CJO - Abstract - Reasons why some UK medical graduates who initially choose psychiatry do not pursue it as a long-term career

Psychological Medicine (2006), 36: 679-684 Cambridge University Press

Copyright © 2006 Cambridge University Press

doi:10.1017/S0033291705007038

Published online by Cambridge University Press 23 Jan 2006

Original Article

Reasons why some UK medical graduates who initially choose psychiatry do not pursue it as a long-term career

TREVOR W. LAMBERT ^a1^c1, GILL TURNER ^a1, SEENA FAZEL ^a2 and MICHAEL J. GOLDACRE ^a1
^a1 UK Medical Careers Research Group, Department of Public Health, Oxford University
^a2 University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford and Oxfordshire Mental Healthcare NHS Trust

Article author query

lambert tw [PubMed] [Google Scholar]

turner g [PubMed] [Google Scholar]

fazel s [PubMed] [Google Scholar]

goldacre mj [PubMed] [Google Scholar]

Abstract

Background. Some doctors who initially choose psychiatry do not pursue it as a long-term career. The study seeks to identify reasons for leaving psychiatry.

Method. Postal questionnaire survey of UK medical graduates of 1988, 1993, 1996 and 1999 identified as having left psychiatry; for comparison, doctors who left general practice or trauma and orthopaedics.

Results. Response rate was 74% (572/778); 488 respondents satisfied study criteria (59 psychiatry, 318 general practice, 111 trauma and orthopaedics). The speciality's poor public image, perceived lack of respect from medical peers, perceived threat of violence from patients, under-resourcing and low morale were problems for psychiatry leavers. Job stress, self-assessed unsuitability, and concerns about the lack of evidence-based treatments also influenced decisions to leave psychiatry.

Conclusions. Early exposure to psychiatry may help trainees assess their suitability. Negative perceptions of workforce issues (e.g. low morale) and of clinical issues (e.g. perceived lack of ability to improve prognosis) need addressing to increase retention.

(Published Online January 23 2006)

Correspondence:
^c1 Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Old Road Campus, Oxford OX3 7LF. (Email: trevor.lambert@dphpc.ox.ac.uk)