Until recently, a doctor beginning a career in psychiatry would usually apply for a combined SHO/registrar rotation lasting approximately 3½ years. Trainees could expect promotion from SHO to registrar after about 18 months, subject to passing the Part I of the MRCPsych examination and also to their educational and clinical progress having been judged to be satisfactory by the scheme tutor and organising committee. Life has changed! The emergence of Achieving a Balance (Department of Health, 1988), the proposals of which are intended to be phased in over the next ten years, has meant that scheme organisers have had to quickly change the basis on which their rotations are run. This paper is an account of how this has been done in the SE Thames Region.
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