To identify the determinants of practice location and of outreach consultation of recently graduated psychiatrists.
We surveyed 153 psychiatrists who graduated from the University of Toronto Department of Psychiatry between January 1990 and June 2002 (response rate 51%), on the basis of a self-administered mail questionnaire. The survey assessed factors that influenced practice location and outreach consultation, such as demographics, links to practice communities, and outreach experiences, including rural or northern electives as a resident.
Professional variables were rated as the most important factors in choosing a practice location. Variables such as age or sex were not significantly associated with location. Nine percent reported working in communities of less than 100,000, and only 1% practised in Northern Ontario. Eighteen percent practised in the same location where they were born or raised. Forty-four percent had rural or northern experience as a resident but almost exclusively in the form of short, fly-in consultation electives. Twenty-four percent indicated that they provide outreach consultation. Psychiatry residents who participated in outreach electives were 10 times as likely as those who did not participate to continue outreach as a consultant.
Although early exposure to rural or northern medicine leads to significantly greater continued involvement in outreach activities after graduation, our findings suggest the need for more long-term, on-site residency training opportunities in rural and remote areas.
Although the need for specialists in emergency psychiatry is increasing, little attention is given to this field by American psychiatric residency programs, and few psychiatrists choose emergency psychiatry as a career. Like their American counterparts, few Canadian psychiatric residents also choose this specialty. To determine Canadian patterns of emergency education and Canadian residents' opinions of their emergency psychiatry experience, the authors distributed a 41-item questionnaire to 190 psychiatric residents across Canada. The results showed that most residents worked long hours alone, with little complementary education or evaluation. Residents in programs with formal education and evaluation components and on-call assignments no more than once a week found the emergency psychiatry experience most rewarding. The authors make a series of recommendations to strengthen the educational aspects of the emergency psychiatry experience.
OBJECTIVE: To investigate the attitudes of Danish medical students as to the attractiveness of psychiatry as a career possibility and to asses the impact on such attitudes of actual contact with psychiatry. METHOD: A base-line survey included 222 senior medical students, of whom 160 were also surveyed subsequent to a 4-week psychiatric affiliation. RESULTS: The base-line survey shows that psychiatry is rated as less attractive than other specialization groups, and that working as health assistants in psychiatric wards contributes to the problematic image. However, a 4-week psychiatric affiliation resolves a number of image issues, and following such an affiliation more medical students were considering specializing in psychiatry. CONCLUSION: The findings of this study suggest that psychiatric affiliations can influence students' attitudes to psychiatry. The observed changes in attitudes lead to the presumption that some aspects of the image problem of psychiatry stem from inadequate knowledge of psychiatry as a specialty and the actual work psychiatrists perform.
A systematic effort is underway to rationalize the planning of physician supply. This paper summarizes the current methodologies available and focuses on the attempts to determine the optimal psychiatrist-to-population ratio in Canada. The impact of several variables influencing this ratio is discussed. An outline of the correlation between target physician supply and requirements of future trainees is presented. While the relevant methodology is rapidly evolving, an improved process of data collection is urgently required. A number of challenges for our profession lay ahead, such as the need for sensitive and reliable measures of the adequacy of psychiatrist and subspecialist supply and public issues arising from the poor geographic distribution of psychiatric manpower.
A critical aspect of the problem of mental health service delivery to Hispanics is the inadequacy of manpower resources, especially the lack of professional workers with a knowledge of the Hispanic culture and language. Two factors--underrepresentation of Hispanics at professional levels and curriculum deficits in training programs--account for the persistence of inadequate manpower. The author discusses both themes from the Puerto Rican perspective, emphasizing the development of didactic and practical learning experiences for both Puerto Rican and non-Hispanic trainees and their implications for diagnosis and treatment. Training models are discussed.