RESEARCH ARTICLE Open Access Why medical students choose psychiatry- a 20 country cross-sectional survey

Background: Recruitment to psychiatry is insufficient to meet projected mental health service needs world-wide. We report on the career plans of final year medical students from 20 countries, investigating factors identified from the literature which influence psychiatric career choice. Methods: Cross sectional electronic or paper survey. Subjects were final year medical students at 46 medical schools in participating countries. We assessed students ’ career intentions, motivations, medical school teaching and exposure to psychiatry. We assessed students ’ attitudes and personality factors. The main outcome measure was likelihood of specializing in psychiatry. Multilevel logistic regression was used to examine the joint effect of factors upon the main outcome. Results: 2198 of 9135 (24%) of students responded (range 4 to 91%) across the countries. Internationally 4.5 % of students definitely considered psychiatry as a career (range 1 to 12%). 19 % of students (range 0 to 33%) were “quite likely”, and 25 % were “definitely not ” considering psychiatry. Female gender, experience of mental/physical illness, media portrayal of doctors, and positive attitudes to psychiatry, but not personality factors, were associated with choosing psychiatry. Quality of psychiatric placement (correlation coefficient = 0.22, p < 0.001) and number of placements (correlation coefficient =0.21, p < 0.001) were associated with higher ATP scores. During medical school, experience of psychiatric enrichment activities (special studies modules and university psychiatry clubs), experienc