Mental health problems affect millions of people worldwide, yet many doctors still leave medical school with limited exposure to psychiatry. A new study from South India suggests that efforts to change this through elective placements are showing promise, but are being undermined by staffing gaps and a lack of awareness among institutions.

The research, published in the Annals of Indian Psychiatry, surveyed 44 medical colleges to understand how well psychiatry electives have been implemented under India’s competency based medical education framework. This model, introduced nationally in 2019, was designed to shift training away from rote learning and towards practical clinical skills.

Electives in psychiatry were added to the undergraduate curriculum in 2020, giving students the chance to spend a short block of time immersed in the specialty. According to the findings, three quarters of the institutions surveyed had managed to offer these placements to their students, while a quarter had not yet done so.

Addiction psychiatry emerged as the most popular topic for these electives, chosen by more than a third of colleges. Other areas, including child and geriatric psychiatry, sexual medicine, mood disorders and psychosis, were offered far less often, suggesting that many institutions are only scratching the surface of what psychiatric training could cover.

Where electives were running, teaching relied heavily on case based discussions, lectures and seminars, with fewer colleges using bedside clinics or small group work. Assessment tended to lean on written tests and clinical evaluations, and most departments made a point of collecting and giving feedback to students afterwards, which researchers noted is a core part of competency based learning.

Despite these encouraging signs, the study highlighted real obstacles. Poor student attendance and limited engagement were common complaints, while staff shortages and time pressures made it difficult for psychiatry departments to run electives alongside their usual clinical workload. Space constraints and unclear teaching resources added further strain, particularly for colleges trying to keep students occupied for a full day of learning.

For institutions that had not offered psychiatry electives at all, the most frequent explanation was simply that they were not required to by the college, followed by staff shortages and a lack of awareness that the option existed. Some departments also reported that broader medical specialties were prioritised over psychiatry when it came to allocating teaching resources.

To bridge these gaps, the study’s authors point to postgraduate trainees as an underused resource, noting that involving them as teaching support helped ease pressure on stretched faculty. Better scheduling, structured learning objectives and the use of simulated patients were also flagged as practical ways forward.

With mental illness continuing to carry stigma in many communities, researchers argue that early, hands on exposure to psychiatry could help shape more confident and empathetic doctors, whatever field they eventually choose to practise in.