title: Impact of a psychiatry clerkship on stigma, attitudes towards psychiatry, and psychiatry as a career choice.
abstract: BACKGROUND
  Mental illnesses are a major public health problem around the world and the prevalence and burden of common mental disorders is growing. Psychiatry is an unpopular career choice for many medical students and this impacts negatively on the supply of psychiatrists to the workforce. The psychiatry clerkship can play an important role in influencing students' attitudes towards psychiatry, either positively or negatively. However, stigma towards mental illness detracts students from considering a career in psychiatry. The aim of this study was to assess the impact of an eight week psychiatry clerkship on i) student knowledge and interest in psychiatry; ii) psychiatry as a career choice; iii) attitudes towards psychiatry; and iv) perceptions of stigma towards mental illness.
  
  
  METHODS
  Year 4 medical students at the University of Western Australia completed two questionnaires, the Balon Attitudes Towards Psychiatry and the Mental Illness Clinicians Attitudes (MICA), at the beginning and end of the psychiatry clerkship. Interest in, knowledge of, and consideration of psychiatry as a career were also assessed. Non-parametric tests were used to compare baseline and follow-up differences on the Balon and MICA. Unpaired t-tests compared mean differences for interest, knowledge and psychiatry as a career.
  
  
  RESULTS
  Attitudes towards psychiatry were positive at the beginning of the clerkship. Overall, there was a significant decrease in negative and stigmatising views towards mental illness post clerkship measured by the MICA, but the follow-up mean score remained close to the neutral value with views in some areas becoming more negative. There was no significant improvement in students' interest in psychiatry post clerkship, however, knowledge of psychiatry improved significantly. Numbers of students 'definitely considering' psychiatry as a career increased significantly from 7 (4.6%) students at baseline to 17 (10.5%) at follow-up.
  
  
  CONCLUSIONS
  The clerkship made a modest impact on students' attitudes to psychiatry, stigma and consideration of psychiatry as a career. Integration of strategies to overcome stigma towards mental illness and the mental health profession into pre-clinical teaching may provide students with skills to prepare them for the clerkship. This may assist in improving attitudes towards psychiatry and encourage more students towards a psychiatry career.
authors.affiliation: School of Psychiatry and Clinical Neurosciences, M521, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Western Australia, Australia. zaza.lyons@uwa.edu.au.
authors.forename: Zaza
authors.initials: Z
authors.lastname: Lyons
authors.affiliation: School of Psychiatry and Clinical Neurosciences, M521, The University of Western Australia, 35 Stirling Highway, Crawley, Perth, 6009, Western Australia, Australia. aleksandar.janca@uwa.edu.au.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Janca
mesh_terms: D001291:Attitude of Health Personnel; D002321:Career Choice; D002982:Clinical Clerkship / Q000379:methods; D003479:Curriculum; D004504:Education, Medical, Undergraduate / Q000379:methods*; D004521:Educational Measurement; D005260:Female; D006801:Humans; D008297:Male; D011570:Psychiatry / Q000193:education*; D057545:Social Stigma; D013337:Students, Medical / Q000523:psychology; D011795:Surveys and Questionnaires; D014904:Western Australia; D055815:Young Adult