Psychiatric services around the globe are undergoing significant changes. As has been repeatedly pointed out, in the next decade depression is likely to become more prevalent and carry a higher burden. In addition, it is well recognized that chronic physical diseases will contribute to psychiatric disorders, and vice versa. In spite of the ever increasing knowledge base of psychiatry, the speciality is still seen as unscientific, and that is one of the major reasons why medical students do not choose psychiatry as a speciality. However, this is not a universal observation. In some countries, such as Armenia and Japan, anecdotal evidence has suggested that the number of applicants far exceeds vacancies in training posts. Furthermore, in other countries – such as the UK and the USA – the number of applicants per training vacancy is barely sufficient to fill the posts, and these countries rely on international medical graduates. Another example is in countries such as India, where the number of training posts is extremely limited in comparison with the number of medical graduates per year.
Not withstanding these variations, it would appear that there exists a major shortage of medical workforce in psychiatry. Over the past three decades, the reasons for poor recruitment have been studied in different settings and the attitudes of medical students towards psychiatry have been influenced by a number of factors. As mentioned above, seeing psychiatry as unscientific is but one factor. Other observations have suggested that seeing the speciality as poorly resourced, with increasing demands, as well as changing roles from therapeutic interventions to a more restrictive and coercive responsibility associated with public and professional stigma, project a negative and unattractive image. In the UK, for instance, it has been shown that some medical schools are much better than others at sending larger proportions of their medical students to psychiatry. This has been attributed to better role models, hands-on clinical experience and active involvement in patient care. Other factors include an interest in humanities and arts.
This volume brings together for the first time an international team of researchers and educators to compare and contrast experiences in recruitment to psychiatry.
We are especially grateful to Professor Mario Maj, Immediate Past President of the World Psychiatric Association, for his foresight and initiative in funding a study which forms the basis of this special issue. We would like to thank our contributors who, in spite of their busy schedules, managed to deliver their manuscripts on schedule.