Factors that could influence medical students' choice of psychiatry as a career: a potential opportunity for improving mental health care access in Nigeria.

Abstract

Background: Mental disorders are quite prevalent and cause significant burden and disabilities. The access of much of the world's population, especially in low and middle- income countries (LMICs), to mental health services is inadequate despite the enormous needs for those services. There is a potential opportunity in recruiting medical students to take up psychiatry as a career to ensure the future of mental health services delivery in Nigeria. This study examines the factors that determine the choice of specialty, especially psychiatry, with the aim of improving mental health care delivery.

Materials And Methods: A cross-sectional study of medical students from the University of Maiduguri to determine factors that affect their career choices with special emphasis on psychiatry.

Results: Participants in the study were 117 students mean age of 26years ± 2.9 SD. Majority were males (66.7%). Most were fifth year students (83.8%). All participants said they would specialize and some of the factors they would consider were “sheer interest" and clinical man-hours required in 41.9% and 23.1% respectively. Obstetrics and gynecology (O&G) had the highest number of prospective specialists followed by Surgery, Internal medicine, and Pediatrics in 27.4%, 22.2%, 15.4%, and 12.8% respectively. Laboratory medicine and Psychiatry, respectively, trailed with 6.0% and 5.1%. Most (54.7%) would consider Psychiatry as a second option while 45.3% wouldn't. “Longer duration of Psychiatric clinical posting” as well as “more mentoring” will make them consider psychiatry (60.6% and 68.3% respectively). Only 29.1% of the respondents were discouraged by Stigma from considering Psychiatry. There was association
between potential specialty and sex of the students (÷2 =23, p=0.028). There was also significant association between being Muslim and considering psychiatry as second option (÷2= 6.2, p= 0.013) with odds ratio of 2.74 and (95% CI, 1.23- 6.12).

Conclusion: Medical students could be encouraged to take up psychiatry as a specialty by paying attention to the factors that determine how they choose a specialty and the factors that may encourage or dissuade them from taking up psychiatry. This will have far reaching positive consequences towards improving the population access to mental health services.