hospitalA campaign has been launched that aims to expose the practice of badmouthing – or ‘bashing’ – certain medical disciplines such as psychiatry, which is putting off medical students from choosing it as a speciality.

Sir Simon Wessely, president of the Royal College of Psychiatrists, has launched the campaign as medical students and trainee doctors are reporting that the badmouthing of certain medical disciplines is impacting on their freedom to choose psychiatry as a speciality.

‘Bashing’ threatens to deplete an already under-subscribed medical specialism. A paper published in BJPsych Bulletin online describes the practice and the impact it is having on young medics and the medical profession.

Choosing a career specialty is one of the most important decisions that a medical student will make and shapes the rest of their working lives. While some students decide early on what career path they want to pursue, most make the specialty choice during medical school, with some remaining unsure into their final year and even as foundation year doctors.

This choice is influenced by many factors, in particular the teachers the students encounter, their experience during clinical placements, desired work-life balance, and also by gender and personality.

In one US study, 76% of students had heard ‘bashing’ of their career choice specialty and 17% stated that this had made them alter their choice. In another study of third-year US students, family medicine was the most ‘bashed’ specialty but psychiatry was not far behind with 39% of students stating that they had heard disparaging comments about the discipline.

Psychiatry continues to face a worldwide problem with recruitment. In the UK, the Royal College of Psychiatrists has maintained an active recruitment programme for several years, but rates of students interested in psychiatry as a career remain at 4-5%; insufficient to meet future needs.

The authors of the BJPsych Bulletin paper developed an online questionnaire study to ascertain the prevalence and impact of ‘bashing’ in the UK, and 960 medical students completed the survey. From the list of 8 medical specialties provided, students reported that psychiatry and general practice attracted the greatest number of negative comments.

Although 80.5% of students condemned badmouthing as being unprofessional, 71.5% believed it to be an ever-present part of practising medicine. While 57.3% viewed it as ‘just a bit of fun’, 74% agreed that there is an unspoken hierarchy of specialties in medicine.

Overall, 27% of students agreed that they had changed their career choice as a direct result of negative comments made about them.

“There is no psychiatrist in the land who cannot remember the reactions they received from some colleagues – especially the senior ones – when they announced that they wanted to pursue a career in psychiatry,” said Professor Wessely. “A bit of humour is all very well, but behind this is something unacceptable – an implication that the best and brightest doctors are somehow wasting their time in psychiatry. This has to stop, and this campaign is going to do that. People with mental disorders – just like those with physical disorders – deserve the best minds to find new treatments and provide the best care.”