When medical school educators – polished veteran doctors – review data on their students’ attitudes towards residencies, they remember their own long days in the anatomy dissection room. They recall treating their first teenage patient and comforting a patient seeking solace while succumbing to a fatal illness. They think about why they made their important career choice. Thus the glory days of medical school become a defining and shaping experience for physicians, similar to boot camp for veteran paratroopers.

There is a growing concern in many countries over the low recruitment into psychiatry among medical graduates. This has led to studies that aim: (1) to study the attitudes of medical students towards psychiatry, (2) to determine factors that influence such attitudes, (3) to assess the possible causes of this low recruitment and (4) to try to change students’ views of psychiatry during their medical education to improve recruitment.

Psychiatry has probably always been the least attractive of the medical specialties. The choice of psychiatry as a career has been consistently low in the English-speaking world over the past 50 years (British Medical Journal, 1973; Feifel et al, 1999; Brockington & Mumford, 2002). Over the past decade there has probably been a further decline in the proportion of medical graduates choosing to train in psychiatry (Sierles & Taylor, 1995; Feifel et al, 1999).

The Islamic Republic of Iran is located in the Middle East between the Caspian Sea and the Persian Gulf. Iran's total land area is 1 648 000 km2. Its total population in 2003 was about 68 920 000 (UNICEF, 2003). The population growth rate is 1.41%. Of the total population, 60.4% live in urban and 39.6% in rural areas (Yasamy et al, 2001).

Lithuania is a country with an approximate area of 65 000 km2. Its population is 3.422 million, and the gender ratio (expressed as men per 100 women) is 87. The proportion of the population under the age of 15 years is 18%, and the proportion above the age of 60 years is 20%. The literacy rate is 99.6% for both men and women. The country is in the higher middle-income group (by World Bank 2004 criteria).

Australia, a vast continent of 7 700 000 km2 (including the island state of Tasmania), is roughly the size of Western Europe or mainland USA, but with a population of only 20.2 million (2004 estimate), mainly concentrated in coastal areas.

The terms ‘conversion’, ‘hysteria’ and ‘conversion hysteria’ were used interchangeably to describe a condition characterised by a single somatised symptom, often pseudo-neurological in nature. DSM–III (American Psychiatric Association, 1980) expanded the concept of conversion to generalised symptoms involving loss or alteration of physical functioning suggestive of a physical disorder, along with a clinical indication that the conversion was an expression of psychological conflict or need. The type of symptom or deficit should be specified as: with motor symptom or deficit, with sensory symptom or deficit, with seizure or convulsions, or with mixed presentation (Kaplan & Sadock, 2004).

The vision of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) is of ‘a fellowship of psychiatrists working with and for the general community to achieve the best attainable quality of psychiatric care and mental health’. It is the principal organisation representing the specialty of psychiatry in Australia and New Zealand; it currently has around 2600 Fellows, who account for approximately 85% of psychiatrists in Australia and 50% of psychiatrists in New Zealand. The RANZCP sets the curriculum, accredits training and training programmes, and assesses trainee psychiatrists. In addition, it administers a continuing professional development programme for practising psychiatrists, has a role in policy development, publishes two scientific journals – the Australian and New Zealand Journal of Psychiatry and Australasian Psychiatry – and holds an annual scientific congress.