Barriers to Choosing Psychiatry as a Career in Pakistani Medical Students and Junior Doctors – Survey Study

AIMS: In a majority of low and middle-income countries, the mental health system is weakened due to poor resources as well as poorer recruitment and retention rates in psychiatry among junior doctors. The present study utilizes a mixed-methods approach to explore the factors associated with low recruitment and retention of junior doctors in Psychiatry. METHODS: This study utilized an online survey administered among medical students and postgraduate trainees in psychiatry in Pakistan. The survey was open for 5 weeks for data collection from Nov 21st to Dec 31st, 2022. The survey was distributed conveniently using social media platforms and supplemented by snowball sampling procedures. This survey explored common myths about mental illness and psychiatrists using close-ended questions. Open-ended questions were asked to probe the participants on solutions to improve recruitment into psychiatry be improved. RESULTS: A total of 103 responses were received on the online survey, with the majority (83, 80%) of respondents being females. A majority (66, 64%) of respondents were medical students and 37 (36%) were junior doctors. Most responses were received from the two largest government sector medical universities in Karachi Pakistan, Jinnah Sindh Medical University (67%) & Dow University of Health Sciences (23%). A total of 62 (60%) respondents reported a lack of exposure to Psychiatry in medical students, to make it a career choice. A larger proportion 57 (55%) felt working in Psychiatry can affect their own mental health. A total of 43 (40%) were not sure if Psychiatry is fulfilling enough as a career and 58 (56%) felt that job satisfaction in psychiatry is difficult to achieve. Around 60% were concerned that mental health conditions are chronic and enduring psychiatrists may not have many options for treatment. In open-ended responses, several common themes emerged. Most respondents commented about their lack of exposure to psychiatry as medical students, which accounts for their reluctance to choose Psychiatry. CONCLUSION: Psychiatry forms a very limited part of the medical school curriculum and students' placements. Myths and stigma around mental illness can lead to low recruitment in Psychiatry and stigma can be challenged with more exposure to psychiatry during medical university years. Early medical study years have an influence on career choice and Psychiatry should be introduced relatively early as clinical placement. Psychiatry conferences, seminars and workshops on the local and national level can help in inspiring Medical students and junior doctors.