The south-west Mentoring Scheme has developed in the context of a general and increasing concern for the health and morale of senior doctors (British Medical Association (BMA), 2000). Their problems are now well described (Allen, 1999; Ghodse et al, 2000), but there is little evidence of effective intervention. The aspirations of the National Service Framework and the NHS Plan will come to nothing if there are not sufficient trained and experienced staff to implement them, and senior staff are increasingly looking forward to early retirement rather than the continued satisfactions of working within the NHS. Recruitment and retention of consultant psychiatrists is the most problematic of all medical specialities, with 14% of posts empty or occupied by locums (Sainsbury Centre for Mental Health, 2000). There is a clear need to find ways of preventing work-related ill health, stress and burn-out among practitioners (Roberts, 1997; Department of Health, 1999: p 115), and to sustain their creative and productive engagement in health care. A demotivated profession cannot be expected to deliver an effective service (McBride & Metcalf, 1995; Appleton et al, 1998) and policy is not a substitute for personnel.

A recent article in the Bulletin (Rees, 2000) suggests that cognitive–analytic therapy (CAT) “may emerge as the preferred form of psychotherapy within the NHS”. I would question Rees' claim that CAT “uses an understandable language and straightforward techniques”. For many patients – and therapists – it is too ridden with jargon and complex diagrams. Moreover, as he admits, “formal CAT training is long [2 years for basic qualification] … this is impractical for most psychiatrists”. In addition, “research has yet to provide a robust evidence base for its effectiveness”. CAT in expert hands is an attractive and powerful model, but does not suit the needs of junior psychiatrists striving to rapidly acquire and integrate broad effective psychotherapeutic techniques. I suggest that another of the ‘newer’ therapies, interpersonal theray (IPT), would fit the bill better.

Psychiatry has always relegated itself to being the Cinderella speciality of medicine. Nowadays it appears that general adult psychiatry is competing for the Cinderella subspeciality of the speciality. The profession may or may not be in crisis but it probably is depressed. Would we accept, unchallenged, such low self-regard and hopelessness from patients? Not if we are trying to be in the least bit therapeutic.

Clinical governance was introduced in 1998: ‘a framework through which NHS organisations are accountable for constantly improving the quality of services and safeguarding standards of care by creating an environment in which excellence in clinical care can flourish’. (Department of Health, 1997)

Uganda has a rich history of medical education (Odonga, 1989) that was severely harmed by the rise of Idi Amin and the years of internal strife. It is only over recent years that the country has begun to rebuild itself (Boardman & Ovuga, 1997).

Palestinian sources estimated the population in 1992 on the West Bank as approaching 1.5 million, and that of Gaza as just under 800 000 (Abdeen & Abu-Libdeh, 1993), with an increase of about 45% anticipated over the next decade (Planning and Research Centre, 1994). Significant numbers of Palestinians also live in surrounding Arab countries, especially Jordan, where they may even be in a majority (Stendel, 1996). About 1 million Israeli Arabs also live within the borders of Israel. The majority of Palestinians are Muslim, but about 6% are Christian (Bin-Talal, 1995).

At a time of increasing European harmonisation this paper gives a brief history of the main European organisation for trainees in psychiatry (the European Federation of Psychiatric Trainees) and details the proceedings of the most recent European Forum held in Berlin.

Currently there are about 2000 practising consultant psychiatrists in Australia, 80% of whom are in private practice. In terms of training there are close to 700 trainees (registrars) with approximately 100 qualifying each year (Henderson, 2000). Training takes place all over the country but, as with many other aspects of Australian life, is largely confined to a small number of larger cities dotted around the coast of the mainland.

Training in psychotherapy is a mandatory part of general professional training in psychiatry. The College produced guidelines in 1993 outlining the breadth and depth of training required (Royal College of Psychiatrists, 1993).