Wigney Tessa, Parker Gordon
School of Psychiatry, University of New South Wales, Black Dog Institute, Prince of Wales Hospital, Randwick, NSW, Australia.
Aust N Z J Psychiatry. 2007 Sep;41(9):726-31. doi: 10.1080/00048670701518023.
Interest in training in psychiatry appears to be in decline. To pursue reasons why a career in psychiatry is not regarded as an attractive option for trainees, attitudes of senior Australian medical students were surveyed.
Fifty five medical students from one university were set a question inviting them to detail reasons why doctors might be less likely to train in psychiatry as part of their written examination in psychiatry. Several major themes and salient statements were identified from a qualitative analysis.
Analysis identified several multifaceted factors, including a difficult and pressured work environment and lack of resources due to chronic underfunding; perceived deficiency of personal skills, such as empathy; inadequate income; negative implications of stigma, low prestige, and limited patient gratitude and job satisfaction. These issues, coupled with the widespread belief that the discipline is unscientific and not "real medicine", may contribute to later decisions not to pursue training in psychiatry.
While the framing of the research question was biased towards eliciting negative evaluations of a career in psychiatry, the responses are nonetheless instructive in helping to understand the reasons why potential trainees might be discouraged from the field. If psychiatry is to attract high-quality recruits, there is clearly a need to address stigmatizing attitudes within the medical hierarchy, and provide positive educational experiences for medical students that excite their imagination about a career or even a calling - as against its negative 'job' status.
对精神病学培训的兴趣似乎在下降。为探究为何精神病学职业对实习生而言并非具有吸引力的选择，我们对澳大利亚高年级医学生的态度进行了调查。
在一所大学的55名医学生参加精神病学笔试时，设置了一个问题，邀请他们详细说明医生不太可能选择精神病学培训的原因。通过定性分析确定了几个主要主题和突出陈述。
分析确定了几个多方面的因素，包括工作环境困难且压力大，以及由于长期资金不足导致资源匮乏；个人技能方面被认为存在缺陷，如缺乏同理心；收入不足；污名化的负面影响、声望低、患者感激度有限以及工作满意度低。这些问题，再加上普遍认为该学科不科学且不是“真正的医学”，可能导致后来决定不从事精神病学培训。
虽然研究问题的框架倾向于引发对精神病学职业的负面评价，但这些回答对于帮助理解潜在实习生可能对该领域望而却步的原因仍具有指导意义。如果精神病学要吸引高素质的新成员，显然有必要消除医学等级制度中的污名化态度，并为医学生提供积极的教育体验，激发他们对该职业甚至使命感的想象，而不是其负面 的“工作”地位。
