Influence of factors before and during medical school on choice of psychiatry as a specialty.

Prompted by the recruitment problem facing psychiatry, the authors investigated the influence of factors before and during medical school on choice of psychiatry. A questionnaire was completed by 392 of the 1982 graduates from 114 United States medical schools who entered a psychiatric training program in 1982. College courses, work experience, and experience with someone having a psychiatric disorder were the most positive "before" factors; the clinical psychiatric elective, the psychiatrist-patient relationship, inpatient experiences during the psychiatric clerkship, and control over practice hours were the most positive "during" factors.

Predictive validity of the medical Specialty preference inventory.

The medical specialty preference inventory (MSPI) was developed to provide information about specialty preferences to medical students facing the question of specialty choice prior to their entry into graduate medical education. The predictive validity of the MSPI was tested using the six MSPI specialty preference scores of each of 385 students from five U.S. medical schools to predict a specialty. The first-year graduate programme the student obtained was used as the criterion measure for determining accuracy of the prediction. A prediction was made for one of the six specialties for which preference scores are provided on the MSPI. Of the 385 predictions, 198 (51%) were accurate. Compared to a conservative chance expectancy level of 17% (1 out of 6) accuracy, the 51% accuracy level indicates that the MSPI has substantial predictive validity. Considerable variation existed among the five schools on a number of variables.

Geriatric psychiatry consultations in a university hospital.

A review was conducted of the records of 147 patients above the age of 60 in a 350-bed general university hospital for whom a request for consultations was made over a two-year period by a geriatric psychiatry division in a department of psychiatry. Findings were compared with those obtained by Mainprize and Rodin and by Ruskin. Most referrals in the present study were from internal medicine as they were in the other two studies. The principal reason for referrals in this and in Mainprize and Rodin's study was depression (48% and 37%, respectively) but not in Ruskin's study (10%). The primary DSM-III-R diagnoses of the referred patients in this study were affective disorder (27%), adjustment disorders (26%), and dementia (22%). Affective disorder was also the most frequent diagnosis in Ruskin's study. Psychotropic medication was the most frequently cited recommendation in all three studies.

How psychiatrists use vocational rehabilitation resources.

Little information is available in the literature on the extent to which psychiatrists use vocational rehabilitation resources for their patients and the kind of services they use. A survey of 174 members of a regional psychiatric society on their use of vocational rehabilitation services showed that psychiatrists referred few patients, that younger patients were referred more often than older ones, and that men were more often referred than women. Seriously disturbed patients were more often referred than less seriously ill patients. The state vocational rehabilitation agency was the one most often used by the referring psychiatrists. The authors suggest improvements in psychiatric residency training and the establishment of information programs to increase the use of vocational rehabilitation referrals by psychiatrists.