Exploring Career Choice Among Black Psychiatry Interns: an Exploratory Qualitative Study.

OBJECTIVE: Relative to the Black American population size, there is an underrepresentation of Black psychiatrists in the USA. In order to address this issue, it is important to explore factors that contribute to Black medical students' decision to pursue a career in psychiatry. METHODS: First-year psychiatry residents who identify as Black (N = 7) were interviewed. Career Construction Theory provided a structured framework for the interview process. For qualitative analysis of data, codes were assigned to reflect concepts and develop themes. RESULTS: All participants mentioned the impact of being a Black psychiatrist in the Black community, the influence of strong female role models on their life, and the importance of the fit between their personality and the work done within psychiatry. The majority of interviewees identified macro-level and cultural events that had influenced them and discussed a desire for advocacy and the influence of Black role models, perseverance, and the importance of work-life balance. CONCLUSION: This qualitative study identified many influential factors that were deemed important to Black interns in their decision to pursue a residency in psychiatry. With the information learned from these interviews, educators within psychiatry can bolster their support of Black medical students, encourage pursuit of a career in psychiatry, and ultimately, work toward reducing disparities in psychiatric care. Future research should examine additional collective notions of career decision-making.

Psychiatry Residency Directors' Attitudes Toward and Uses of the Medical Student Performance Evaluation and Other Potential Tools for Residency Selection.

OBJECTIVE: A survey was conducted to determine US psychiatry residency directors' attitudes regarding current measures of medical student performance and their preferences for the future. METHODS: A team of psychiatry medical student educators and residency program directors developed a 23-question survey. In July 2021, links to the survey were sent out to all program directors registered with the American Association of Directors of Psychiatric Residency Training. RESULTS: Seventy program directors out of 223 initiated the survey, resulting in a response rate of 31.4%. Forty percent of respondents reported that the most important use of the Medical Student Performance Evaluation (MSPE) is in screening out applicants for interviews, and only 26.1% reported that the MSPE in its current form could be trusted to provide a valid and reliable assessment of a student's medical school performance. Most respondents agreed that in the absence of United States Medical Licensing Examination (USMLE) step 1 numerical scores, the existing MSPE format/content requirements should be modified, use a set of ranking categories that are uniform across all medical schools, and be supplemented with additional measures of the student's character and ability specific to psychiatry. CONCLUSIONS: US psychiatry program directors are eager for change when it comes to the MSPE and how it reports rankings, grades, and professionalism. The transition of the USMLE step 1 score reporting to pass/fail presents an opportunity to pursue this change and for stakeholders from all medical specialties to work together toward a shared goal of an improved residency selection process.

The 2016 Survey of the Association of Directors of Medical Student Education in Psychiatry.

OBJECTIVE: The members of the Association of Directors of Medical Student Education in Psychiatry (ADMSEP) had been last surveyed in 2010 to identify trends in medical student education in psychiatry, teaching methods, academic productivity, and administrative issues. With increasing requirements, ADMSEP members were surveyed in 2016 to characterize current expectations for and needs of medical student educators in psychiatry. METHODS: A 53-item survey was sent to members of ADMSEP (n=260) and to clerkship directors nationwide. The current survey expanded past surveys with questions about current issues in medical education. Questions included categorical and scaled items (1 = strongly disagree to 5 = strongly agree). All ADMSEP members were invited to complete the survey, but half of the questions were for those who identified as clerkship directors. The survey was sent electronically with two reminders. RESULTS: The survey had a response rate of 42.7%. Half identified themselves as clerkship directors (49.5%), with an average of 6 years as both a clerkship director and member of ADMSEP. Respondents noted that being involved in education (mean 4.1) and ADMSEP (mean 4.2) were a benefit to their career, and also reported that they had adequate access to faculty resources. Respondents also reported concerns with access to educational research consultants and personnel management. CONCLUSION: Results of the 2016 ADMSEP survey echoed previous membership surveys. However, training in personnel management, diminishing faculty resources, and compensation for education time emerged in this survey. Conducting a membership survey continues to provide beneficial information regarding the administration and education that occurs within psychiatry clerkship. Additionally, topics meriting further details have been identified that will be investigated in future membership surveys.

Factors Associated with Grade Appeals: A Survey of Psychiatry Clerkship Directors.

PURPOSE: In an effort to provide medical students with opportunities for accurate grading, some psychiatry clerkship directors allow for grade appeals. The authors examined the appeals process from the clerkship directors' perspective. METHODS: A 23-item survey, consisting of multiple choice and narrative questions, was sent to allopathic and osteopathic accredited schools in North America. Questions included information about the medical school, the clerkship director, and the grade appeal processes. StatPlus sorted and analyzed the data, and grade challenge rates were compared between schools. The narrative responses were independently sorted by the authors. RESULTS: Sixty-one responses were received (35% of programs). A grade challenge rate was calculated for each response, using the number of appeals/students per year, allowing for further comparison of grade challenges. Clerkships with an honors/pass/fail grading schema had a higher grade challenge rate (p = 0.002) when compared to all other reported grading schemas. Clerkships where the grade appeal could result in a lower grade had a smaller grade challenge rate (p = 0.026) as compared to programs where a grade appeal could not result in a lower grade. The authors observed three common pathways for the processing of grade appeals and four common themes among clerkship directors as contributors to grade appeals. CONCLUSION: A grade appeal is often the final step in the grading process for medical students. By identifying factors that contribute to grade appeals, areas for targeted interventions in the evaluation process are potentially identified. Future study of grade appeals, including from the medical students' perspective, is warranted.