6-Hour Intervention Prompts More Med Students to Consider Psychiatry as a Career

Megan Brooks

May 21, 2019

SAN FRANCISCO — A brief intervention improves medical students' attitudes toward mental illness and prompts more to consider psychiatry as a career, new research shows.

Stigma toward psychiatry and individuals with mental illness is prevalent among healthcare providers, including medical students, which may adversely affect medical care and choice of psychiatry as a specialty, lead researcher Doron Amsalem, MD, from Tel Aviv University in Israel, noted in an interview with Medscape Medical News.

The investigators found that including a short anti-stigma intervention curriculum (ASIC) can reduce stigma toward psychiatry among medical students. "It was just a 6-hour intervention during their rotation and it made an amazing difference," Amsalem said.

Amsalem presented his research here at the American Psychiatric Association (APA) 2019 annual meeting.

Exposure "Therapy"

For the study, medical students were divided into intervention (n = 57) and no-intervention control (n = 163) groups just before beginning the 6-week psychiatry rotation in eight hospitals during one academic year. The students completed the Attitudes to Psychiatry scale (ATP-30) and the Attitudes toward Mental Illness scale (AMI), at the beginning and end of their rotation.

The anti-stigma interventions targeted prejudices and stigma by direct, informal yet supervised encounters with people with severe mental illness, during periods of remission and recovery. These encounters were designed to expose students to the underlying personal human narrative of people with psychiatric diagnosis.

Core components of the anti-stigma curriculum included small group discussions on salient topics such as liberty vs need in psychiatric care, evidence-based medicine in psychiatry, and the neuroscientific underpinnings of clinical psychiatry. Total time of the intervention was 6 hours.

The intervention led to significant improvement in the students' attitudes toward psychiatric patients (P < .001), psychiatric illness (P < .001), as well as in their knowledge of psychiatric clinical practice (P = .001) and psychiatric treatments (P = .018).

In addition, while changing attitudes toward psychiatry as a career choice was not part of the intervention, there was a significant increase in the percentage of students saying they'd pick psychiatry as a career after the intervention (P < .001). At baseline, 17% of students in the anti-stigma intervention group said they'd choose psychiatry. That jumped to 43% after the intervention.

"What was really interesting," said Amsalem, "is that we only targeted trying to change attitude toward psychiatric patients, illnesses, treatment, and knowledge. We never discussed why you should be a psychiatrist, yet attitude about psychiatry as a career improved, so this is a very positive by-product of the intervention."

Gaining Popularity

"Psychiatry is becoming one of the most popular specialities for American graduates," incoming APA President Bruce Schwartz, MD, told Medscape Medical News. "Every year, the number of medical students going into psychiatry has been increasing. Currently, about 6% of American graduates from medical school are choosing psychiatry," he said.

"Psychiatry is really the last field where you really get to talk to your patients. Rather than seeing a patient every 8 minutes or 10 minutes, we actually talk to our patients. That, I think, is very appealing," said Schwartz.

"The tragedy is that many graduates from medical school come with such enormous debt and that encourages some of them to go into the very highest paying specialties, which is not the reason why most people want to go to medical school in the first place," he added.

The study had no specific funding. Amsalem and Schwartz have have disclosed no relevant financial relationships.

American Psychiatric Association (APA) 2019: Abstract 161. Presented May 19, 2019.

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