Career choice decision making among Psychiatry and Child and adolescent psychiatry trainees in the Czech Republic
Abstract
Introduction: There has been a low interest in pursuing career in Psychiatry and Child and adolescent psychiatry among medical school graduates. The aim of our study was to identify factors that influenced choice of these medical disciplines among psychiatric trainees.
Method: In this qualitative study we conducted semi-structured interviews with purposively sampled trainees in Psychiatry and Child adolescent psychiatry programs in the Czech Republic. An analytical framework for this study is based on the concept of dynamics ofcareer choice among medical students.
Results: Out of 21 respondents there were 14 trainees in Psychiatry program (8 women, 6 men) and 7 in Child and adolescent psychiatry program (4 women, 3 men). The length of their training was between 4 months and 5 years.
We identified 15 factors, that were cathegorized into 4 groups: characteristics and values, career needs during decision making proces of specialty choice, psychiatry and child and adolescent psychiatry perception and factors of remaining in profession. Conclusion: Motivating factors were oportunity for working with patients based on communication and therapeutic relationship; complexity of psychiatry that includes somatic, pharmacological and psychological care as well as social and forencis aspects.
From a practical point of view psychiatry seemed to allow better worklife balance and was viewed as less stresfull with more time available for doctor-patient interaction, including diagnostics and treatment. Specific factor for child psychiatry was relationship to children, which motivated respondents for entering medical school.
Trainees in Child and adolescent psychiatry appreciated spontaneity and playfulness of children and early developmental phase of life with a chance for behavioral change. There were also pragmatic reasons, namely chance for finding a job.
Another reason was opportunity for intelectual development as there are many possible topics for research. De-motivating factors included societal prejudice, which was indentified in parents of half of respondents, regardless of their profession.
Students were exposed to stigmatizing comments by academic staff after declaring their interest in psychiatry during medical school. Fundamental problem was lack of information about the existence of Child and adolescent psychiatry as a unique speciality with training available right after graduation and practically no exposure to this medical speciality during medical school