as their preferred residency career. When stated career interest in psychiatry at medical school entry was not included in a regression model, an exit career choice in psychiatry was predicted by a student's desire for prestige, lesser interest in medical compared with social problems, low hospital orientation, and not volunteering in sports. When an entry career interest in psychiatry was included in the model, this variable became the only predictor of an exit career choice in psychiatry. Conclusion: While experience and attitudes at medical school entry can predict whether students will chose a psychiatry career, the strongest predictor is an early career interest in psychiatry. Can J Psychiatry. 2011;56(10):605-613. Clinical Implications * Our study produced a model that predicts, on entry to medical school, students who will ultimately apply for a psychiatry residency. * The strongest predictor of a psychiatry residency choice is an interest in psychiatry on entry to medical school. * About 5.3% of students in our study applied for psychiatry residencies, which is lower than the current percentage of physicians practising psychiatry. Limitations * A larger sample may have allowed us to discern other variables predictive of a psychiatry residency choice. * Attitudes at medical school application may differ from those 2 weeks after entry to medical school. * While our study was carried out at 8 medical schools, there are regions of Canada that it does not represent. Key Words: education, medical student, undergraduate, career choice, psychiatry Abbreviations CAPER Canadian Post-MD Education Registry CaRMS Canadian Residency Matching Service CIHI Canadian Institute for Health Information Comprehensive national data on the prevalence of mental illness in Canada are lacking. However, it has been suggested that at some point in their lives all Canadians are likely to be effected by the mental illness of a family member, friend, or colleague1 with the attendant emotional and economic impact of these illnesses. While provision of timely and efficacious mental health care could reduce not only the tremendous financial cost2 but also the social and emotional burden of mental illness, the availability of and access to mental health professionals in Canada is limited.3 As only 6.6% of practising Canadian physicians are trained psychiatrists,4 mental health services are currently provided largely by family physicians.5 With limited psychiatry residency positions available (5.4% of residency positions in the 2010 CaRMS match),6 this situation is unlikely to improve in the foreseeable future. Should a decision be made to increase training positions for psychiatry, it is vital that an adequate supply of students interested in this career be admitted to medical school. …