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 Table of Contents 
ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 648-651  

Why psychiatry as a career: Effect of factors on medical students' motivation


1 College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
2 College of Medicine, King Saud bin Abdulaziz University for Health Sciences; King Abdullah International Medical Research, Riyadh, Saudi Arabia

Date of Web Publication28-Feb-2019

Correspondence Address:
Dr. Fahad Marzouq Shafi AlOsaimi
Irqa, Riyadh
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jfmpc.jfmpc_399_18

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  Abstract 


Context: The number of Saudi psychiatrists in Saudi Arabia is not sufficient to keep up with the increasing need.[1] Approximately out of 6873 physicians, only 148 are psychiatrists, which is barely 2.1%.[2] Despite the high number of medical students graduating each year and the high demand for psychiatry physicians, only few medical graduates choose psychiatry as a career option.[3] Aims: To investigate the profile of final year medical students of both sexes at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. In terms of their decisions regarding specialization, this study aimed to identify the motivators and deterrents that impact the choice of psychiatry as specialty. Subjects and Methods: Students filled in a self-reported questionnaire focusing on the several factors that act as motivators, deterrents, or have no impact on psychiatry career choice. Statistical Analysis Used: Statistical analysis was done using Statistical Package for Social Sciences (SPSS)® version 20. Different factors were expressed in terms of numbers and percentages. Chi-square test was used to compare responses to the questionnaire between male and female students and whether the GPA had an effect on their choice. P value less than 0.05 was considered significant. Results: It was noted that 85% did not choose psychiatry, with the most important deterrent being “Family member is psychologically ill” and “Available job position” being the most common motivator for choosing a specialty. Conclusion: In conclusion, there are many factors that play an important role in career choice. No difference was found among male and female students, and no effect was identified while comparing GPA with career choice.

Keywords: Career, medical students, psychiatry


How to cite this article:
AlOsaimi FM, AlShehri HM, AlHasson WI, Agha S, Omair A. Why psychiatry as a career: Effect of factors on medical students' motivation. J Family Med Prim Care 2019;8:648-51

How to cite this URL:
AlOsaimi FM, AlShehri HM, AlHasson WI, Agha S, Omair A. Why psychiatry as a career: Effect of factors on medical students' motivation. J Family Med Prim Care [serial online] 2019 [cited 2019 Jun 16];8:648-51. Available from: http://www.jfmpc.com/text.asp?2019/8/2/648/253025




  Introduction Top


During their clinical years, students gain vast amount of knowledge about medicine and receive training on real patients in an authentic learning environment. This training in real settings with real patients may help students in their career selection. They get to identify their limitations and develop interest in the field of their choice.[4]

The choice of a specialty is a challenge that all students face in their clinical years of medical education, particularly during their internship years. Different factors play a role in selection as reported in a study conducted in family medicine that identified various factors that have an impact on the career choice among students. The most commonly reported factors are social status, ability to help others, availability of position, personal interest, and financial benefits.[4] In the last 10 years, many medical colleges have been established in Saudi Arabia, and approximately 9,210 students graduate from 32 medical colleges in the country every year. The Ministry of Health (MOH) in its report published in 2017 stated that the number of Saudi physicians in Riyadh region till date is approximately 6873, of which only 148 are Saudi psychiatrists, which barely reaches 2.1%; moreover, there is a shortage of doctors in many specialties including psychiatry.[2]

Psychiatry as a career choice is still not popular among students due to its negative impact and the associated stigma.[5] To elucidate this concept is the need of the hour is that can be improved and strengthened through lectures, during clerkship in psychiatry units, as well as conferences on psychiatry.[6] A qualitative study assessed the impact of psychiatry training and identified the positive impact of psychiatric clerkship on students' career choice. In addition, this study reported that integration of psychiatry with teaching medical sciences and awareness at the secondary school level may have a positive impact on the attitude of medical students toward psychiatry as a career choice.[7]

Although psychiatry has been given due importance, there are reports on the weakness in the mental health services in Saudi Arabia.[1],[8] A previous study done in Jazan in 2016 showed that the preferred specialties were surgery, pediatrics, and internal medicine. Psychiatry was also frequently chosen as a specialty by students. Very few students chose community medicine and public health and gynecology.[3]

Different factors influenced these choices such as the possibility of a foreign scholarship, opportunity for helping people, and challenging the nature of the field.[3] Choices like these affect the health sector by over supplying or creating shortages in some specialties, e.g., the only 121 psychiatrists out of 5,821 physicians in Riyadh (MOH 2017). Another established factor is the short duration of exposure during the clinical years of medical school.[9] Stigmatization toward psychiatric patients has also been attributed to affect the choice of psychiatry as a speciality.[8]

To the best of authors' knowledge, only few studies have been done on this subject, but no study has been conducted on elucidating the contributing factors in the selection of psychiatry as a career choice. Thus, study on the decision of psychiatry as a specialty chosen among medical students in KSAU-HS will be done with an objective to assess the factors that play a role in this choice. The result will provide better insights and help stakeholders in the planning of psychiatry teaching with medical sciences and in raising awareness.


  Subjects and Methods Top


The study was a cross-sectional survey conducted among last year students in KSAU-HS. A purposive sampling method was used. A total of 81 students responded to the questionnaire administered to final year medical students (157 students), with a response rate of 51.5%. All students were in the last year of their study. Participation in the study was voluntary, and an informed consent form was also administered along with the questionnaire.

The questionnaire was composed of two parts. The first part dealt with the demographic details, and if they considered psychiatry as the first career choice [Table 1], while the second part was a two-point questionnaire which had 23 factors marking each factor as a motivator or nonimpactful\deterrent evaluating student's perceptions regarding the factors influencing the specialty choices according to their own perception [Table 2]. These factors included community need, lifestyle, available job position, available scholarship, psychologically ill family member, prestige, high income, program length, geographic location, service–training balance, research opportunities, formal mentorship, elective opportunities, benefits, emphasis on psychotherapy, job market for psychiatry, concerns regarding personal safety, stigma maong students, emphasis on neuroscience, limited treatments, and outreach opportunities.
Table 1: Demographics of students

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Table 2: Responses of students on different items with high percentage

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Statistical analysis was done using Statistical Package for Social Sciences (SPSS)® version 20. Different factors were expressed in terms of numbers and percentages. Chisquare test was used to compare responses to the questionnaire between male and female students and whether the GPA had an effect. P value less than 0.05 was considered significant.


  Results Top


A total of 81 responses were obtained (71 males and 10 females). Only 15% chose psychiatry as a career choice whereas 86% did not. Overall, 72% of the students found “available job position” to be one of the main factors that motivated them to a specialty followed by “lifestyle” among 69%, as having lesser night duties and nature of workload led to choosing a specialty suitable for them.

Approximately 67% of the students considered “benefits” and 63% considered “high financial income” as important motivators to consider, keeping in mind that 55% of the students have an income of 30,000 and above.

On the other hand, 88.9% mentioned that “family member is psychologically ill” to be the most nonimpactful\deterrent to choose a specialty, whereas the “stigma among students” was considered to be a deterrent in 60%, and “program length” was considered by 49%, as the students divided with duration of the postgraduate studies length.

Analyzing the difference in the response to the questionnaire, gender and GPA showed no significant difference. Different genders showed no significant difference in influencing factors (Chi-square, 0.23; P value, 0.64), as well as GPA (Chi-square, 0.03; P value, 0.99). [Table 3]
Table 3: Gender and GPA wise comparison with career choice

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According to these results, students were more concerned with lifestyle and availability of positions.[7]


  Discussion Top


This study was conducted with an objective to identify the motivators and deterrents for choosing psychiatry as a specialty. A total of 81 students participated in the study. Among them 85% of the final-year students preferred other specialties over psychiatry (Need of MOH). The choice was influenced by several factors, with availability of job positions and lifestyle being the most important motivating factors having a strong influence on students' specialty choice. Surprisingly, having a family member who is psychologically ill was a deterring factor [Table 4].
Table 4: Factor-wise comparison of student career choice

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Another study conducted in London conducted among psychiatry trainees showed that early exposure and a positive role model were very influential factors.[7] Moreover, availability of posts after graduation was very valuable. It was suggested that raising awareness in secondary schools, challenging the stigma among medical educators, and promoting more integration within the medical specialities improves medical attitude and promotes enrolment into psychiatry.

Another study conducted in Riyadh investigated the career preferences of 109 first-year medical students (57 females and 53 males), and showed that the top speciality choices were general surgery (23%), pediatrics (18%), and dermatology (15%). Important factors affecting these choices included primary aptitude, advice of peers, reputation, financial rewards, and the challenges involved.[10]

In a cross-sectional online study done among 502 students in Singapore[11] showed that several factors categorized as non-medical factors influenced choosing psychiatry as a career choice, i.e., preschool influence, interest in the field, and having a family member or close contact with psychiatric illness. Among medical factors, i.e., attending psychiatry health club and having an optional elective course in the speciality were significant factors for choosing to enrol in psychiatry. Having a negative attitude toward psychiatry, being uninterested, and prior training with some level of responsibility on psychiatric patients were strong deterrents for choosing psychiatry.

In a 20-country study involving 2198 students conducted to determine the factors influencing their choice of psychiatry,[12] only 4.5% of students reported psychiatry as their first choice as a career specialty. Female gender along with a personal experience of psychiatric illness and media portrayal of doctors were associated with positive choices of psychiatry. In the study, males were less likely to choose psychiatry than females as (16% vs. 21%) unlike our study which showed no gender difference.


  Conclusion/Recommendation Top


This study concluded that several factors played an important rule in the career choice such as available job positions and lifestyle. GPA and gender did not have any impact on the decision regarding career choice. The study had some limitations which need to be addressed to generalize the results on a broader level. Our first limitation is that the study was done only in one medical college and with one batch of final-year medical students. It is imperative to expand it to other universities and internship students. The second limitation was the duration and time of the study. The study was conducted when many students were busy in their midterm examination and data were collected in a month, which might be the reason for low response rate, especially from female students. More research is recommended on a larger scale. It is recommended that psychiatry teaching should be improved by adopting a longitudinal approach with other medical sciences field. Ministry of Health in Saudi Arabia and medical colleges should develop programs to raise awareness.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
AI-Sughayir M. Attitude to Psychiatry three-year follow-up of a cohort of Saudi medical students, at their first post-graduate year. Arab J Psychiatric 2004;15:60-75.  Back to cited text no. 1
    
2.
Ministry of Health, Kingdom of Saudi Arabia: Statistics Book; 2017. p. 70. Available from: https://www.moh.gov.sa/en/Ministry/Statistics/book/Documents/ANNUAL-STATISTICAL-BOOK-1438H.pdf.  Back to cited text no. 2
    
3.
Khalafalla HE, Albasheer O, Najjar MA, Alshafie AY, Maghfoori HB, Mahnashi MM, et al. Medical specialty choice and related factors among medical students of Jazan University, Saudi Arabia. Int J Prevent Public Health Sci 2016;1:1-5.  Back to cited text no. 3
    
4.
Avery D, Wheat JR, McKnight JT, Leeper JD. Factors associated with choosing family medicine as a career specialty: What can we use?. Am J Clin Med 2009;6:54-8.  Back to cited text no. 4
    
5.
Lyons Z, Janca A. Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice. BMC Med Educ 2015;15:34.  Back to cited text no. 5
    
6.
Sarker MR, Khan MZ, Jahan N, Maruf MM, Chowdhury AW, Abdul Hamid MD, et al. Attitudes towards psychiatry among undergraduate medical students. Bang J Psychiatry 2014;28:45-9.  Back to cited text no. 6
    
7.
Appleton A, Singh S, Eady N, Buszewicz M. Why did you choose psychiatry? A qualitative study of psychiatry trainees investigating the impact of psychiatry teaching at medical school on career choice. BMC Psychiatry 2017;17:276.  Back to cited text no. 7
    
8.
El-Islern F. Cultural applications of social Psychiatry in Arabian Gulf communities. Arab J Psychiatric 1994;5:57-81.  Back to cited text no. 8
    
9.
Lau JT, Zamani D, Lee EK, Asli KD, Gill J, Brager N, et al. Factors affecting recruitment into psychiatry: A Canadian experience. Acad Psychiatry 2015;39:246-52.  Back to cited text no. 9
    
10.
Kaliyadan F, Amin TT, Qureshi H, Alwadani F. Specialty preferences of 1st year medical students in a Saudi Medical School – Factors affecting these choices and the influence of gender. Avicenna J Med 2015;5:134-9.  Back to cited text no. 10
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11.
Seow LSE, Chua BY, Mahendran R, Verma S, Ong HL, Samari E, et al. Psychiatry as a career choice among medical students: A cross-sectional study examining school-related and non-school factors. BMJ Open 2018;8:e022201.  Back to cited text no. 11
    
12.
Farooq K, Lydall GJ, Malik A, Ndetei DM, Group I, Bhugra D. Why medical students choose psychiatry-a 20 country cross-sectional survey. BMC Med Educ 2014;14:12.  Back to cited text no. 12
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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