Importance of Undergraduate Psychiatric Training

The basic purpose of teaching and training at undergraduate level is to prepare medical graduates to serve better at primary health care level. The patients with physical illness have concomitant emotional problems requiring professional handling, therefore teaching of psychiatry at undergraduate level becomes even more relevant and essential. The main aim of primary health care is to de-professionalize and decentralize the medical care, so that basic health care as per WHO'S definition, can reach all the countrymen. The Medical Council of India therefore recommends for an obligatory . two weeks psychiatry training, however there exists vast variation regarding the duration of posting and quantum of teaching from one medical college to another. Whatever may be the nature of the illness, the approach should be holistic i.e. to pay attention to the patients as a human being and treat his problems in totality. Thus it is vital that medical students should be trained such that they develop a clinical acumen that views the patient from an emotional as well as a somatic perspective. Medical students awareness about mental illness becomes more important , if viewed in the context of various researches which have conclusively shown that nearly 30% of the patients seeking help in general health services, in fact suffer from emotional, psychosocial problems and psychiatric symptoms Moreover, the literature supports the idea that undergraduate psychiatry teaching enhance the students positive attitudes towards understanding psyr chiatric illness. These doctors have more acceptance of psychiatric illness, make differential diagnosis in which psychiatric problem are also considered and have less anxiety in dealing with such patients. We have to face the fact that India a developing country is still nursing the paediatric phase of psychiatry speciality. It is in this context that a medical student, who is both the subject and consumer of our efforts to teach psychiatry, becomes all the more important We know that our manpower in terms of trained psychiatrists is too less so as to meet the mental health demands of the nation. Therefore for many decades to come general practitioners and other health professionals will have to be the main providers of psychiatric care. It is in this view that our under graduate training of psychiatry is expected to go a long way and may compensate for the deficient manpower. Another important issue before we talk about the need for psychiatry undergraduate teaching or the need for change in the existing teaching is the perception of medical students about this speciality. Western literature shows that in late seventies and early eighties at a time when there was a sharp decline in recruitment at postgraduate psychiatry level, medical students viewed psychiatry as low in status, low in efficacy, high in potential for inducing anxiety, practised by generally well meaning, intellectual, kind, but some what fuzzy mind and at times down right neurotic practitioners. It has also been observed that there was social pressure placed on medical students to avoid psychiatry and the stigmatization of those who asserted there interest in this field (Light, 1975). It was also seen that undergraduate student appeared to be negatively influenced by the antipsychiatric views of non psychiatric faculty, house staff and peers. It was viewed as of low prestige and low precision. Lau et al. (1976) found that after undergraduate teaching in psychiatry, majority of students had a positive improvement in the attitudes of students towards psychiatry In a similar study using an "opinion about mental illness" questionnaire the authors found a positive change in attitudes during the internship which was maintained even after graduation from medical school.