Recruitment and retention in psychiatry

L. Clarke-Smith

Cefn Coed Hospital, Waunarlwydd Road, Cockett, Swansea SA2 0GH, UK

R. Tranter

Hergest Unit, Ysbyty Gwynedd, Bangor LL57 2PW, UK

EDITED BY KHALIDA ISMAIL

We were encouraged to read both a review article and an editorial on recruitment in psychiatry (Brockington & Mumford, 2002; Storer, 2002). Recruitment and retention is surely one of the most important challenges for British psychiatry today. It may be of interest to point out that not only have similar recruitment problems been identified in Wales but also that research into this is ongoing.

An initial qualitative study using grounded interviews with medical students, pre-registration house officers and psychiatrists of all grades across Wales has been completed. On the basis of this, a questionnaire was developed which has been distributed to all psychiatric senior house officers, specialist registrars and staff grade doctors in Wales. These questionnaires explore various aspects of psychiatric training experience and motivations behind career intentions. From the responses, we hope to gain a greater understanding of the reasons behind the crisis.

From the initial work, one theme that is emerging is the importance of a positive training experience, initially at undergraduate level but also at later stages in a doctor's career. An enthusiastic teacher was particularly seen as a strong motivator to entering psychiatry. However, this was counterbalanced by the effect of the stigma of entering a speciality perceived as inferior. As well as problems with recruitment, there are increasing problems with retention of senior house officers, and subsequent lack of applicants for specialist registrar posts. Some disincentives to continue within training seem to be the perception of demoralised consultants not providing ideal role models for young aspiring psychiatrists. This is linked to the experience of a pressurised service that lacks resources. Both these factors appear to be an affliction affecting general psychiatry to a greater extent than the other specialities. Perceived stigma directed towards psychiatrists, mental health services and patients from our medical colleagues is a worryingly common observation, and is another potentially important finding in relation to the Royal College of Psychiatrists' ‘Changing Minds’ campaign.

We look forward to being able to share the results of our survey later this year and hope that it will provide some direction to develop solutions to this crisis.

REFERENCES

Brockington, I. & Mumford, D. (2002) Recruitment into psychiatry. British Journal of Psychiatry, 180, 307-312.[Abstract/Free Full Text]

Storer, D. (2002) Recruiting and retaining psychiatrists. British Journal of Psychiatry, 180, 296-297.[Free Full Text]





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