The old lady in black was bent over the body of her son. She rocked backwards and forwards, wailing. Do I really need to watch this I thought? I switched over and was subjected to the woeful groans of East Enders. That's enough, I thought. As I was about to take my cup of tea into the conservatory, my son Steve, who had been quietly studying the floor, suddenly raised his head and demanded to know why I had rung the BBC. ‘BBC! What are you talking about?’ ‘You know,’ he retorted. ‘You rang the BBC to tell them what a lazy sod I am; they've been broadcasting it all day.’ My heart missed a beat. I went cold, my stomach turned – I had become a carer.

The training of junior doctors is one of the priorities of the Royal College of Psychiatrists. An essential part of this training happens in multidisciplinary teams, and the ability to work effectively as a member of a clinical team is one of the core attributes of our professional identity as psychiatrists.

The authors, all consultant child and adolescent psychiatrists working in the north-west of England (an area that has experienced recruitment difficulties throughout the past decade), seek to stimulate discussion about the serious issues of recruitment and retention faced by child and adolescent psychiatry. Current thinking about staffing and models of provision is challenged.

The NHS International Fellowship Scheme for consultants offers overseas consultants, in specialties including psychiatry, an opportunity to work in the UK (Goldberg, 2003). This was launched by the Department of Health in 2002 and so far over 100 consultant psychiatrists have been recruited. However, there are several aspects of the project that are unclear. How long will this recruitment continue? Are there any arrangements in place to encourage overseas consultants to return to their home country at the end of their fellowship? Are they eligible to train senior house officers (SHOs) and specialist registrars (SpRs)? Will the recruitment under the scheme have an impact on job opportunities for SpRs currently training in the UK? Why is membership of the Royal College of Psychiatrists being granted to the newly recruited consultants without an examination? These and many more concerns have arisen in the wake of this scheme. In this article, we evaluate the scheme, discuss its implications and suggest possible ways forward.

Narrative medicine is a well established academic field and has been shown to increase clinical skill and improve the therapeutic relationship of those who study its principles (Banks et al, 1995; Jones, 1999). Literary analysis is a convenient means of fostering advanced communication skills. Moreover, the skills gained from such an education are highly applicable to everyday psychiatric practice. The evidence for the efficacy of narrative medicine is well established, and on this basis a strong argument can be made for its inclusion as a compulsory part of the current MRCPsych course.

Media training is designed to prepare people for print, radio and TV interviews. It is especially challenging to prepare psychiatrists for interviews with the media because reporting of issues related to mental health is often distorted and stigmatising. Although media coverage of women's rights, Black civil rights and disability has changed markedly, mental health coverage has yet to come in from the cold (Crisp et al, 2005; Nairn & Coverdale, 2005). Psychiatrists are better placed than anyone else to change the climate, but some fear being ineffectual or misrepresented. One even likened the challenge to climbing Everest (Harrison, 1998), a view highlighted by a national newspaper survey of 306 health-related articles in which psychiatry coverage was four times more likely to be negative than coverage of general clinical medicine (Lawrie, 2000).

A 9-year-old girl with large moist eyes stares past the doctor. She had been admitted to a district hospital with fever the morning the tsunami struck. Many patients, nurses and doctors died there, and the girl still has night terrors. The doctor interviewing her lost a number of colleagues and was traumatised himself.

As Professor Eastman (2000) has noted: the law is fond of ‘using’ psychiatry for its own ends at times, but the Mental Health Act 1983 is an example of psychiatrists using the law as a tool of public policy. This makes their education in and interpretation of it all the more vital. The MRCPsych part II module ‘Ethics and the Law’ requires candidates to demonstrate knowledge of relevant mental health and human rights legislation, and to illustrate the appropriate application of such information (Royal College of Psychiatrists, 2001). We submit a masked case study that in practice seems to us a misinterpretation of the Act.

Journal clubs have traditionally been important means by which clinicians, academics and trainees appraise research that relates to their field. In recent years the evidence-based style has become more prevalent, allowing knowledge gleaned from research to be applied to clinical situations. Currently, the main approach of evidence-based journal clubs is quantitative. This paper describes the evaluation of a modified journal club format, developed in an academic department of a medical school and combining the appraisal of both qualitative and quantitative papers.

Higher specialist training in psychiatry requires the development of a broad range of knowledge and skills in a short space of time. However, a brief national survey of programme directors confirms reports from peers that structured, targeted teaching tends not to continue beyond completion of College Membership examinations. Exceptions to this rule are child and adolescent psychiatry and to a lesser extent psychotherapy, which reflects requirements laid out in the Higher Specialist Training Handbook (Royal College of Psychiatrists, 1998). Specialist registrars must therefore, using limited study time and funding, attempt to acquire knowledge from local and national courses. These, however, are usually aimed at more generic groups: for example, all health service specialist registrars or at consultants for fulfilment of continuing professional development.