Abstract
Aims and methodPsychiatry in the UK has long-standing issues in recruiting UK-trained doctors. A key potential influence on interest in psychiatry during medical school is the clinical attachment. This narrative review investigates how the clinical experience of psychiatry affects medical students' attitudes towards the specialty.ResultsWe identified 107 studies, of which 46 were included. They showed that clinical attachments in psychiatry did result in more positive attitudes towards the specialty and increased career interest. There was inconsistent evidence on whether interest was maintained, with some studies indicating that the increase is transient. Factors which may influence attitudes include attachment setting, duration and student demographics.Clinical implicationsThe results suggest a need to actively maintain interest in psychiatry throughout medical school. Research with long-term follow-up and evaluation of schemes to maintain students' interest is needed.
Highlights
We identified 107 studies, of which 46 were included. They showed that clinical attachments in psychiatry did result in more positive attitudes towards the specialty and increased career interest
Clinical implications The results suggest a need to actively maintain interest in psychiatry throughout medical school
The Studies used a variety of tools, including the Attitudes to Mental Illness Questionnaire,[22] the Attitudes Towards Psychiatry questionnaire (ATP-30),[23] the Child and Adolescent Psychiatry Experiences Questionnaire,[24] the Libertarian Mental Health Ideology Scale,[25] the Opinions About Mental Illness questionnaire,[26,27] the Specific Attitudes towards Psychiatry questionnaire,[28] and the Derogatis’ Symptom Checklist.[29]
Summary
107 publications were identified, of which 61 studies were excluded. this review is based on 46 publications, which report 41 studies; 31 studies explored attitude change following attachments in general psychiatry. The evidence suggests that attitudes to psychiatry significantly improved after clinical attachments, the evidence level is inconsistent (positive: 20; no change: 11; negative: 1; note that this includes two results from Kuhnigk et al,[30] as this study had a cross-sectional and a longitudinal group). Cross-sectional studies surveying attitudes towards general psychiatry across medical school years provided inconsistent evidence (positive: 4; no change: 4; negative: 1). Longitudinal studies, where attitudes were measured before and after attachments, provided strong evidence of a positive change following clinical exposure (positive: 16; no change: 7; negative: 0). The relationship between clinical attachments, attitudes to psychiatry and subsequent career interest was explored by 14 studies They provided strong evidence of increased career interest post-attachment (increased: 10 studies; no change: 3 studies; decreased: 1 study).
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