The <scp>WPA</scp> Global Study on Psychiatric Training

Recent and ongoing crises (income inequality, political instability, pandemics, armed conflicts and wars, increasing numbers of refugees, climate change) have raised even greater awareness of the importance of mental health and psychiatry in supporting general well-being and public health1, 2. This situation has led to a growing need for accessible psychiatric care, including inpatient and community mental health services, simultaneously placing ever increasing demands on the already limited and overwhelmed service systems1. Due to their specialized medical training and extensive education in biological, psychological and social sciences, psychiatrists play a critical role in the provision of mental health services for patients and their families. However, there is a critical global shortage of psychiatrists to meet these growing needs, that is aggravated by a geographic maldistribution of these professionals. Recruitment into psychiatry is a global challenge, more acute in some countries in which a significant number of psychiatrists are reaching the age of retirement3. Books such as Where There Is No Psychiatrist4 or Where There Is No Child Psychiatrist5 might now surge in popularity, not necessarily for the reasons they were initially intended. Attracting medical students to psychiatry is crucial when planning tomorrow's mental health workforce. While some students enter medical school with the goal of becoming psychiatrists, many decide to specialize in psychiatry later, after their clinical and educational experiences in medical school. Having a positive experience of psychiatry through teaching, placement with clinical activities, exposure to psychotherapy during medical school, and/or additional exposure through clinical electives, can influence the choice of psychiatry3. However, many students find psychiatry interesting during their medical education, but ultimately decide to pursue another specialty. While successful recruitment into psychiatry is an essential goal, medical students who have high-quality psychiatry training can later be important members of the broader mental health workforce. Psychiatric knowledge acquired in medical school is crucial, as this may be the only exposure to psychiatry for most future physicians. Irrespective of the medical specialty they choose, future doctors will be required to care for patients and family members who have mental health needs that are integral to their physical health. For these physicians, expertise in psychiatry can not only benefit their patients, but also facilitate the optimal timing and nature of referrals to psychiatrists. The WPA has a well-documented track record of strengthening undergraduate psychiatry training worldwide. Beginning 25 years ago, it collaborated with the World Federation for Medical Education to define the Core Curriculum in Psychiatry, which provided a framework for equipping future doctors with the skills necessary to identify and treat mental disorders in a timely and non-stigmatizing way6. This Core Curriculum was subsequently revised to align with the principles of “new medicine”, which recognizes that healing and treatment alone are not sufficient, and requires a growing emphasis on prevention of mental disorders and promotion of mental health. More recently, the WPA Working Group on Medical Students has focused on attracting medical students to psychiatry by addressing stigma and providing educational resources7. This working group produced Stigma, a video with free online modules covering topics such as “well-being”, “stigma in psychiatry”, and “an introduction to psychiatry”. The group has also organized several in-person and virtual events, including competitions and mentorship programs for medical students, that have garnered significant interest and attendance7. There are several studies initiated by WPA components that have been addressing the attitudes of undergraduate medical students toward psychiatry7-10. For example, a study conducted several years ago8 asked medical students to clarify how they were taught psychiatry in their undergraduate courses, allowing the identification of differences across regions and countries. This study was performed by the WPA in collaboration with the International Federation of Medical Students. Psychiatry was reported to be included as a mandatory course in 81 out of 83 countries, and as an elective course in the other two8. While students' opinions on teaching of psychiatry are highly valuable, a recent global study on how psychiatry is taught to medical students from the psychiatrists' perspective is lacking. Such a study would have the potential to promote undergraduate psychiatry education and training worldwide, by identifying effective educational practices and practice gaps. Learning about effective strategies on how to attract future doctors to psychiatry and implementing these strategies can assist in addressing the global shortage of psychiatrists. The WPA Committee on Education and Scientific Publications is going to launch a Global Study on Psychiatric Training, to explore the structure and quality of psychiatry teaching to medical students in many countries around the world, by examining the integration of and the emphasis on psychiatry within undergraduate medical curricula. This will include whether psychiatry is mandatory in the curriculum, the duration of clinical placements, and the range of subspecialties covered. Additionally, the study will evaluate current challenges and offer potential improvements in psychiatry training, including the availability of qualified trainers, examination formats, and opportunities for international collaboration and resource development. The study will also address how the WPA can best help countries improve psychiatry training for medical students. Ultimately, it will help us all as we work to address global mental health needs and disparities by providing effective educational strategies that take regional contexts into account, while trying to reduce stigma and attract more medical students to psychiatry. The WPA, through its Committee on Education and Scientific Publications, will contact the leadership of national psychiatric societies, inviting them to provide information via an online questionnaire. All societies will be invited to collaborate in the analysis and dissemination of the results. The greater the participation, the greater the possibility for meaningful change.

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