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\def\RunningAuthor{Venkatraman Natarajan et al.}
\firstPage{1471}
\articleType{Original Article}
\receivedDate{02 Feb 2021}
\acceptedDate{13 Mar 2021}
\revisedDate{08 Mar 2021}
\journalVolume{2021, 12}
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\title{Comparison of attitude towards Psychiatry as a speciality between undergraduate students and interns in a Tertiary Care Teaching Hospital}
\author{Venkatraman~Natarajan\textsuperscript{*}\textsuperscript{1},  
            Diwakar~Thiagarajan\textsuperscript{2},  
            Iniyan~Selvamani\textsuperscript{1}, 
            Raman~K\textsuperscript{1}~\\[5pt]{\textsuperscript{1}Department of Psychiatry, Saveetha Medical College, Chennai{\textendash} 602105, Tamil Nadu, India}~\\{\textsuperscript{2}Saveetha Medical College, Chennai{\textendash} 602105, Tamil Nadu, India}}

\begin{abstract}
Nowadays, a declining interest in psychiatry as well in the professional arena is seen. This attitude is significant for Interns and an important study phase of medical UGs for extreme care of psychiatric patients. The aim was to study and compare the attitude of undergraduate students and medical interns towards psychiatry. It was a cross-sectional study done at Saveetha Medical College and Hospital, Thandalam, Chennai, where a comparison between medical interns and undergraduate students weremade. The study sample consisted of about 100 interns and 200 medical undergraduates who gave their consent for this study. The Attitude towards psychiatry (ATP) questionnaire consisting of 30 questions was given and from the data collected, the mean scores were calculated and analyzed using the Student t-test by SPSS version20. The medical undergraduates exhibited a more positive attitude towards psychiatry than interns (P-value estimated was 0.001). However, only 15\% of interns and 7\% of medical undergraduates strongly agreed and wanted to pursue psychiatry as their profession. Interns showing negative attitude in psychiatry may be due to strange stereotypic remarks made by peers, existing stigma towards psychiatry, less clinical rotations and less hours of teaching during the undergraduate days. 
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Psychiatry,\newline Interns,\newline Undergraduates,\newline Stigma,\newline Psychiatric illness
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Venkatraman~Natarajan~\\ Phone:\ 9865333755~\\  Email:\ venkatknr2001@gmail.com
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
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\section{Introduction}
Mental disorders comprise of a wide range of problems and different symptoms. These disorders are categorized based upon their composition of emotions, relationships, and thoughts, which are abnormal. Psychiatry is a branch which deals with mental illness, personality disorders, \& any form of learning disabilities. According to WHO the mental illness holds 30\% of the disease burden, which are non-fatal and 10\% disease burden, which results in disability and fatality worldwide \unskip~\citep{1086310:22079080}. In a report published by Global Burden of Diseases, mental disorders causes almost 13\% of total DALYs lost for Years Lived with Disability (YLD) \unskip~\citep{1086310:22079071}. 

Psychiatrists for every 10,000 population have gradually increased over the years and according to WHO there were 1.3 psychiatrists for every 10,000 population in the year 2017, whereas in 2014 survey showed there were only 0.9 psychiatrists for every 10,000 population globally. In India, there were 0.5 psychiatrists in the year 2017, which is considered very low, leading to an increased treatment gap. The number of psychiatrists available as per NMHS (National Mental Health Survey) in various Indian states varies from as low as 0.05 per lakh population in Madhya Pradesh to the highest as in 1.2 per 100,000 populations in Kerala \unskip~\citep{1086310:22079079}.

By 2030 WHO evaluates that the most prevalent cause of disease overload would be overcome by uni polar depression. Social stigma refers to the discrimination of that particular person based upon their specific characteristics. This stigma and stereotypical cultures are arduously present all over the world. One of the studies analyzed that negative attitude and the social stigma the people tend to exhibit towards patients who are mentally ill. Psychiatry in the medical field is being affected by the presence of social stigma, which may be due to various reasons such as poor awareness, labeling them, misapprehension, people lacking perception, and if this persists, it leads to the negative outcome of the patient resulting in severe disability \unskip~\citep{1086310:22079074,1086310:22079078}.

The attitude of the medical students and the knowledge they possess play a vital role in treating the mentally ill person and the people who have the disease but don't get treated accordingly, and this gets reduced drastically if medical students show a positive attitude regarding psychiatry and its illness. Some believe that separating the mainstream subjects from psychiatry has led to its ignorance, and if this continues to persist, it would be resulting in rejecting attitudes among medical students \unskip~\citep{1086310:22079069,1086310:22079075}.

Current studies have reported having mixed attitudes of UG students and Interns but negative attitude dominated overall \unskip~\citep{1086310:22079068}. But there were studies showing positive attitudes on comparing psychiatry with other medical subjects and also among medical UGs and PGs. These kinds of researches are of greater importance in India as social stigma exists widely \unskip~\citep{1086310:22079077,1086310:22079073}.

Another study showed that increasing the duration of psychiatry postings resulted in a more positive impact on Interns' attitude. \unskip~\citep{1086310:22079076} Similar to our study was another study done in South Africa which was a gender-based comparative study that showed females had a more positive impact after clinical rotation \unskip~\citep{1086310:22079081}.

This study was all about knowing how much the medical graduates know about psychiatry and their attitude towards it as a sole speciality compared between medical undergraduates and Interns.
    
\section{Materials and Methods}
This study was conducted at Saveetha medical college Hospital (SMCH), Thandalam, Chennai, a teaching medical school where they provide the best service in Tertiary health care for the patients at a reasonable cost. This comparative study allying medical students and interns come from different parts of India, which also includes the admission of NRI students where everyone is admitted through a standard entrance examination which is common to all. 


\bgroup
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\centering \makeatletter\IfFileExists{images/99184579-05c8-4ef1-acf4-fbbbab5ca850-upicture1.png}{\includegraphics{images/99184579-05c8-4ef1-acf4-fbbbab5ca850-upicture1.png}}{}
\makeatother 
\caption{\boldmath {Year-wise Gender distribution of the participants}}
\label{f-a1bc0295bce9}
\end{figure*}
\egroup
The study sample of this Cross-sectional study comprised of 200 medical undergraduate students and 100 interns of different years of exposure to medical subjects like Anatomy, Biochemistry, Physiology, Pathology, Medicine etc. that are being taught during the 4.5 years of UG curriculum and one additional year of compulsory residential rotatory internship (CRRI). The study was approved by the Institutional Ethics Committee. 

Every participant was given a questionnaire of attitude towards psychiatry [ATP -30] consisting of 30 questions that are to be answered. It is a Likert type scale measuring the attitude of medical students approaching psychiatry. It collects basic information (sociodemographic details, which are the experimental variables Eg. Gender, Age, etc.), including the willingness and intention towards psychiatry. This scale has been reliable and has shown good validity, which is being used regionally and worldwide. The score ranges from 30 to 150, where more positive results are achieved when you get higher values. Scores {\textless}90 implies a negative attitude towards psychiatry,{\textgreater}90 suggests a positive outcome of the results, =90 tells us a neutral attitude towards psychiatry. The students were so informed about it, and consent was obtained for their willingness to participate and fill out the forms. The participation was purely voluntary, and confidentiality was maintained throughout.

The survey was conducted from February 2020 to June 2020. This ATP 30 questionnaire is based on a Likert scale consisting of responses -strongly disagree to strongly agree. In this study, we reverse coded the scale as it helps in reducing (Response bias) to make sure that they pay attention in filling out the forms. (1 - Strongly disagree; 2 {\textendash} Disagree; 3 {\textendash} Neutral; 4 {\textendash} Agree;5- Strongly Agree). The data collected was expressed as Mean \ensuremath{\pm} Standard deviation. The mean scores were analyzed using the Student 't' test using the statistical software SPSS version 20.
    
\section{Results}
The necessary sample size of 200 medical students and 100 interns was achieved by their active participation. The sex proportion was diverse in each group of undergraduates, and female participation was far higher than males. (Figure~\ref{f-a1bc0295bce9}) Most of them were from urban areas (92\%). 


\begin{table*}[!htbp]
\caption{\boldmath {Mean \& Standard deviation of ATP Score {\textendash} Year -wise} }
\label{tw-dab6e6ae2c20}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.25\linewidth-2\tabcolsep}p{\dimexpr.17740000000000002\linewidth-2\tabcolsep}p{\dimexpr.25619999999999997\linewidth-2\tabcolsep}p{\dimexpr.3164\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Year of study & N & Mean Score & Standard deviation\\
\tblmidrule 
1st year &
  61 &
  100.42 &
  9.687\\
2nd year &
  56 &
  102.89 &
  11.517\\
3rd year &
  60 &
  102.10 &
  10.359\\
4th year &
  23 &
  105.78 &
  12.262\\
Internship &
  100 &
  99.92 &
  13.08\\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Responses of the Participants} }
\label{tw-f0c42b47bfd6}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.23819999999999997\linewidth-2\tabcolsep}p{\dimexpr.26639999999999997\linewidth-2\tabcolsep}p{\dimexpr.2067\linewidth-2\tabcolsep}p{\dimexpr.1535\linewidth-2\tabcolsep}p{\dimexpr.1352\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Responses & \% of UG Students & \% of Interns & T(df) & P-value\\
\tblmidrule 
Strongly disagree &
  11.3 &
  5.3 &
   &
  \\
Disagree &
  14.3 &
  8.0 &
   &
  \\
Neutral &
  25.3 &
  8.3 &
  2.069(4) &
   0.10\\
Agree &
  11.0 &
  6.7 &
   &
  \\
Strongly Agree &
  4.7 &
  5.0 &
   &
  \\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Comparison of Mean ATP scores of negative items between medical UG students and Interns} }
\label{tw-e81f3800f361}
\centering 
\begin{threeparttable}

\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.1019\linewidth-2\tabcolsep}p{\dimexpr.4543\linewidth-2\tabcolsep}p{\dimexpr.17839999999999996\linewidth-2\tabcolsep}p{\dimexpr.12189999999999996\linewidth-2\tabcolsep}p{\dimexpr.1435\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Item number  & \cAlignHack Items & \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{\cAlignHack Medical students \mbox{}\protect\newline (Mean \ensuremath{\pm} SD)} &  P-value\\
\rowcolor{kwdboxcolor}as per ATP scale &  & UG students & Interns & \\
\tblmidrule 
1 &
  Psychiatry is unappealing because it makes so little use of medical training. &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.76\ensuremath{\pm}1.13   3.795\ensuremath{\pm}0.99} &
  0.001\\
2 &
  Psychiatrists talk a lot but do very little.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.7\ensuremath{\pm}1.02  3.79\ensuremath{\pm}1.19} &
  0.005\\
3 &
  Psychiatric hospitals are little more than prisons.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.52\ensuremath{\pm}1.04  3.68\ensuremath{\pm}1.19} &
  0.004\\
6 &
  On the whole. People taking up psychiatric training are running away from participation in real medicine. &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.39\ensuremath{\pm}1.09  3.36\ensuremath{\pm}1.29} &
  0..001\\
7 &
  Psychiatrists seem to talk about nothing but sex.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{4.01\ensuremath{\pm}1.01  3.82\ensuremath{\pm}1.20} &
  0.001\\
8 &
  The practice of psychotherapy basically is fraudulent since there is no strong evidence that it is effective.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.77\ensuremath{\pm}1.00  3.48\ensuremath{\pm}1.21} &
  0.004\\
15 &
  Psychiatrists tend to be at least as stable as the average doctor.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{2.74\ensuremath{\pm}1.01  2.98\ensuremath{\pm}1.32} &
  0.26\\
16 &
  The psychiatric treatment causes patients to worry too much about their symptoms.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{2.98\ensuremath{\pm}1.02  2.89\ensuremath{\pm}1.28} &
  0.001\\
17 &
  Psychiatrists get less satisfaction from their work than other specialists. &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.20\ensuremath{\pm}1.10  3.07\ensuremath{\pm}1.23} &
  0.003\\
19 &
  There is very little that psychiatrists can do for their patients.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.54\ensuremath{\pm}1.08  3.35\ensuremath{\pm}1.32} &
  0.01\\
21 &
  If I~were asked what I~considered to be the three most exciting medical specialities, psychiatry would be excluded.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{2.99\ensuremath{\pm}1.04  3.10\ensuremath{\pm}1.20} &
  0.006\\
22 &
  At times it is hard to think of psychiatrists as equal to other doctors.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.42\ensuremath{\pm}1.09  3.42\ensuremath{\pm}1.27} &
  0.001\\
24 &
  Psychiatry is so unscientific that even psychiatrists can't agree as to what its basic applied sciences are.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.47\ensuremath{\pm}0.90  3.33\ensuremath{\pm}1.18} &
  0.03\\
26 &
  Most of the so-called facts in psychiatry are really just vague speculations.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.33\ensuremath{\pm}0.86  3.36\ensuremath{\pm}1.25} &
  0.01\\
30 &
  Psychiatry is so amorphous that it cannot really be taught effectively.  &
  \multicolumn{2}{p{\dimexpr(.30029999999999994\linewidth-2\tabcolsep)}}{3.095\ensuremath{\pm}0.99   3.12\ensuremath{\pm}1.19} &
  0.05\\
\tblbottomrule 
\end{tabulary}\par 
\begin{tablenotes}\footnotesize 
    
\item{*Question number as per ATP scale}
\end{tablenotes}
\end{threeparttable}

\end{table*}

\begin{table*}[!htbp]
\caption{\boldmath {Comparison of Mean ATP scores of positive items between medical UG students and Interns} }
\label{tw-0f74fcb21994}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.15180000000000001\linewidth-2\tabcolsep}p{\dimexpr.38769999999999996\linewidth-2\tabcolsep}p{\dimexpr.19340000000000003\linewidth-2\tabcolsep}p{\dimexpr.1203\linewidth-2\tabcolsep}p{\dimexpr.1468\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Item number  & \cAlignHack Items & \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{\cAlignHack Medical students \mbox{}\protect\newline (Mean \ensuremath{\pm} SD)} & P-value\\
\rowcolor{kwdboxcolor}as per ATP scale &  & UG students & Interns & \\
\tblmidrule 
5 &
  It's quite easy for me to accept the efficacy of psychotherapy. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.13\ensuremath{\pm}0.99  3.23\ensuremath{\pm}1.15} &
  0.40\\
9 &
  Psychiatric teaching increases our understanding of medical and surgical patients. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.45\ensuremath{\pm}0.97  3.28\ensuremath{\pm}1.33} &
  0.001\\
10 &
  The majority of students report that their psychiatric undergraduate training has been valuable. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.23\ensuremath{\pm}0.91  2.86\ensuremath{\pm}1.19} &
  0.30\\
11 &
  Psychiatry is a respected branch of medicine. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.61\ensuremath{\pm}0.99  3.40\ensuremath{\pm}1.34} &
  0.62\\
12 &
  Psychiatric illness deserves at least as much attention as physical illness. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.90\ensuremath{\pm}1.05  3.47\ensuremath{\pm}1.45} &
  0.24\\
13 &
  Psychiatry has very little scientific information to go on. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{2.68\ensuremath{\pm}1.01  2.79\ensuremath{\pm}1.25} &
  0.003\\
14 &
  With the forms of therapy now at hand, most psychiatric patients improve. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.48\ensuremath{\pm}0.94  3.21\ensuremath{\pm}1.25} &
  0.03\\
18 &
  It is interesting to try to unravel the cause of a psychiatric illness. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.57\ensuremath{\pm}1.02  3.32\ensuremath{\pm}1.28} &
  0.12\\
20 &
  Psychiatric hospitals have a specific contribution to make to the treatment of the mentally ill. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.50\ensuremath{\pm}1.02  3.36\ensuremath{\pm}1.29} &
  0.002\\
23 &
  These days psychiatry is the most important part of the curriculum in medical schools. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.4\ensuremath{\pm}1.00  3.32\ensuremath{\pm}1.27} &
  0.004\\
25 &
  In recent years psychiatric treatment has become quite effective.  &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.66\ensuremath{\pm}0.94  3.35\ensuremath{\pm}1.20} &
  0.005\\
27 &
  If we listen to them, psychiatric patients are just as human as other people. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.78\ensuremath{\pm}1.00  3.22\ensuremath{\pm}1.28} &
  0.02\\
28 &
  The practice of psychiatry allows the development of really rewarding relationships with people. &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.66\ensuremath{\pm}0.933  3.39\ensuremath{\pm}1.27} &
  0.001\\
29 &
  Psychiatric patients are often more interesting to work with than other patients.  &
  \multicolumn{2}{p{\dimexpr(.31370000000000005\linewidth-2\tabcolsep)}}{3.41\ensuremath{\pm}0.94  3.33\ensuremath{\pm}1.18} &
  0.001\\
\tblbottomrule 
\end{tabulary}\par 
\end{table*}
The mean age of participants were 20.23 years with a standard deviation of 1.34 for undergraduates and 23.25 a standard deviation of 1.29 for interns.

The mean ATP scores calculated for the medical students (1st to 4th yr) and the interns are shown in Table~\ref{tw-dab6e6ae2c20}. The medical undergraduates have a more positive demeanor than the interns. (P =0.001)

However, only 5\% of interns and 4.7\% of medical undergraduates have strongly agreed that they wanted to be a psychiatrist, as given in Table~\ref{tw-f0c42b47bfd6}.

Table~\ref{tw-e81f3800f361} depicts the mean score of negative items between medical UG students and interns in estimating attitude towards psychiatry. In Item number 21, the mean scores of interns are found to be higher (UGs 2.99\ensuremath{\pm}1.04 versus interns 3.10\ensuremath{\pm}1.20) depicts that Interns have little interest in taking up psychiatry as a medical speciality. The Items 7, 8,16, 17 and 24, which relates to negative perspectives about psychiatry and specialists, showed higher scores among medical UG students.

Here the interns accept the reality that psychotherapy is efficacious (Item 5). The UG students agree to almost all the facts given in Table~\ref{tw-0f74fcb21994}.
    
\section{Discussion}
This cross-sectional study was intended to know the mentality of clinical undergraduates and interns towards psychiatry as a future career option. The medical undergraduates have a more positive demeanor than the interns (p=0.001). As in our study, they have done a comparison between UGs and interns and interestingly found that females have shown more interest in psychiatry \unskip~\citep{1086310:22079073}. Regardless of whether this decline in mentality toward psychiatry was identified, diminish in scrutiny for psychiatry, or to rise in enthusiasm for different medical fields need further explanation.

The 4th item of the questionnaire I~would like to be a psychiatrist has been stressed because it gives a relationship between a large, broad attitude and professional decision. To our surprise, only 7\% of the undergraduates and 15\% of the interns chose to be a specialist in psychiatry. Comparable difference between positive demeanor and picking psychiatry as a profession decision was likewise found in other studies which are done in India.

The conceivable clarification concerning cacophony could be the constantly diligent and universal disgrace connected to mental issues. Stereotypic ideas appended to mental medicinal services experts in the public arena settle on the claim to fame an avoidable decision.

Negative mentalities toward mental issues got evident when the greater part of respondents didn't feel good to try and converse with mental patients. Up to 50 \% of the undergraduates accepted that mental patients were not unemployable independent of their recuperated status and protested the chance of a nearby relative being hitched to an individual with mental confusion. 

In another study, they have taken only the interns who have attended their first clinical postings but interestingly, they have done a gender-based comparison; unlike our study, it resulted in male students having favorable outcomes towards psychiatry.

Almost all the medical UG students agreed that their training of psychiatry subject was being effective and valuable but surprisingly, many interns disagreed with it.

In the field of psychiatry teaching and knowledge, both Medical UG students and PG students agreed that they play a vital role in forming a part of their educational program, which helps in improving the patient-doctor relationship. Nevertheless, both the groups considered that the subject is so vague and it is all about speculations. Our results were also consistent with a similar study done in Rajasthan \unskip~\citep{1086310:22079070}.

The medical students concurred that psychiatry is unclear and informal. It might be expected to having no corroborative test like psychiatric imaging, laboratory investigations which is on the contrary to the other clinical specialities more dependence instruments for clarifying and explaining different disorders.

Both the groups acknowledged that in comparing with the other patients, psychiatric patients are far more intriguing to work with but shockingly, both groups have strongly agreed upon the fact that psychotherapy is fraudulent due to lack of evidence; they have also admitted that a psychiatrist will have very little to do much about their patients, unlike in \unskip~\citep{1086310:22079070} study. However, both the groups agreed on the fact that treatment for the psychiatric patients has become effective. The contrast in attitudes may be because of a less or rare visit to the psychiatric wards or not attending clinical posting. This reflects upon the opinion that the UG students are not aware of the scientific proposition of drug-free techniques in the treatment of psychiatric patients. Considering a previous article, unlike our study, they have taken two medical conditions (psychiatric illness and Diabetes Meliitus) and have used the Medical Condition Regard Scale (MRCS) score. This kind of study is rarely done but holds greater significance. They are off to the conclusion that more exposure results in a positive attitude towards psychiatry illness. \unskip~\citep{1086310:22079072}

Interns concurred that these psychiatrists are not equivalent to different specialists; they get less fulfilment, they jabber yet do practically nothing; individuals who are undergoing training in psychiatry tend to run away from partaking in real medical science and also emphasized that psychiatry is unappealing. It might be a direct result of psychiatrists who are frequently exposed to ludicrous stereotypic remarks and comments by all professionals having a place with some other specialities.

It isn't extraordinary to discover clinical instructors proposing helpless open picture of specialist, they don't do anything more than recommending narcotics and sedatives, and their activity is neither mentally animating nor monetarily fulfilling. It is likewise recommended that specialists themselves are more defenceless to create mental issues.

The term of clerkships ought to be expanded in psychiatry. Clerkships or rotations play a vital role in redefining clinical teachings done in medical colleges where the students meet the psychiatric patients, which most often forms their first exposure generally. According to previous studies, the average duration of clinical rotation was estimated to be 5.5 weeks.

Students should be exposed to different psychiatric subspecialties such as child mental health care, addiction, mental health care, geriatric mental health care. The negative observation that specialist can't do much about their patients could change through underlining nature, anticipation, and treatment of those mental sicknesses having more odds of backsliding/repeat, for example, substance abuse and schizophrenia. We should discover creative approaches to acquaint undergraduates with our claim to recognition. Exhibiting the neurobiological premise of mental diseases with the facilitation of the present-day neuroimaging methods to undergraduate students will make a positive impression of psychiatry.

Similar to other studies, there are a few constraints of this study involving less sample size, and it included medical students of the single university as it were. Consequently, it is proposed that a study with a wide range of sample size which has similar details of subjects from various Medical schools who represent the various parts of the nation might be done, or comparative investigation might be directed anywhere in the country. The volunteers for our study knew about our zone of intrigue, which could have impacted a section of reactions.
    
\section{Conclusions}
In this study, we found that the UG students and interns both have alacunae in their insight about mentally ill patients, their diseases, treatment, about the psychiatric subject and the psychiatrists. The medical UG students show a favourable outcome (positive attitude) towards psychiatry than Interns. The negative attitude shown by the Interns may be due to stereotypic remarks and comments among the peers, giving lesser importance to psychiatry as a speciality by having lesser durations of clinical rotations, poor exposure duringtheir under graduation. Direct exposure in clinical rotations containing an assortment of clinical experience and exceptional teaching in-depth will show a favorable outcome. Psychiatry as a subject gets neglected throughout their undergraduate days. Therefore, there's a requirement to evaluate and modify UG student's current course of study.

\textbf{Conflict of Interest}

The authors declare that they have no conflict of interest for this study.

\textbf{Funding Support}

The authors declare that they have no funding support for this study.
    

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