Changes in the attitudes of Israeli students at the Hebrew university medical school toward residency in psychiatry: A cohort study

Introduction: Recruitment of medical students to the field of psychiatry has been on the decline in the western world over the last decades. Trends in students' interest in psychiatry is a topic of research studied by medical educators in many countries. Our aim was to examine changes in the attitudes of Israeli medical students toward different specialties, including psychiatry, over the course of their training. We attempted to identify trends and patterns in these perceptions. Method: A standard validated 26-item questionnaire was administered to 307 medical students during their clinical years at the Hebrew University Medical School in 2003-2004. The response rate of the current survey was 69%. The questionnaire evaluated medical students' opinions and perceptions towards psychiatry, compared with other medical specialties. The results were compared with those found by Abramowitz and Gofrit in 2005 dealing with the same student population during their preclinical studies in 2000-2002. Results: Psychiatry was ranked as the least attractive specialty by the whole population of students in their clinical years (4th-6th year) with an average of 14.9% of students regarding psychiatry as a possible career option; 32.8% of the same cohort considered psychiatry as a specialty during the preclinical years in medical school. Significantly, psychiatry's attractiveness was rated the lowest in many aspects, and most attractive in lifestyle. These opinions showed a marked deterioration from those expressed by the same cohort during the preclinical years. Discussion: Attitudes toward psychiatry at the start of medical school are positive. Thus the potential for recruitment of future psychiatrists among the students is good. However, the present study showed a marked negative change in medical students' perceptions towards psychiatry as a possible career choice during their training. The problematic image of psychiatry as a profession has been documented in several countries. Our findings are similar. In addition, we identify the decline in interest in selecting psychiatry as a possible residency as occurring during the clinical training years. Programs should be targeted to those who show initial curiosity and interest in the workings of the mind and spirit.