title: Choosing psychiatry as a career: motivators and deterrents at a critical decision-making juncture.
abstract: OBJECTIVE
  To examine factors influencing the choice of psychiatry as a career between residency program application and ranking decision making.
  
  
  METHODS
  Using an online questionnaire, applicants to the largest Canadian psychiatry residency program were surveyed about the impact of various factors on their ultimate decision to enter psychiatry residency training.
  
  
  RESULTS
  Applicants reported that patient-related stigma was a motivator in considering psychiatry as a career, but that negative comments from colleagues, friends, and family about choosing psychiatry was a deterrent. Training program length, limited treatments, and insufficient clerkship exposure were noted as deterrents to choosing psychiatry, though future job prospects, the growing role of neuroscience, and diagnostic complexity positively influenced choosing psychiatry as a specialty. Research and elective time away opportunities were deemed relatively unimportant to ranking decisions, compared with more highly weighted factors, such as program flexibility, emphasis on psychotherapy, service- training balance, and training program location. Most applicants also reported continuing to fine tune ranking decisions between the application and ranking submission deadline.
  
  
  CONCLUSIONS
  Stigma, exposure to psychiatry, diagnostic complexity, and an encouraging job market were highlighted as positive influences on the choice to enter psychiatry residency. Interview and information days represent opportunities for continued targeted recruitment activity for psychiatry residency programs.
authors.affiliation: Deputy Psychiatrist-in-Chief, Mount Sinai Hospital, Toronto, Ontario; Assistant Professor, Department of Psychiatry, University of Toronto, Toronto, Ontario; Associate Director, Post-graduate Medical Education, Department of Psychiatry, University of Toronto, Toronto, Ontario.
authors.forename: Lesley
authors.initials: L
authors.lastname: Wiesenfeld
authors.affiliation: Psychiatrist-in-Chief, University Hospital Network-Toronto General Hospital, Toronto, Ontario; Professor, University of Toronto, Toronto, Ontario.
authors.forename: Susan
authors.initials: S
authors.lastname: Abbey
authors.affiliation: Director, Education and Research, Post-graduate Medical Education, University of Toronto, Toronto, Ontario; Associate Professor, Department of Public Health, University of Toronto, Toronto, Ontario.
authors.forename: Sue Glover
authors.initials: SG
authors.lastname: Takahashi
authors.affiliation: Director, Policy and Analysis, Post-graduate Medical Education, University of Toronto, Toronto, Ontario.
authors.forename: Caroline
authors.initials: C
authors.lastname: Abrahams
mesh_terms: D002321:Career Choice; D002982:Clinical Clerkship; D003479:Curriculum; D003625:Data Collection; D003657:Decision Making; D006801:Humans; D007396:Internship and Residency; D009042:Motivation; D009864:Ontario; D011570:Psychiatry / Q000193:education*; D011613:Psychotherapy / Q000193:education; D057545:Social Stigma