The finding:
This fascinating qualitative study examined the experience of stigmatizing attitudes towards psychiatric services as noticed by six trainee psychiatrists across four hospitals in New Zealand. The study examined trainee perceptions of the experience stigma had on patient care, their ability to effectively liaise with medical colleagues, trainee wellbeing, and the training experience as a whole. The study found stigmatizing attitudes left trainees feeling isolated and undervalued, discouraged their desire to pursue careers in C-L, and concerned that patients with psychiatric issues would have worse care. Trainees expressed beliefs that improved integration and communication with general hospital services could improve collegiality and improved education could combat stigmatizing attitudes.

Strength and weaknesses:
As a qualitative study, these findings are not well generalizable, though the authors provide reassurance on the demographic diversity of the subjects (the specifics of diversity could not be disclosed to ensure anonymity). Interviews were de-identified and reviewed by two authors then coded independently, although one of the reviewers was the interviewer. The interviewer was also a trainee which may have led to overidentification with the subjects, which could have affected responses. All interviews were conducted by phone, and the lack of non-verbal cues and communication may have reduced the depth of interviews.

Relevance:
C-L psychiatrists work in a variety of diverse settings, with colleagues from diverse specialties and backgrounds, and with trainees of various levels of experience. This study highlights the importance of ensuring the lead psychiatrists of a team, whether inpatient or outpatient, is consistently checking in with trainees on their experience of interaction with our medical and surgical colleagues, and the influence this may have on the training experience. C-L psychiatrists, by nature of their training and experience, may be less sensitive to stigmatizing attitudes that are experienced as novel and shocking to trainees. This study highlights the various impacts this may have, not only on recruiting psychiatrists into C-L but on our patients as well.