Influences from Psychiatric Education on Subsequent Career Choice: With Special Reference to Work in State Mental Hospitals and the Shift to Private Practice

Abstract

323 psychiatric residents and 883 graduated psychiatrists responded to a mail-return questionnaire which ascertained their anticipated or actual choice of jobs, their views on how training experiences affect initial job choice, and their views regarding quality of care provided by state mental hospitals. As expected, a psychiatrist typically works in more than one practice setting. A majority anticipated or took a first job which was primarily in a public setting. This is seen as consistent with a finding that clinical care experiences in public settings were rated as the most important training experiences affecting job choice. In the 10 years following graduation, about two-thirds of psychiatrists surveyed moved from a predominantly public to a predominantly private setting. The authors suggest this shift to private practice derives from dissatisfactions with public jobs, rather than from financial or other incentives of private practice.