East Asian Arch Psychiatry 2012;22:134

LETTER TO THE EDITOR

Medical Students’ Specialty Choices

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We read with interest the article by Wiguna et al.1 At the Yong Loo Lin School of Medicine, Singapore, psychiatry used to be taught in years 3 and 4 in a 4-week clinical rotation. With revisions of the medical school curriculum, psychiatry is now taught in year 4 in a 6-week clinical rotation. We too were concerned about falling interest in psychiatry and take-up of postgraduate traineeship positions in psychiatry. Recently, however, interest in psychiatry has gradually increased. Whether the renewed interest is related to the revamp of all postgraduate training in the country, improved teaching at the undergraduate level in psychiatry, or greater opportunities for electives and student internship programmes in psychiatry, is unclear. We are at interesting crossroads with the introduction of the American residency– styled postgraduate training programme, with accreditation of training sites by the Accreditation Council for Graduate Medical Education.

In our earlier studies of undergraduate specialty choices (n = 382), we found that 34.1%, and significantly the women (p = 0.007) had a clear specialty interest prior to entering medical school. Among the top reasons for these choices were interest (97.3%), lifestyle (35.6%), finance (27.5%), and status (26.2%).2 By the third year, a clear specialty choice had increased significantly to 41.9% (p = 0.01). However, there were changes in specialty choices, with increasing interest in surgical disciplines and decreased interest in medical disciplines. These data showed that specialty choices are clearly dynamic.

While controllable lifestyle was a major quest for US medical students, it was not a significant factor for medical undergraduates in Singapore.3 However, slightly more than one-third of medical students did include lifestyle as a factor for specialty choice. As Singapore develops rapidly, this may become a more important factor and might also be the reason for more students taking up psychiatry. While it would be interesting to track and understand specialty choices of medical students in Asia, the greater impact of that information would be in ensuring the availability of training opportunities and positions and in meeting national health care requirements.

Rathi Mahendran (medrm@nus.edu.sg)
Birit Broekman
Department of Psychological Medicine, National University Health System, NUHS Tower Block, Level 9, 1E Kent Ridge Road, Singapore 119228

References

1. Wiguna T, Yap KS, Tan BW, Siew T, Danaway J. Factors related to choosing psychiatry as a future medical career among medical students at the Faculty of Medicine of the University of Indonesia. East Asian Arch Psychiatry 2012;22:57-61.
2. Mahendran R, Kua EH, Broekman B, Peh LH. Third year medical students specialty choices. Proceedings of the 7th Asia Pacific Medical Education Conference (APMEC); 2010 Feb 4-8; Singapore. National University of Singapore; 2010.
3. Dorsey ER, Jarjoura D, Rutecki GW. Influence of controllable lifestyle on recent trends in specialty choice by US medical students. JAMA 2003;290:1173-8.