Concern over shrinking numbers of UK recruits to psychiatry

Royal college cites doctors’ ‘negative attitudes’ to subject in highlighting dearth of entrants. Hannah Fearn reports

May 26, 2009

A marked drop in the recruitment of medicine graduates into psychiatry is threatening the UK’s academic standing in the discipline.

The falling number of UK medicine graduates choosing the specialty is being blamed on a negative attitude towards the subject among doctors, and the Royal College of Psychiatrists fears the decline is putting the UK’s reputation in the field under threat.

“The single most important threat facing psychiatry and the care of people with mental illness in this country is the inability to attract our own medical graduates into psychiatry,” said Rob Howard, dean of the college.

“Academically it’s a complete disaster because the very best people won’t think of coming into psychiatry, and scholarship won’t move on in this country.

“We’ve really punched above our weight historically, but we’ll lose our academic edge and our place as a world leader,” Professor Howard said.

The proportion of UK nationals among the graduates sitting the college’s membership examinations has fallen from an average of between 15 and 20 per cent over the past decade to just 6 per cent last year.

Professor Howard said that the attitudes of doctors and academics in other medical disciplines were putting young graduates off psychiatry.

“We do have to accept some of the stigma attached to our patients. Lots of other doctors don’t think we’re ‘real doctors’. They will tell young doctors: ‘You don’t want to do that, you’re a real doctor,’” he said.

“There’s a stigma at every stage. Even when they’ve finished their two foundation years, they tell their bosses they’re thinking of being a psychiatrist and they come under lots of pressure.”

He said UK psychiatry was now becoming reliant on foreign doctors and academics.

“When it becomes unpopular, you become dependent on doctors from overseas. Then people get the feeling that it’s not something that we train in as a UK trainee,” he said.

“It’s never been particularly popular so the baseline we’ve dropped from isn’t particularly high.”

Concern about the fall in applications is so great that the college has called on high-profile figures, including Stephen Fry, the actor and author who has spoken of his history of depression, to urge medical students to specialise in psychiatry.

Professor Howard said that improved teaching in university medical schools would help. “I don’t think psychiatry has been taught in a very inspiring way. We’re thinking about how to make the curriculum more sexy and exciting,” he said.

The Royal College of Psychiatrists is also encouraging student associates to join the professional body, and is hosting summer schools for undergraduates interested in moving into psychiatry.

However, Professor Howard said psychiatrists had to do more to promote the benefits of a career in the discipline. “The recruitment crisis is everybody’s problem and everybody’s business,” he said.

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