In order to inform planning decisions, we aim to show how an in-patient consultation-liaison service has changed in 30 years. A year's referral of 175 inpatients was compared with surveys carried out in the same hospital 20 and 30 years previously. Neurosciences continue to refer the greatest percentage of its patients while general medicine produces the greatest demands on the service. There has been a large increase in substance misuse referrals, although other diagnostic groups have similar referral rates. Liaison service planners should be aware of the unmet demand for psychiatric services of the general hospital in-patient population.

Unrecognised and untreated depression is common, particularly in the elderly. This paper describes an attempt to offer screening for depression to 4,500 people over the age of 60. Only two people attended and both were depressed. This may have related to the arrangements for screening, to the symptoms of depression, to inadequate publicity or to characteristics of the elderly population. Others contemplating screening for depression in elderly populations are advised to adopt a different methodology.

The benefits of experience in paediatric genetics to child psychiatrists are discussed. Pursuing a special interest within a child psychiatry rotational training scheme is an important way of widening experience in light of the proposed reforms to training for hospital doctors.

This is the second in a short series of articles on portraits of children from the point of view of a child psychiatrist.

“Hogarth's Rakes's Progress paintings, which I saw in 1947 on a chance visit to the Chicago Art Institute, immediately suggested a series of operatic scenes to me.” (Stravinsky & Craft, 1960). By 1947 Stravinsky's career, which had started so brilliantly and stormily with the revolutionary Rite of Spring, was almost totally becalmed. Since emigrating from Paris to California in 1940, he had written a couple of untempestuous orchestral pieces, Circus Polka, “composed for a young elephant”, and little else. He was depressed by the lack of originality of his work and was eager to write an opera in English. When he saw the paintings of the Rake's Progress, he seized his opportunity.

Little has been published by junior trainees of their experience of part-time training. This paper discusses two different arrangements of flexible training at registrar level based on the personal experience of a married couple where both partners wished to combine psychiatric training with childcare. Job-share by working alternate periods of six months is compared with being in separate flexible training posts as super numerary registrars.

This is the first in a short series of articles on portraits of children from the point of view of a child psychiatrist.

In the year of the College's 150th anniversary, the President invited essays with the title The Therapeutic Effects on Psychiatric Patients of a Pleasant and Congenial Environment’. Writers were asked to consider “current literature”.

Psychiatric trainees' knowledge and understanding of the therapeutic principles underlying the appropriate use of psychotropic medication comes from many sources. They receive a grounding in neuropharmacology as a medical student and this is updated and expanded by attendance at a university lecture course in preparation for the MRCPsych examinations. Practical advice is handed down by supervising consultants and is augmented by reference to standard textbooks and research literature. Pharmaceutical representatives occasionally provide useful information though this may be biased, concentrating on specific drugs in isolation and without comparisons to competitors. Because of the variety and uneveness of these sources there is a risk, especially in the earlier years of training that knowledge is patchy, impractical or unsoundly based on dogmatic or out of date advice. There have been calls for training in psychopharmacology to be improved and suggestions as to how this may be achieved (Ferrier & Cooper, 1994). This paper describes the clinical pharmacy services in Fife and their value in improving the knowledge and practice of therapeutics amongst psychiatric trainees.

The comprehensive implementation of the care programme approach is described within a large Mental Health Unit serving two London boroughs. Methods used to introduce an incremental improvement in the care programme approach (CPA) practice and documentation are outlined together with an account of the development of a set of quality standards and a CPA annual audit system.

‘Induction days' are becoming more popular for trainees and are a useful way of communicating important local information to the new intake. The authors feel that a handbook given out during the induction can serve as an aide-memoire, and have provided a suggested layout which they themselves have used in preparing several such books.

Publications in the Psychiatric Bulletin have highlighted trainees' interest in part-time training and described different kinds of part-time training, but the feasibility of working as little as four hours a week has not been addressed. I have made unusual use of a Retainer Scheme for Doctors with Domestic Commitments to support part-time psychiatry in a general practice setting. This has proved a useful short-term option for bridging a career gap.

D. Hartman looks at the work of the painter De Kooning, following the BBC1's Omnibus programme of 21 February 1995.

Part-time training has been available for over 25 years. However, women remain under represented in the higher grades. Following the report of the Joint Working Party on Flexible Training, April 1993, we aimed to investigate awareness and attitudes towards flexible training in Birmingham among psychiatric trainees and their consultants. The results suggest that while most had heard of flexible training, many had little knowledge of the recent registrar flexible training scheme locally. A substantial minority of doctors agreed with pejorative statements about part-time training and more of these were Juniors. Senior psychiatrists did not perceive part-time training adversely and many would consider part-time work in the future.

This article offers suggestions to psychiatric trainees who might be interested in spending a period of training in the USA, including ideas about employment, qualifications, differences in practice, and useful addresses and sources of information.