Psychiatry profession ‘must make itself more appealing to state educated non-whites’, new study suggests

Doctors are more likely to apply for psychiatry training if they are older, white and privately educated, with below average performance at medical school, according to a new study.

The statistics come from research led by the University of Plymouth, using figures from the UK Medical Education Database (UKMED). The sample comprised 7,634 doctors who entered UK medical schools in 2007/8 and who made first time specialty training applications in 2015.

Applications to specialise in specific areas of medicine follow five years of medical school and two years as a foundation doctor.

Among the findings, the statistics show that the odds of a doctor having applied to Core Psychiatry speciality training increased by 5% for each one year increase in age at entry to medical school.

In addition, just 1% of non-white doctors in the top two quartiles for educational performance measures (EPM) applied for the specialty, compared with 4% of white doctors in the bottom two EPM quartiles.

The figures come amid the ongoing shortage of psychiatrists in the UK. Alongside general practice (GP), the specialty is one of those currently experiencing a significant recruitment shortage; the latest UK census by the Royal College of Psychiatrists in 2017 identified that 10% of consultant posts and 14% of training posts in Psychiatry remained vacant despite recruitment efforts.

The study, published in the British Journal of Psychiatry Bulletin, is the first to look at statistics alone in determining factors associated with choosing to apply for psychiatry. Existing research is mainly based on surveys and feedback from those in the profession.

Lead author Dr Paul Lambe, from the Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA) at the University of Plymouth, explained why the findings were important.

“National policies are looking to widen participation in medicine, so that more people from diverse backgrounds have the opportunity to undertake a medical career,” he said. “However, the study suggests that these initiatives put in place won’t necessarily have an effect on psychiatry applications, when we consider the likely characteristics of those who apply.”
Dr Tom Gale, Project Lead and Director of CAMERA added: 

“We know that specialty choice is shaped by multiple factors and there’s more that needs to be done to understand it fully. But this new research indicates that psychiatry must make itself more attractive to all doctors in order to reduce workforce shortages, especially those from under-represented groups such as state-educated non-whites. Otherwise, national policies to widen participation in the study of medicine by such groups are unlikely to help the current recruitment crisis.”

The study follows a 2018 CAMERA study that showed junior doctors were more likely to apply to be a general practitioner (GP) if they were female, non-white, from a lower socio-economic class background and UK secondary educated.

The new research, entitled Sociodemographic and educational characteristics of doctors applying for psychiatry training in the UK: secondary analysis of data from the UK Medical Education Database project, is available to view in the British Journal of Psychiatry Bulletin (doi: 10.1192/bjb.2019.33).

Collaboration for the Advancement of Medical Education Research and Assessment (CAMERA)

We seek to inform assessment across medical education through funded collaborative research that impacts on the international literature, educational theory, practice and policy at Plymouth, nationally and internationally.

CAMERA brings together a research group dedicated to the improvement of healthcare through evidence based education.

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