Self-Perceived Incompetence in Psychiatric Practice of Practitioners from Southern Thailand: One Year Following Graduation

Abstract

General psychiatric training is one of the essential requirements for all Thai medical doctors, as declared by the Medical Council of Thailand in 2012. Hence, psychiatric training for medical students must be fulfilled to achieve these requirements. This study was designed to examine the change of subjects and the self-perceived incompetence in psychiatric practice of a cohort of medical doctors who graduated in the academic year of 2017, in concerns to their practices one year after graduation. Most participants were female doctors, with an average age of 25.7 years, and were working in Southern Thailand. Compared with 1 year prior, they showed a statistically significant frequency of physical disorders and increasing stress from their work. The largest topic of psychiatric practice, for which they were statistically more concerned with, concerned child and adolescent psychiatry. Self-perceived incompetence in both diagnosis and treatment significantly increased from graduation, with the exceptions of diagnoses of mental retardation, attention deficit hyperactivity, and tics/Tourette’s disorder. Substance-related disorders in adults, along with basic psychological support, were found to be general practice self-perceived incompetence, at both outpatient clinics and inpatient units. However, practice in adult outpatients at psychiatric clinics mostly demonstrated significantly more self-perceived competence. Moreover, emergency care, especially concerning patient suicide and multi-disciplinary practice, was shown to have increasing self-perceived competence among general practitioners having worked for a year following graduation. This information should be used as feedback for stakeholders in both medical education and mental health care. HIGHLIGHTS Medical doctors who graduated in southern Thailand the previous year mostly worked in the same part of Thailand and significantly increased stress and physical illness Basic psychological support in both outpatient and inpatient unit’s practices, were statistically significantly increased, compared with when the doctors graduated one year earlier The general practitioners stated that they had been most concerned with children and adolescent psychiatric practice since they graduated Emergency care and multi-disciplinary practice in psychiatric practice were shown to have increasing self-perceived competence among those who graduated M.D. a year before