Ruthless marketing or medicine refined by ethical conduct - it’s time to speak up

Aug 27, 2026

Examines recruitment of consultants to the UK NHS through an international fellowship framework, scrutinizing arguments about sourcing from developing countries. Discusses how terminology and “active” versus “passive” recruitment via the internet should be interpreted, and questions the practical impact of drawing medical elites from poorer nations. Uses comparative references and data on specialist shortages to highlight ethical inconsistencies, particularly effects on psychiatric services where provider ratios are already low.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Psychiatry as a career choice

Training experiences and student attitudes

Role of clinical teachers in recruitment

Help is at Hand

Accessibility of psychiatric leaflets

Ruthless marketing or medicine refined by ethical conduct

Scrutiny of consultant recruitment from developing countries

Columns Correspondence the columns correspondence Foundation years I am pleased that the new foundation years for junior doctor training are happening so soon, and that psychiatry is to be included in the second foundation year (Carey, 2000). It is, however, important that all psychiatric specialties are included in rotational schemes, and not only adult psychiatry, as I have heard suggested. Just as time spent in old age medicine and paediatrics would be valuable ^ and not only time spent in adult medicine ^ so experience in old age psychiatry, child psychiatry or learning disability would provide a useful grounding for the future careers of junior doctors. CAREY, S. (2000) Pre-registration training period in psychiatry. Psychiatric Bulletin, 24,316 . Stephen J. Carey Consultant Psychiatrist, Stratheden Hospital, Cupar KY15 5RR Psychiatry as a career choice The finding by Rajagopal et al (Psychiatric Bulletin, December 2004, 28, 444^446) that psychiatry was the least popular clinical specialty amongst medical students is unsurprising but is clearly an issue that needs addressing. The authors suggested that the Royal College of Psychiatrists should undertake a campaign similar to the College’s ‘Changing Minds’initiative to destigmatise psychiatry in the eyes of medical students. I agree that it is important to try to change medical students’ attitudes to psychiatry but believe it can be achieved by improving their experiences during their placements. This issue was explored by McParlandet al (2003). They found that an improvement in students’ attitudes to psychiatry, following their placement, was predicted by factors such as receiving encouragement from consultants, seeing patients respond well to treatment and having direct involvement in patient care. This is consistent with my personal experience. Prior to my psychiatric attachment at medical school, I had many misconceptions about psychiatry and it was certainly not a career I was contemplating. However, during my placement I received excellent teaching and encouragement from my consultant and other members of the team. I was able to see patients improve and feel that I had a direct, if small, role to play in their care. This positive experience caused me to reassess my opinions about psychiatry and to decide it was a fascinating and challenging career choice. It is clear that medical students’ attitudes to psychiatry are dependent on the actions of clinical teachers. An improvement in these attitudes will lead to more medical students considering a career in psychiatry. Therefore, it is my belief that more effective training to produce dynamic undergraduate clinical teachers will significantly improve recruitment to psychiatry. McPARLAND, M. , NOBLE, L. M. , LIVINGSTON, G. , et al (2003) The effect of a psychiatric attachment on students’attitudes to and intention to pursue psychiatry as a career. Medical Education, 37, 447^454 . Clare Oakley Senior House Officer, Queen Elizabeth Psychiatric Hospital, MindelsohnWay, Edgbaston, Birmingham Help is at Hand Dr Dosani (Psychiatric Bulletin, January 2005, 29, 1^2) is not completely correct in saying that, ‘the many blind or partially sighted people in the UK are currently unable to access ‘‘Help is at Hand’’’. All of the leaflets are available free on the College’s website ([www. rcpsych.ac. uk](www. rcpsych.ac. uk)), and we have taken care that the web versions conform to the appropriate accessibility standards, so that they can all be read using voice browsers, the text can be resized to suit the reader, and so on. Dave Jago Head of Publications,The Royal College of Psychiatrists Ruthless marketing or medicine refined by ethical conduct: it’s time to speak up The response by Goldberg (2004) to Khan (2004) on the recruitment of consultants from poor countries for work in the UK deserves careful scrutiny. True, ‘India overproduces doctors and not all of them can [or are necessarily exper

FAQs

Why does the document argue that psychiatry recruitment needs addressing?

It links low student popularity to experiences during clinical placements and the actions of clinical teachers. Improving teaching and involvement is presented as a way to change attitudes and encourage career choice.

What factors are said to improve medical students’ attitudes toward psychiatry after placement?

Encouragement from consultants, seeing patients respond well to treatment, and direct involvement in patient care are identified as predictive factors.

How does the document evaluate the ethical concerns around recruiting consultants from outside the UK?

It critiques claims about where recruitment occurs and distinguishes “active” recruitment from passive internet advertising. It argues the fellowship programme still draws from countries with existing specialist shortages, affecting access to psychiatric care.

Aug 27, 2026

Upload by Oliver Hayes