Hong Kong has two established medical schools, at the University of Hong Kong and at the Chinese University of Hong Kong (CUHK), and these are soon to be joined by a new school at the Hong Kong University of Science and Technology (HKUST). This article outlines undergraduate psychiatry education in the 6-year MBChB programme at CUHK and in a new medical school at HKUST.

Most psychiatric disorders in adulthood originate in childhood or adolescence. Hence, managing mental health in children and adolescents is crucial. This clinical reflection aims to capture some of the contemporary and emerging trends in teaching and training in child and adolescent psychiatry worldwide. Future directions for child and adolescent psychiatry training programmes are also highlighted.

This clinical reflection explores the evolving landscape of teaching and training in old age psychiatry, highlighting recent reforms such as the 2022 UK curriculum revision, which emphasises person-centred, interdisciplinary and digitally enhanced care. It examines national and international initiatives addressing health inequalities, integration of artificial intelligence, and co-produced education. The article underscores the need for adaptable, inclusive and forward-thinking training to meet the complex mental health needs of an ageing global population.

There has been a boom in the availability of wearable neuromodulator devices for the treatment of mental health problems. These can be purchased outside of medical practitioner oversight or prescription. Psychiatrists need to know what these can offer and consider whether, and how, they may be integrated into psychiatric practice. This article briefly considers examples of these devices and their evidence base. It describes the experiences of the author and her husband in using such devices for their own mental healthcare and well-being.

Generative artificial intelligence (GenAI) shows promise for mental healthcare by increasing access to treatment. In this article, we analyse recent evidence on the use of GenAI chatbots as a treatment for common mental disorders. We examine key ethical and methodological considerations and discuss the specific risks for delusions. Adopting a precision psychiatry perspective, we propose that the therapeutic alliance can be improved by tailoring GenAI to mimic a user’s psychological traits, a version of socioaffective alignment.

Psychiatry education at both undergraduate and postgraduate level plays a critical role in shaping the future of psychiatry services. South Asia varies in the training offered and this article captures this aspect.

This article describes a trainee-led women’s health project aimed at connecting psychiatry and gynaecology to better meet the needs of perimenopausal and menopausal women. Cognitive–behavioural therapy (CBT) is a NICE-recommended treatment for menopause-related vasovagal symptoms. A menopause-focused CBT (mCBT) group intervention for women unable to take hormone replacement therapy was developed and piloted in collaboration with local menopause specialists. This article documents some of the challenges experienced and insights gained along the way by the trainees who developed it.

Children with social communication difficulties or an autism diagnosis and co-occurring mental health needs can struggle to access and engage in psychological treatment. This can have a negative effect on well-being and recovery. A service improvement pilot study investigated the impact of a values-focused intervention on the well-being of this patient group. Here, an anonymised clinical case demonstrates the key phases of the intervention. Reflections highlight the importance of a flexible and person-centred approach for these young people.

This reflection explores the unique challenges and opportunities in psychiatric medical education in the Middle Eastern region. The variation in aspects of teaching across the region can be explained by the influence of cultural and religious perspectives on the understanding of mental illness. Key barriers include pervasive stigma, shortages of teaching staff and limited clinical placements. Innovations like virtual learning and regional collaboration offer pathways to strengthen curricula, enhance competency-based assessment and further improve the future of psychiatry education.

This article reflects on a collaborative drawing group in a mother and baby unit, exploring the clinical value of arts-based interventions in perinatal psychiatry. Grounded in an evolutionary and biopsychosocial theory, it highlights how creative practice can reduce hierarchy, support emotion regulation and foster relational safety. A practical group model is described, encouraging clinicians to draw on their own creative skills to enrich care, build connection and hold space for meaning beyond symptom management.

In this clinical reflection, we briefly overview how physicians’ emotion regulation has been addressed within communication training in the context of Western European medical undergraduate, postgraduate and continuing medical education. For illustrative purposes, two examples of recently developed training programmes targeting both communication skills and physicians’ emotion regulation are described. We also discuss the existing gaps in emotion regulation-based communication training, as well as future directions for medical education regarding these skills.

All doctors will encounter patients with intellectual disabilities and neurodevelopmental disorders, but most medical subspecialty training does not explicitly cover the needs of this population. This can leave doctors feeling underskilled and lacking in confidence to assess and manage these patients. It can also increase the risk of diagnostic overshadowing, adversely affecting patients’ health outcomes. This article reviews the current state of medical education in the psychiatry of intellectual disability and associated neurodevelopmental disorders in the UK. It follows the medical training pathway from undergraduate through to postgraduate level, highlighting the expected learning outcomes. Key challenges and gaps in training at each level are discussed, along with potential solutions. Looking more widely, the article finishes with a short description of the paediatric neurodisability specialty training pathway, and a description of the UK’s contribution to international medical training in intellectual disability.

In medical practice it is crucial that symptom descriptions are as precise and objective as possible, which psychiatry attempts to achieve through its psychopathological lexicon. The term ‘autism spectrum disorder’ has now entered psychiatric nosology, but the symptom definitions on which it is based are not robust, potentially making reliable and valid diagnoses a problem. This is further compounded by the spectral nature of the disorder and its lack of clear diagnostic boundaries. To overcome this, there is a need for a psychopathological lexicon of 'social cognition’ and a classification system that splits rather than lumps disorders with core difficulties in social interaction.

Faster internet speeds and ever-present mobile phones present a new challenge to psychiatric wards – the ability for patients to live stream their in-patient stays. What are the benefits and the risks to the patient streaming and the ward as a whole? This article is to help start a conversation about this unique problem and how health professionals might go about addressing it.

Professionals, patients and patient organisations have advocated for the renaming of ‘schizophrenia’, seeing the term as misleading, stigmatising and a barrier to specialised care. In countries where a name change has occurred (e.g. Japan), the advantages of renaming seem to far outweigh disadvantages. Nevertheless, a name change would be a long and complex process that would not be useful if it were not accompanied by parallel changes in legislation, services and the education of professionals and the public.

This reflection summarises the evidence regarding the management of bipolar II disorder in the perinatal period, compares this to the authors’ clinical experience using case studies and considers the treatment of patients in current clinical practice.

Medical dramas such as Grey's Anatomy influence young people's career aspirations, creating unrealistic expectations. This article examines the gap between these portrayals and the reality of medical practice, highlighting challenges such as rigorous training and high stress. Using Italy's ‘numero chiuso’ (‘closed number’) system as a case study, it addresses the global issue of intense competition in medical school admissions. The article advocates for realistic education and better support to prepare future healthcare professionals.

If a Mental Health Act section 136 lapses at 24 h because no in-patient bed is available, the legal grounds to continue holding an individual in the place of safety are dubious. Duty of candour and a senior clinical review are essential. The use of common law and the Mental Capacity Act have limitations, the latter also raising a question about whether deprivation of liberty safeguards would also apply. Clarity of this dilemma is needed through legislation.

Acute behavioural disturbance is relatively common during the perinatal period. The management of agitation in pregnant women is similar to that in the general population, although with some additional considerations, such as modifications to restraint techniques, careful medication selection, monitoring of maternal and fetal well-being and the importance of a debrief. There are benefits of agreeing a pre-determined care plan for women who are at risk.

Rapid retitration of clozapine may be necessary to reduce the known high risk of mental state destabilisation in patients who have had a 48 h treatment break. It may carry a high risk of complications, including seizures and myocarditis. We reflect on the literature on standard and rapid retitration and present a case of rapid retitration in the community. In this case, of a 54-year-old homeless man with treatment-resistant schizophrenia and polysubstance misuse, we safely retitrated clozapine in a community setting four times during a 6-month period; each retitration was completed over 4 days. We used a specific protocol based on his psychiatric history. We are now more confident in delivering clozapine retitration to other patients, thus preventing unnecessary admissions.