Organ-system–based psychiatry education in undergraduate medicine: learning outcomes and specialty choice

Abstract

Background: Uptake into psychiatry remains modest in many medical education systems, potentially related to limited curricular integration. We implemented an organ-system–based psychiatry module to improve relevance and engagement, evaluating medical students’ satisfaction and subsequent specialty choice. Methods: This study was conducted in Peking University’s 8-year clinical medicine program, in which students enter directly after high school, study psychiatry in Year 3, and in Year 6 select their specialty for standardized residency training. Four consecutive Year-3 cohorts exposed to the reformed psychiatry module (entering classes of 2019–2022) completed an anonymous 15-item post-course questionnaire (4-point Likert scale) covering Teaching Content, Teaching Methods, Course-related Learning Outcomes and Personal Growth. Internal consistency was assessed using Cronbach’s α, and student satisfaction was summarized as mean domain scores with item-level percentages. Between-cohort differences were tested using Welch’s ANOVA with Games–Howell post-hoc comparisons. For specialty choice, administrative records were used to compare the proportion of students selecting psychiatry in Year 6 before (Classes of 2014–2018) versus after the reform (Classes of 2019–2020). Specialty choice data are available only for the Classes of 2019–2020. Results: Of 655 eligible students, 502 completed the survey (76.6% response rate). The overall Cronbach’s α for the questionnaire was 0.81, with reliability ranging from α = 0.40 to 0.88. Teaching Content and Learning Outcomes had acceptable reliability (α = 0.71), Personal Growth was highly reliable (α = 0.88), and Teaching Methods had low reliability (α = 0.40). Domain scores were generally favorable: Teaching Content (3.14 ± 0.73), Teaching Methods (3.24 ± 0.46), Course-related Learning Outcomes (3.14 ± 0.54), and Personal Growth (3.37 ± 0.56). Teaching Methods scores varied across years, while other domains were stable. The proportion entering psychiatry residency increased from 13/546 (2.38%) in pre-reform cohorts to 17/307 (5.54%) in post-reform cohorts (absolute difference 3.16% points, 95% CI 0.30–6.02; z = 2.16, p = 0.031). Conclusions: An organ-system–based psychiatry module was associated with favorable learner evaluations and a higher proportion of entry into psychiatry residency. Embedding psychiatry within organ-system curricula may enhance student engagement and interest in psychiatry.