Enticing GP trainees

Dein et al's article (Psychiatric Bulletin, June 2007, 31, ) is fascinating and worrying, given recent developments in the structure of training rotations. The authors emphasise the importance of exposure to psychiatry after medical school, and that it is too soon to evaluate the impact of the foundation year. Previously, the main opportunity for postgraduate exposure was through GP vocational programmes. In many parts of the country, as a consequence of MMC/MTAS, such programmes have expanded: for example, in the South East, excluding London, the balance between psychiatric and GP trainees has shifted massively in favour of the latter, with over 80 posts being ‘converted’ this summer. However, simultaneously, 6-month training slots have been reduced now to 4 months’ duration, to meet the needs of the GP rotations.

I question whether 4 months’ exposure is enough to encourage GP trainees to switch to psychiatry, as has been common in the past. Rather, the structure of the new senior house officer (SHO) jobs, which have moved towards being generic site duty doctors for in-patient units, while the committed psychiatric trainees staff the more interesting community and specialist jobs, is I believe less likely to contribute to the important postgraduate factors of empathy, better working conditions and a sense of fulfilment with improvement or interface with other disciplines.

If we wish to encourage GP trainees to switch to psychiatry, we need urgently to rethink what we provide during their brief 4-month exposure so that it makes a lasting and positive impression, not treat them as workhorses passing briefly through.