In recent years, due to social transformation and other reasons, mental problems such as anxiety and depression have significantly increased. However, psychiatric professionals in China are obviously insufficient. The psychiatric major aims to train specialists in mental health institutions at all levels and medical research departments who are engaged in clinical prevention, treatment, teaching and research focusing on mental illnesses [4]. In recent years, the government has increased its investment in psychiatry and mental health. It has formulated the "National Mental Health Development Program" and the "Mental Health Law", organized the Xiangshan Conference of Neuroscience, and put the Chinese Brain Project on board, focused on the construction of local psychiatric hospitals. In terms of resources, the Health and Family Planning Commission further improved the professional title evaluation methods for specialists, and implemented the salary policy for mental health personnels; in terms of medical education, encouraging universities to hold undergraduate major in psychiatry, Guaranteeing the teaching hours of psychiatry and medical psychology. All show that the national government attaches greater importance to the cultivation of psychiatric professionals. But in fact, there are still many difficulties in cultivating psychiatric professionals. Xiangya Medical College, the first one which offer psychiatry major, has recruited 28 periods psychiatric undergraduates and 632 graduates since 1988, The psychiatric related employment rate was 57.2%, and nearly half of the students did not provide medical services in their major, while the psychiatric related employment rate of Jining Medical College and Xinxiang Medical College during the same period was not optimistic either. This phenomenon may be related to many factors such as social prejudice, psychiatrist's working environment, income level, discrimination, and identification with psychiatric major.
In our survey, we found that 39.9% of the students occasionally contacted with psychiatric patients, and 50.2% of the students had never contacted with psychiatric patients. Before applying for the psychiatric major, 38.6% Of the students did not understand the psychiatric patients. Among the attitudes towards the psychiatric patients, 47% of the students felt sympathetic, and 28.3% felt that they had no special feelings. In general, students have less contact with psychiatric patients, and more feel that they are pitiful. In this regard, it is very important to create a good social evaluation and correct social prejudice. The government should strengthen the propaganda of general knowledge of mental illness, hold early contact, early clinical activities, help to raise students’ awareness of this group [5].
Regarding the development of psychiatry, most students maintained a relatively optimistic attitude. 37.3% of students said that psychiatry was very useful, 47% of students said it was useful, and 80.6% of students said they were willing or quite willing to continue master degree in psychiatry after they graduated, but 5.7% of students said they were extremely reluctant or unwilling. Generally speaking, most of the students had a positive attitude towards further studies in the field of psychiatry. However, when it came to whether psychiatry was the first choice in the college entrance examination, Only 42.4% of the students said it was the first choice, and 57.6% of the students entered the psychiatric major through major transfer. In terms of the future development of psychiatry, 94.9% of students believed that the future of psychiatry was relatively optimistic, but if there was an opportunity to change major, 18.2% of students would choose to change major. This showed that although students were generally optimistic about the future of psychiatry, there were still many students who were passively chosen psychiatry major, and their recognition of the major was still not stable. On the one hand, it is necessary to continue to strengthen the ideological education of psychiatric students, to stabilize the ideological fluctuations of some students, give students correct and rational guidance, and deepen professional feelings; on the other hand, in teaching and internship, strengthen communication with teachers and hospitals, and take responsibility for teaching skills, and supervise the training of graduates to improve the status quo of graduates switching to non-mental health jobs or applying for clinical medicine majors [6].
Regarding whether they are willing to be a psychiatrist in the future, 78.6% of the students are willing or quite willing. The main reasons for their willingness are their interest on psychiatry (67.7%), good employment prospects (58.3%) and social needs of psychiatric doctors (71.9%) , shows that interests and good employment expectations are still the main reasons for being willing to engage in psychiatry. 21.9% of students believe that easier work is also one of the reasons why they choose. Among the reasons for unwillingness to be a psychiatrist, low income (27.2%), poor working environment (18.0%), and fear of being discriminated against (25.3%) are the main reasons. Regarding the low social status of psychiatrists, work in poor environment and other conditions, previous domestic studies have similar results. Liu Tieqiao et al found that 53.1% of students agreed with this statement partially or completely on the issue of medical students’ recognition of the low social status of psychiatry [7], However, this research mainly focused on non-psychiatric students, and its proportion was higher than our survey results in psychiatric undergraduate major. In terms of the income of psychiatrists, 46.5% of students surveyed by Wang Xuyi et al believed that the income of psychiatrists was lower than that of other doctors [8], which was also higher than the survey conducted in our school. In this article, the first ranked reason why unwilling to be a psychiatrist is because of fear of being beaten and scolded by psychiatric patients. Guo Jing et al investigated the situation of hospital violence experienced by medical staffs in 136 tertiary hospitals in China and found departments of Obstetrics and gynecology and pediatrics were high-incidence departments of violence, and psychiatry was not among the top [9]. Yang Yang conducted a questionnaire of 500 medical staffs in 4 hospitals in Tianjin. Among them, the emergency department had the highest incidence of violence [10]. The psychiatric department is certainly a high-risk department that is prone to violence. However, due to the high vigilance of psychiatric doctors and the constant risk assessment of patients at work, the actual incidents of violence and injury are not at the forefront. In the process of student training, early education should be provided to correct students’ misperceptions.
In summary, students’ impressions of psychiatry, the development prospects of psychiatry, and the employment of psychiatrist are generally good, but there are still some negative opinions. More negative attitudes include the social reputation of psychiatry, low income of psychiatrists, high risk of violence, etc. Due to the existence of these negative opinions, medical students will face resistance from all sides when they choose to become psychiatrists in the future. Some of these negative attitudes need to be improved through targeted medical education, and some are more related to misunderstandings that are common in the whole society, requiring the joint efforts of all psychiatric circles and the whole society.