Choice of Psychiatry as a Profession amongst Medical Graduates: A Cross Sectional Survey of Career Choices made by KEMU Graduates of 2008 to 2010

Aftab Asif¹, Shahana Naz², Usman Amin Hotiana³

¹MBBS, MRCPsych., Professor, Chairperson of Academic Psychiatry, King Edward Medical University

²MS Clinical Psychology, Research coordinator & Clinical psychologist, King Edward Medical University

³MBBS, FCPS (Psych.), Assistant Professor (HEC),King Edward Medical University

For Correspondence

Dr Usman Amin Hotiana, 

Ph.: 0333 425 3170,

Email: drhotiana@gmail.com

Objective: To determine the speciality preference amongst doctors during house job and postgraduate studies, their preferred place of working / choice of continuation in their profession.

Design: Survey research design.

Place and duration of study: The study was conducted at the Academic Department of Psychiatry & Behavioural Sciences,   King Edward Medical University, Lahore, Pakistan from March 2014 to September 2014.

Subjects and Methods: Doctors of King Edward Medical University, session 2008 to 2010 were contacted through a mail survey by using convenience sampling. After ethical approval, 600 doctors were sent a questionnaire. 401 doctors responded. The questionnaire covered the demographic details, preferences about career, specialties, post-graduation program and current working place.

Results: Our study revealed that out of 401 doctors who responded, 53 % were female and 47% were male with a mean age of 28.5 years (±1.4). 277 (69.1%) were doing their post-graduation in different specialties. 60% were working in Pakistan while 40% doctors had proceeded abroad. A majority of doctors have continued in their profession (80%), while 20% have changed their profession to another field. 39.4% of those who responded are working in government hospitals. Medicine and surgery were the most preferred specialities while psychiatry was the third least preferred speciality, followed only by dermatology and pathology. Basic sciences were a lower priority than clinical fields. Majority preferred to work in major cities or go abroad.

Conclusion: Most doctors continue to pursue their own profession amongst both the genders. Psychiatry is an uncommon choice made by fresh graduates. Medicine is the commonest career choice. Fellowship and Membership of College of Physicians and Surgeons, Pakistan are the commonest postgraduate programmes chosen. A large number of doctors however continue to opt to settle abroad.

Keywords: doctors, graduates, specialties, career, medicine, surgery, psychiatry

Introduction

Understanding patterns of career choices in medical field is important for educators and policy-makers to plan the supply of specialists¹. Medical students are a significant factor regarding the future of any country’s health care system². Career choice of medical students and young doctors is a topic that continues to attract the interest of medical educators and health service providers³. Career preferences can help provide important health information to aid in planning educational programs, setting priorities, and planning for the provision of adequate health care to general public.⁴

Pakistan has a long-standing deficiency of psychiatrists and there is an ever increasing need for doctors to opt for this profession in Pakistan. This however has not been the case. Past studies in many countries have also revealed that an increased number of women doctors continued with their postgraduate training and their choice of specialties differs from those of males. General practice, community medicine, anaesthesiology, radiology, pathology and psychiatry were more popular among women than men.⁵

Medical specialties within an institution can influence the career choices of medical students and practical experience in a particular field is a major factor spurring a student’s interest in a particular specialty⁶. Despite producing a large number of doctors each year, Karachi loses 65 - 95% of its graduates as they move abroad⁷. It has also been recorded that a large number of female doctors opt out of profession to be housewives on account of the socio-cultural values of Pakistan⁸.

This study aims to highlight the speciality preference of medical graduates of King Edward Medical University in the years of 2008-201 and the trends of opting out of medical profession and to settle abroad. The authors’ prime interest was to identify the interest for psychiatry as a profession amongst the study population.

Subjects and Methods

Doctors who graduated in 2008, 2009 and 2010 were included in this study. The authors developed a structured, cross sectional self-administered questionnaire in English language. 14 items questionnaire collected data on age, sex, marital status, house job specialities, career specialties, changing profession, living place and current working place. The forms did not require filling of the identity of the responder. The Ethical Review Board of King Edward Medical University Lahore, Pakistan approved the protocol of the study. A pilot study was conducted with 10 medical doctors to rule out any ambiguity in the questionnaire, and the pilot study data was not included in the final analysis. Minor changes were made in the questionnaire after the pilot study had been conducted. Graduates of KEMU from 2008-2010 who agreed to participate were included and informed consent was taken. Email addresses of all participants were taken from the admission office of KEMU. Data collectors completed the survey by emailing the questionnaire using convenience sampling. Collected data was analysed through SPSS. Percentages were calculated for various variables of the studies. Data were presented in the form of tables. Descriptive statistics were computed. No conflict of interests was encountered in the entire study period. No funding was obtained from any sources.

Results

A total of 600 doctors were approached, however 401(66.8%) doctors returned completely filled out questionnaires. Out of the responders, 190 (47.4%) were males and 211(52.6%) were females. The mean age of the responders was (28.5±1.4).Most responders were married 209 (52.1%). As shown in Table 1, 328 (81.8%) doctors continued in their profession. Those who left the profession, switched to CSS (7.2%), business (2.7%) and other fields (8.2%). 158 (39.4%) doctors were working in Government hospitals (female 18.7% and male 20.7%). 83 (20.7%) were working in private hospitals and only 5 in private clinics.

Table 1

The General Characteristics and Other Related Variables of Present Study Participants (N=401)

Most of the doctors were doing their post-graduation in different specialties (277, 69.1%) while 124 (30.9%) did not. Of the following, medicine specialty (79, 19.7%), Surgery was the second most chosen by doctors (n=35, 8.7%). (Table 2).

Table 2

Specialties and Post-Graduation Programs Chosen By Doctors and Their Corresponding Frequencies and Percentages