title: Reasons why some UK medical graduates who initially choose psychiatry do not pursue it as a long-term career.
abstract: BACKGROUND
  Some doctors who initially choose psychiatry do not pursue it as a long-term career. The study seeks to identify reasons for leaving psychiatry.
  
  
  METHODS
  Postal questionnaire survey of UK medical graduates of 1988, 1993, 1996 and 1999 identified as having left psychiatry; for comparison, doctors who left general practice or trauma and orthopaedics.
  
  
  RESULTS
  Response rate was 74% (572/778); 488 respondents satisfied study criteria (59 psychiatry, 318 general practice, 111 trauma and orthopaedics). The speciality's poor public image, perceived lack of respect from medical peers, perceived threat of violence from patients, under-resourcing and low morale were problems for psychiatry leavers. Job stress, self-assessed unsuitability, and concerns about the lack of evidence-based treatments also influenced decisions to leave psychiatry.
  
  
  CONCLUSIONS
  Early exposure to psychiatry may help trainees assess their suitability. Negative perceptions of workforce issues (e.g. low morale) and of clinical issues (e.g. perceived lack of ability to improve prognosis) need addressing to increase retention.
authors.affiliation: UK Medical Careers Research Group, Department of Public Health, Oxford University. trevor.lambert@dphpc.ox.ac.uk
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Lambert
authors.forename: Gill
authors.initials: G
authors.lastname: Turner
authors.forename: Seena
authors.initials: S
authors.lastname: Fazel
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Goldacre
mesh_terms: D000328:Adult; D002321:Career Choice; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D008505:Medical Staff, Hospital; D009985:Orthopedics; D011570:Psychiatry / Q000193:education; D011795:Surveys and Questionnaires; D006113:United Kingdom; D000078329:Workforce