Brown and Bhugra’s article on the European Working Time Directive has drawn much needed attention to the practical solutions which are being discussed to counter the difficulties following its implementation (Psychiatric Bulletin, May 2005, 29,161-163).
Another important consideration has to be the introduction of revalidation and appraisal. Appraisal involves discussion of a doctor’s clinical practice, and planning improvements in their development as a clinician. For the time being, revalidation is undergoing a review by the Chief Medical Officer, Sir Liam Donaldson, following criticisms in the fifth report of the Shipman Inquiry (see). The review of the basic and higher training programmes provides an opportunity to introduce a process similar to appraisal during these years. An appraisal system could be based on the revised curriculum and allow an opportunity to incorporate other areas of particular interest to the trainee, all integrated in the form of a personal development plan (PDP). The College introduced PDPs in April 2001 and understanding the underlying principles at an earlier stage of one’s career will, over time, allow the system to be refined in its usefulness and become integrated as part of everyday clinical practice, as major changes to clinical practice tend to be resisted by the medical profession.