When I was appointed to my consultant post nearly 10 years ago I was one of several able candidates. This was the culmination of many years' hard work and I was proud to be working at an inner-city teaching hospital, one where I had trained as a medical student. This was probably the last time that my department was fully staffed, with each year since bringing more challenges. In recent years only one of the specialist registrars I have trained has continued with general psychiatry, with the attractions of old age, liaison and forensic psychiatry seemingly unassailable. My confidence finally reached rock bottom when a senior house officer announced that she no longer wished to continue in psychiatry because the role models we (consultants) set were unattractive. Apparently the image we project is of long hours, unlimited demands, endless risks and little time to practise the art of psychiatry. With the anniversary of my appointment approaching now it seems appropriate to consider why my hard fought for job has all the attractions of the plague.
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