A bureaucratic short-cut to consultant posts in the UK

Sir: Many European doctors training in the UK during the past years have complained about the new Certificate of Completion of Specialist Training (CCST) system (Cervilla & Warner, 1996). The time required to become a psychiatrist is still so much longer in the UK than in the continent. Complaints have resulted in the Specialist Training Authority issuing the so called ‘Official Confirmation of UK Training’. This confirms that the trainee has spent four years in UK-recognised training posts (regardless of training level), thus fulfilling EU regulations and leading to accreditation in Europe. Ironically, with this European accreditation, the doctor can come back to the UK and register on the GMC Specialist Register being eligible for appointment as consultant psychiatrists, after as little as four years of senior house officer level training, even if they had failed their MRCPsych (Cervilla, 1996). Moreover, psychiatrists trained in Europe for just four years can also enter GMC Specialist Register straight away. This is in contrast to those British, or indeed European, doctors who stayed in the UK till the end of their psychiatric training and who spent at least six years as psychiatric trainees, including passing the MRCPsych Examination, before entering the Specialist Register. This scenario is unfair to those that spend many years of hard training work at lower pay. In addition, it might give a bad image in Europe of British standards of psychiatric training. More importantly, the quality of care provided by doctors partially trained, but yet fully accredited is likely to be poor and potentially dangerous. Changes in the current regulations are, therefore, needed.