Specialist registrar training – our perspective

We read with interest the article by Vassilas and Brown (Psychiatric Bulletin, February 2005, 29, 47-48). Having trained in the West Midlands region we feel the article gave a limited view of the current situation. What particularly concerned us was the point regarding the ‘ phenomenon’ of senior house officers (SHOs) becoming staff grade and associate specialist grade (SAS) doctors.

It may be helpful to give our perspective on the current situation. In highlighting their experience of the training scheme, the authors have not mentioned that the current funding crisis has resulted in the restriction of adult psychiatry specialist registrar (SpR) numbers for the past year. Lack of information from the deanery regarding this situation has left many of us demoralised and exasperated. This uncertainty has lead to some taking SAS posts while awaiting an increase in the numbers of SpR positions.

We do not deny that pay is an important factor, but this may not be the main reason for taking SAS posts prior to SpR training. Some SHOs do not feel ready to immediately enter higher training and believe the opportunity to work at a staff grade can assist by providing more experience and responsibility. This is an issue that warrants further investigation.

As entry onto the West Midlands SpR rotation in adult psychiatry has become more competitive, emphasis has been placed on candidates having research or publications in order to be short-listed. If the authors’ views are representative of the region, it is disheartening that we are expected to engage in research to enter a scheme that appears not to support research at this level. A survey of SpRs (Vassilas et al, Psychiatric Bulletin, 2002, 26, 313-314) revealed that none felt the research day should be abolished and half felt the day was not used satisfactorily due to a lack of supervision.

We do agree that the future of SpR training is at a crossroads, but the views of trainees should be considered in this debate.