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Objective <p>There is a global recruitment crisis in psychiatry, with insufficient medical students choosing this specialty as their medical career. Previous research describes multiple interacting factors that may influence medical students’ attitudes toward a psychiatry career but not which are most important for whom, in what respects, and in what contexts, nor how they interact to shape attitudes. Therefore, this study aimed to develop a theory to explain the complex factors shaping medical students’ attitudes toward a psychiatry career.</p> Methods <p>This realist evaluation involved three phases: phase 1 was the development of an initial program theory from published literature; in phase 2, a final program theory was developed from realist interviews with 31 UK medical students; in phase 3, evidence-based recommendations were developed.</p> Results <p>This study identified seven important contexts (positive personal experiences of mental health services; exposure to multiple psychiatry subspecialties as undergraduates; positive experiences on psychiatry placement; perceived good work-life balance for psychiatrists; perceived danger from psychiatric patients; perceived poor patient prognoses; perceived negative emotions evoked through work) and six important mechanisms (being inspired to make a difference; being interested in psychiatry; seeing psychiatry as aligned with desired lifestyle; being concerned about safety; feeling unable to make a difference; being concerned about emotional burden). These contexts and mechanisms interacted to shape positive or negative attitudes toward a psychiatry career.</p> Conclusions <p>Based on the findings, the authors recommend more pre-clinical psychiatry placements, exposure to passionate psychiatry teachers especially on psychiatry placements, and a focus on retention of interested students.</p>

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Medical Students’ Attitudes Toward a Career in Psychiatry: A Realist Evaluation

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月21日

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  • Lucy Hollands,
  • Elizabeth McCulloch,
  • Jessica Scott,
  • Jason Hancock,
  • Karen Mattick

摘要

Objective

There is a global recruitment crisis in psychiatry, with insufficient medical students choosing this specialty as their medical career. Previous research describes multiple interacting factors that may influence medical students’ attitudes toward a psychiatry career but not which are most important for whom, in what respects, and in what contexts, nor how they interact to shape attitudes. Therefore, this study aimed to develop a theory to explain the complex factors shaping medical students’ attitudes toward a psychiatry career.

Methods

This realist evaluation involved three phases: phase 1 was the development of an initial program theory from published literature; in phase 2, a final program theory was developed from realist interviews with 31 UK medical students; in phase 3, evidence-based recommendations were developed.

Results

This study identified seven important contexts (positive personal experiences of mental health services; exposure to multiple psychiatry subspecialties as undergraduates; positive experiences on psychiatry placement; perceived good work-life balance for psychiatrists; perceived danger from psychiatric patients; perceived poor patient prognoses; perceived negative emotions evoked through work) and six important mechanisms (being inspired to make a difference; being interested in psychiatry; seeing psychiatry as aligned with desired lifestyle; being concerned about safety; feeling unable to make a difference; being concerned about emotional burden). These contexts and mechanisms interacted to shape positive or negative attitudes toward a psychiatry career.

Conclusions

Based on the findings, the authors recommend more pre-clinical psychiatry placements, exposure to passionate psychiatry teachers especially on psychiatry placements, and a focus on retention of interested students.