Objective: The aim of this study was to help clarify the range of acute medical problems experienced by patients on an acute psychiatric unit during a period of 28 days and nights, as encountered by psychiatric trainees, and to document any difficulties experienced by the trainee during these patient contacts.

Method: This survey was carried out prospectively over 28 days and nights in an acute psychiatric ward attached to a teaching University Hospital. Following contact with an individual patient, the trainee recorded diagnosis, intervention and any difficulties encountered.

Results: Thirty-three patient contacts were recorded (n = 33). Trainees faced a range of primary care problems 22/33 (67%), but moreover, three patients demonstrated more serious and potentially life threatening problems, leading to 11/33 (33%) patient contacts requiring urgent interventions.

Conclusions: While the debate continues as to who is best placed to provide medical healthcare for psychiatric patients, this study provides evidence that psychiatry trainees are required to draw on their previous medical and surgical experience on an almost daily basis. As psychiatrists we should consider our options on how best to manage medical problems on the acute psychiatric unit and consequently ensure confident liaison with our medical and surgical colleagues.