Psychiatry is increasingly neglected by medical students, more than a third of whom say they are “afraid” of this specialty. Stigmatization, lack of resources, ignorance of the discipline… Professionals are warning about the lack of attractiveness of the sector, while Michel Barnier’s government has established mental health as a “Great national cause for 2025”.
When he began studying medicine, Ali-Kemal, 26, was predestined for neurology. “When I finally told my friends that I had chosen psychiatry, some of them laughed a little, or kindly made a few jokes at me…” However, the student in Paris assures him: his choice for this specialty was totally ” voluntary “.
Ali-Kemal is one of some 424 students in France who have opted, at the start of the 2024 school year, for this specialty. Note that 65 positions remained vacant – a figure up 13.3% compared to last year, as highlighted by the National College of University Psychiatrists (CNUP). “We are seeing a certain disenchantment with this discipline, linked in particular to its lack of knowledge”laments Olivier Bonnot, professor of child and adolescent psychiatry and president of the CNUP.
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A misunderstanding of the discipline perceptible in the general population, while more than six out of ten French people judge the world of psychiatry “anxiety-provoking », according to the barometer produced by the CSA institute for the CNUP, the National Association of Medical Students of France (ANEMF) and the National Association of Psychiatry Residents (AFFEP).
Even more worrying for professionals in the sector: “The students generally agree with this assertion”deplores Olivier Bonnot. In fact, 37% of them are “to be afraid” of this specialty, which remains confined to the top 4 of students’ last choices, at the end of the national ranking tests, with public health, occupational medicine and biology.
“We cling to our prejudices”
And the teaching method, during the first years of medical studies, did nothing to dispel the students’ many preconceptions: “We are given a simple list of symptoms and the courses are not thorough enough compared to other disciplines. In fact, there is a lack of information on this subject, particularly regarding patient monitoring. We cling to our prejudices and some continue to think that psychiatry comes down to giving antidepressants”regrets Dahlia, a gap student between her third and fourth year of medicine, who has not yet made her choice about her future specialty.
One thing is certain: the 20-year-old young woman wants to do an internship in psychiatry to try to get past the theory she skimmed over on the benches of her faculty in Creil (Oise) to try her hand at practice. Because, if certain internships are compulsory such as in surgery or general medicine, that of psychiatry remains optional – to the great dismay of professionals who have insisted, for many years, on imposing it in the students’ curriculum.
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This lack of consideration contributes to the stigmatization of a discipline, which many continue to not recognize as a medical specialty in its own right. “Practitioners do not consider their psychiatrist colleagues as “real doctors”, which is illustrated in particular by the very frequent absence of medical letters addressed to them”confirms psychiatrist Déborah Sebbane, in an article published in the journal Psychiatric information in 2015.
Great national cause for 2025
It is further considered to be “less prestigious” than other specialties by no less than 62% of students. Opaque, distressing, synonymous with confinement… “It is the unloved of clinical disciplines”notes, wearily, Ali-Kemal, who also regrets the preconceived ideas regarding patients in psychiatry, as well as professionals. “We have the impression that all psychologists have psychiatric problems”notes the student with a yellow laugh.
Indeed, according to the data reported by the journal Psychiatric information56% of interns across all specialties think that a psychiatry student probably has a personal psychiatric history or that he or she is « bizarre ». Psychiatrists are seen as “confused, complex and difficult to understand people”. As a result, the profession is falling into disuse… and as there are not enough students opting for this specialty, demographic renewal is far from assured. Remember that in 2023, a quarter of psychiatrists were over 65 years old.
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However, at the same time, psychiatric disorders have become a priority public health issue, in constant decline since the Covid-19 pandemic. According to the World Health Organization (WHO), one in five French people will be affected at least once in their life by such disorders or by a mental illness. Faced with this observation, the Prime Minister, Michel Barnier, established mental health as a “Great National Cause” for 2025, during his general policy speech on October 1.
A relief for professionals in the sector, who have been waiting for this announcement for many years. “Now we will have to inform the general population about what psychiatric disorders are. For example, when someone breaks a leg, they know they will have to see an orthopedist. On the other hand, when a person hears voices or suffers from depression, it is not obvious that they automatically go to a psychiatrist.observes Olivier Bonnot, who advocates a vast media campaign in this area.
Asked for his part about his expectations of the Barnier government, Ali-Kemal was categorical: “We need sustainable funding. » And the psychiatry intern completes: “The sector suffers from great difficulties in caring for patients because of a system that is on its knees. » Difficulties which, he admits, made him hesitate to choose this discipline for a long time.
