Psychiatrists behaving badly?

The reason why many of us choose psychiatry as our specialty is that we like the human touch of medicine. To a large extent this is our strongest attribute, but as O'Leary et al ¹ have demonstrated, quite perversely it is this affinity that also leads to our failing in the areas we should excel in, namely relationships with colleagues and patients as well as good clinical practice. The implications of the numbers of psychiatrists being referred to the National Clinical Assessment Service (NCAS) should not be underestimated not least to themselves but also to mental services as a whole. Coupled with the recruitment problems in junior training posts and the relative inability to make our specialty attractive to medical undergraduates, ² we are likely to store further problems of recruitment to consultant posts, something that has dogged our profession for many decades but none more so than in the 1980s and 1990s. Elsewhere in the journal, Burns articulates his concerns on how the consultant's role lacks definition, ³ a factor that might well influence our performance and our attitude to others, as well as others' to us. My sense is that we need some creative thinking around how we might promote our specialty, while simultaneously ensuring that our colleagues are supported in the right manner during their stressful years of practice. In this regard, O'Leary et al's call for the College to review the continuing professional development (CPD) programme is not inappropriate, but as the CPD Committee has just set out a new policy ⁴ it could be some time before the next policy comes round. There is evidence that those who participate in CPD are less likely to be disciplined than those who do not and that those who are in mature professional years fare better if they keep up to date with modern practice. ⁵ There is scope within the three domains (clinical, professional and academic) of the new CPD policy to cover all specialty developmental issues while retaining generic medical and psychiatric skills. These might be further reinforced through peer groups. Each of the College faculties has had the opportunity to influence the policy, but I am in agreement with O'Leary et al that further refinement could take place to reflect the growing need to provide specialist care. It would be my aspiration that the CPD policy be more electronically based rather than being set in a publication which sits on the shelf for the next 5 years or more without being updated. I would welcome members' input into how this might be achieved annually, with revision of policy that is in line with their practice.