EDINBURGH – British psychiatry would seem to have a self-image problem.
In a recent survey, a majority of British psychiatrists ranked their profession as the least respected of five listed specialties. They rated surgery as the most respected.
Nonpsychiatrist physicians who participated in the survey had a more generous view of psychiatry than did the psychiatrists themselves. They rated ob.gyn. as the least respected specialty, closely followed by general practice. Internal medicine was their top vote getter as most respected specialty, Dr. V. Gayathri Burrah reported at the congress.
The survey involved 51 psychiatrists and 50 nonpsychiatrists attending continuing education conferences. Twenty-three of the nonpsychiatrists were internists, 18 were general practitioners, and 5 were surgeons.
The five specialties that respondents were asked to rank in order of perceived respect were psychiatry, ob.gyn., internal medicine, general practice, and surgery. Fifty-seven percent of psychiatrists felt their own specialty was the least respected.
Forty-five percent of psychiatrists thought that their advice was not valued by nonpsychiatric colleagues, and 33% thought referrals to psychiatrists were made only as a last resort. Twenty percent thought that on the whole patients were adequately assessed before referral to psychiatry.
Eighty-eight percent of nonpsychiatrists thought that their advice was valued by colleagues in other specialties. Twenty-eight percent agreed that they made referrals to psychiatry only as a last resort. But 58% felt their patients were adequately assessed before psychiatric referral, according to Dr. Burrah of Coventry and Warwickshire Partnership Trust.
Psychiatry in the United Kingdom is struggling to recruit graduates of British medical schools.
“There is a perception that psychiatry is more removed from other medical specialties. This is partly due to the geographical separation of psychiatric services from more mainstream medical services and the perceived differences in the clinical work done,” he explained.
This was borne out in the survey results. When psychiatrists were asked why many medical school students were veering away from careers in psychiatry, 63% responded that psychiatry is seen as being too nonmedical, while 55% thought that there is a stigma attached to being associated with mental illness.
In contrast, only 36% of nonpsychiatrists thought that psychiatry is a relatively unpopular career choice because it is too nonmedical. Eighteen percent thought the explanation lies in the stigma of being associated with mental illness. Forty-eight percent of nonpsychiatrists thought that trainees did not choose psychiatry, because the patients are too challenging, and 36% said they thought the mental health specialty was too emotionally draining.
Only about one-third of psychiatrists and nonpsychiatrists thought psychiatry was taught in an appealing way in medical school. One-quarter of the psychiatrists said they avoid disclosing their profession in social situations. One-third said their family was disappointed in their career choice; none of the nonpsychiatrists felt that way.
Dr. Burrah declared having no financial conflicts.