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Download PDF FileIntroduction
The following research aims to evaluate the influential factors that may affect the decision of psychiatry trainees to choose psychiatry as a medical speciality. The research underpinned the case of post-graduate trainees residing in Scotland. A questionnaire was designed and sent to 278 participant trainees to perform a detailed survey and collect data. Nevertheless, only 83 responded to the assertion. Hence, the response rate has been calculated to be 30%. Considering this aspect, the following section is dedicated to meticulously analyzing the factors.
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The analysis includes an assessment of the reliability of the variables using Cronbach Alpha. It also includes descriptive statistics to comprehend the general characteristics and demographic variables. Furthermore, comprehensive factor analysis has been used to evaluate the most influential factors in each category, including financial support, family support, interest in psychiatry, rewarding aspects of working in psychiatry, societal factors, and personality factors. A comparative analysis has also been conducted to further substantiate the differences in the factors based on gender, MRCP, training stage, and psychiatry placement.
Reliability Testing
Reliability testing is performed as the initial step for analysis. Since the questions related to all the factors were based on the Likert scale, Cronbach Alpha has been used to determine the reliability of the 5-point Likert scale. The result of all the factors except for personality factors has been mentioned as follows:
For the results in Table 1, it has been found that the Cronbach Alpha statistics are computed to be 0.765. The study by Leech, Barrett and Morgan (2016) asserted that the minimum acceptable value is 0.7. Therefore, the results in Table 1 are satisfactory as they are above the threshold. Considering the personality factors, the Cronbach Alpha is computed to be 0.907, presented in Table 2. It depicts the extreme reliability of the factors based on the 5-point Likert scale.
Demographic Characteristics
In this section, the general characteristics have been analyzed, for instance, gender, age, place of medical qualification, and others, considering their possibility of affecting the choice of psychiatry as a medical speciality. In Table 3, most respondents fall in the age group ranging from 20 to 34 years, with 53% concentration. Concerning gender, Table 4 illustrates that 62.2% of females participated in this study. Moreover, Table 5 illustrates that 91.6% of the participants acquired their primary medical qualification from the UK, while 3.6% acquired it from Asia. In addition, Table 7 illustrates that 62.7% of the respondents hold MRCP while 37.3% do not.
Moreover, according to Table 8, 74.7% of the respondents work full-time. Table 9 depicts that 55.4% are at the core psychiatry training stage. Table 10 shows that 71.7% had psychiatry training in the first foundation year. However, in terms of the decision-making stage, 43.4% decided to opt for psychiatry as a medical speciality in the foundation stage; the results are depicted in Table 11.
Descriptive Statistics
In descriptive statistics, mean and standard deviation has been computed concerning each factor. In terms of financial or personal factors, the results have been depicted in Table 11. Most of the responses are from quite important to relatively unimportant because the values are near 3 and approaching 4 while the standard deviation is minimal.
For the results obtained in Table 12, it has been found that mean values near 4 and 5 indicate neutral responses to unimportant responses, and values near 3 indicate quite an important family or personal factors.
Table 13 illustrates that most of the responses are near 2, indicating that they are quite important. The standard deviation is minimal, even in the case of factors associated with psychiatry as a medical speciality.
Table 14 illustrates that most of the responses are near 2, indicating that they are quite important. The standard deviation is computed to be lower in the case of factors associated with rewards.
The social factors are seemingly less important than those based on mean values, as depicted in Table 15.
In Table 16, most respondents are inclined to state that personality factors are important in their choice of psychiatry as a medical speciality. In this case, the deviation is minimal, as found in other cases.
Factor Analysis
Factor analysis has been used to determine which factors are significantly important that affect the choice of psychiatry as a medical speciality in the case of Scotland. This section presents the key results of each main factor. The analysis has been conducted based on financial, family, and psychiatry as interesting subjects, rewarding aspects of working in psychiatry, societal factors, and personality factors based on KMO and Bartlett's test and component matrix.
Financial /employment/ training factors
In factor analysis, KMO and Bartlett's test is used to assert the sample's adequacy. Moreover, a component matrix has been further presented to determine which factors are retained based on factor loadings, where 0.6 has been taken as a threshold value. This threshold is also supported by the study of Yong and Pearce (2013). Regarding financial factors or skills development and training factors, the results have been presented in Table 17 and Table 18. The KMO and Bartlett's table illustrates that the sample is adequate because the asymptotic significance is below 5% (0.05). Therefore, the sampling adequacy can be verified with this.
Moreover, the sampling adequacy is computed as moderately accurate as the value is 0.704. Concerning Table 18, it has been found that four factors are retained. These factors include securing a post after completion of training, recruitment to a training post, shorter duration of training in psychiatry than other medical fields, and the easily manageable aspect of psychiatry.
Family or personal life factors/ preferences
Family factors or personal factors, the results have been presented in Table 19 and Table 20. The KMO and Bartlett's table illustrates that the sample is adequate because the asymptotic significance is below 5% (0.05) (p-value= 0.000< 0.05). Therefore, the sampling adequacy can be confirmed with this. Also, the sampling adequacy is computed as satisfactory as the value is 0.426. Concerning Table 20, it has been found that two factors are retained: proximity of training facility near family and pressure, advice or influence of parents/ family.
Factors Associated with Psychiatry as an interesting subject:
About the factors associated with psychiatry being an interesting subject, the results have been presented in Table 21 and Table 22. The KMO and Bartlett's table illustrates that the sample is adequate because the asymptotic significance is below 5% (0.05). Therefore, the sampling adequacy can be confirmed with this.
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Further, the sampling adequacy is computed as moderately accurate as the value is 0.757. According to Table 22, it has been found that four factors are retained. The retained factors include opportunity in psychiatry, personal interest, a person-centred approach, and an approach to determine the disease based on the bio-psycho-social model.
Table 21: KMO Bartlett's Test (Psychiatric Subject Factors)
Factors associated with Rewarding aspects of working in psychiatry
By the factors associated with rewarding aspects of working in psychiatry as a medical speciality, the results have been presented in Tables 23 and 24 of KMO and Bartlett's test and component matrix, respectively. The KMO and Bartlett's table illustrates that the sample is adequate because the asymptotic significance is below 5% (0.05) (p-value= 0.000< 0.05). Hence, sampling adequacy can be established with this. Moreover, the sampling adequacy is computed as moderately accurate as the value is 0.711.
According to Table 24, it has been found that five factors are retained. The retained factors include the absence of regular on-site calls, on-call work in psychiatry being easy to handle compared to other medical fields, less work pressure, more work-life balance, and less complex work leading to fewer emergency cases than other medical fields.
Table 23: KMO and Bartlett's Test (Rewarding Factors)
Social or societal factors
In light of the social or societal factors, the results have been presented in Table 25 and Table 26 of KMO and Bartlett's test and component matrix, respectively. The KMO and Bartlett's table demonstrates that the sample is adequate because the asymptotic significance is below 5% (0.05) (p-value= 0.001< 0.05). Henceforth, the sampling adequacy can be validated with this.
Besides, the sampling adequacy is moderate as the value is 0.500. In Table 26, it has been found that only two factors are retained. The retained factors include opportunities to work abroad following the completion of training. Another factor is the influence of external factors like media, television, and books that affect the decision to opt for psychiatry in the future.
Personality factors
The results of the personality factors have been presented in Tables 27 and 28 of KMO and Bartlett's test and component matrix, respectively. The KMO and Bartlett's table shows that the sample is adequate because the asymptotic significance is below 5% (0.05) (p-value= 0.000< 0.05). Hence, the sampling adequacy can be recognized with this. In furtherance, the sampling adequacy is computed to be highly accurate as the value is 0.865 and is approaching 1.
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According to Table 28, it has been found that nine factors are retained. The retained factors include specific analysis skills to investigate a patient, interest in solving complex problems with intellectual skills, friendly nature, and good communication skills. Some other factors include good social and interpersonal skills, sentiments of sympathy and empathy, comprehension of emotion, attentive listening, and cooperative nature.
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Comparative Analysis
To evaluate the differences in perception based on Gender and interest in choosing psychiatry as a medical speciality, an independent sample t-test has been used.
Differences in Factors Based on Gender
Firstly, a descriptive statistics data analysis table has been computed concerning Gender, as depicted in Table 29. Secondly, a t-test concerning Levene's test has been conducted to confirm the variances' homogeneity. Following the confirmation, t-statistics have been evaluated and presented in Table 30. It has been found there exists no difference in the perception of male participants and female participants. However, at the 10% significance level, the difference is only found in the social factors. According to group statistics, males prefer social aspects more than females, as their total score is more important.
Table 29: Group Statistics
Differences in Factors Based on Psychiatry Placement
In this case, the participants who chose psychiatry as a medical speciality in the foundation year are compared with the ones who have not had this opportunity. The results have been presented in Table 31 and Table 32. It has been found that the perception of family factors significantly differs based on placement. Group statistics revealed that those not placed in the foundation year prefer family factors to be more critical (p-value= 0.006< 0.05).
In addition, some other factors that can be found having differences in perception if the threshold for significance is 10% are financial factors and rewarding aspects of psychiatry. In both cases, those who have not had the placement in foundation years deem them more important than the ones who have had the placement.
References
Leech, N.L., Barrett, K.C. and Morgan, G.A., 2014. IBM SPSS for intermediate statistics: Use and interpretation. Routledge.
Yong, A.G. and Pearce, S., 2013. A beginner's guide to factor analysis: Focusing on exploratory factor analysis. Tutorials in quantitative methods for psychology, 9(2), pp.79-94.
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