The Psychiatric Clerkship: Its Effect on Medical Students

The teaching of psychiatry to medical students is becoming more oriented toward the needs of the future nonpsychiatrist physician. This is obviously an important aspect of medical education. However, in the United States, where a large percentage of hospital beds are utilized by mental patients, and only 10% of medical school graduates choose psychiatry as their specialty, the issue of recruiting future psychiatrists should not be overlooked. Ideally, then, in addition to instilling in medical students the basic human and social aspects of good medical care, an undergraduate psychiatric program should be able to stimulate medical students’ interest in psychiatry as a specialty.

Choice of psychiatry as a specialty has been shown to be related to many factors, including students’ personality and biographical characteristics. Thus, in a certain sense, specialty choice may antedate the medical school experience. Yet, the group of students who choose psychiatry as their specialty is not a homogeneous one. Recent reports suggest that there are two separate groups of students. The first group is not influenced by the medical school experience, and their commitment to psychiatry appears to be largely predetermined by their premedical school values and interests. The second group, however, characterized by a “general-practitioner/humanitarian” orientation, seems to be more susceptible to the influence of the medical school's experiences and faculty. Their humanistic ideals may find succorance in psychiatry, which emphasizes the value of sensitivity and empathy for patients. With the goal of recruitment in mind, it would then seem logical to give special attention to the education of this latter group of students.

In relation to the effects of the psychiatric clerkship on the choice of psychiatry as a specialty, two studies indicate that after the clerkship, medical students increased the ranking of the attractiveness of psychiatry as a specialty. Two other studies, however, su