The structure of academic training in psychiatry has changed in recent years and little is known about the trainees currently pursuing this career path. Two surveys were conducted of academic trainees in psychiatry and the heads of departments of psychiatry. These surveys aimed to identify the number of trainees currently in academic training, the nature of their positions and opinions about the current system of training in academic psychiatry.

There were 165 academic trainees identified, of whom 101 were not currently in academic clinical fellow (ACF) or academic clinical lecturer (ACL) posts. Academic trainees are located in a relatively small number of universities, with a quarter being based at one institution. In total, 60% of the trainees were in general adult psychiatry. Only 4.6% of respondents rated their academic training as excellent and just over half were certain that they wished to pursue an academic career in the future. Various challenges to academic training in psychiatry were identified by both the heads of departments and trainees.

Current difficulties in academic training in psychiatry, such as lack of flexibility of the training pathway, need addressing to ensure the provision of high-quality research and teaching in psychiatry in the future.

Psychiatry in the UK has long-standing issues in recruiting UK-trained doctors. A key potential influence on interest in psychiatry during medical school is the clinical attachment. This narrative review investigates how the clinical experience of psychiatry affects medical students' attitudes towards the specialty.

We identified 107 studies, of which 46 were included. They showed that clinical attachments in psychiatry did result in more positive attitudes towards the specialty and increased career interest. There was inconsistent evidence on whether interest was maintained, with some studies indicating that the increase is transient. Factors which may influence attitudes include attachment setting, duration and student demographics.

The results suggest a need to actively maintain interest in psychiatry throughout medical school. Research with long-term follow-up and evaluation of schemes to maintain students' interest is needed.

To evaluate the impact of involuntary out-patient commitment (OPC) in patients with severe mental disorder who use hospital services. This is a retrospective–observational study in a population of 91 patients under OPC. The psychiatric diagnosis, sociodemographic variables, who requested the court order and for what motive were studied. The study also looked at the use of the available health services (emergency room visits, admissions, average length of hospital stay) for the period beginning 2 years before and ending 2 years after the initiation of the OPC.

The number of emergency room visits, admissions and the length of hospitalisation diminished in the 2 years following the initiation of the OPC. In terms of diagnosis, the OPC has the most impact on individuals with schizophrenia and delusional disorder.

The OPC can be useful for certain patients with severe mental disorder, particularly individuals with schizophrenia and delusional disorder.

To determine the provision of teaching in psychiatry for foundation doctors up to the point of making specialty applications. Data for the cohort of foundation doctors entering training in 2010 were collected from teaching programmes across the Mersey Deanery and North Western Foundation Schools.

In the 17 hospitals that provided data, ‘protected teaching’ totalled 2354 h; 1.8% of time was dedicated to psychiatry, with 4 hospitals providing no teaching on mental health topics. The mean duration of psychiatry teaching was higher in university teaching hospitals (3 h 34 min) than district general hospitals (2 h 57 min); and almost a quarter of teaching sessions were titled only ‘psychiatry’.

For many foundation doctors their only experience of psychiatry will be through teaching sessions, and this is potentially the only time to change opinions and build interest in the specialty. Psychiatrists need to take a more active role in the provision of high-quality teaching for foundation doctors and become the visible role models which are currently lacking.

Summer schools are advocated as part of the national recruitment initiative despite little evidence of their impact. This study evaluates the effectiveness of a 3-day non-clinical initiative. Change in attitudes and career intention were measured by administering a questionnaire, which included the 30-item Attitudes Toward Psychiatry (ATP-30) survey, at the start and end of the event.

Mean ATP-30 scores increased from 119 to 128, which represented a highly statistically significant change (t = 5.40, d.f. = 18, P < 0.001). A positive shift in intention to pursue psychiatry as a career was demonstrated.

These results suggest well-planned summer schools can have a significant impact on students' attitudes. Despite high initial ATP-30 scores a positive shift in attitudes and career intentions was still seen. Further evaluation of the longitudinal impact is needed. Events such as this are important and likely produce a cumulative effect alongside other recruitment strategies.

To estimate the community prevalence of combination antipsychotic therapy and high-dose antipsychotic treatment via audit. Patients with an ICD-10 diagnosis of schizophrenia were identified through the NHS Greater Glasgow and Clyde Health Board patient information management system and their mental health records examined.

In audit 1, 135 records were examined. The age range of patients was 24–74 years; 73% were male. Twelve per cent were on combined antipsychotic treatment and 3.7% required high-dose antipsychotics. Sixty-nine per cent of patients had documented in their record the reason for combined antipsychotic treatment compared with 40% on high-dose antipsychotics. In audit 2 (1 year later), 150 records were examined. Demographic details and prescription patterns remained similar to that of audit 1. However, 10% of patients received combined antipsychotic therapy and 2% remained on high-dose antipsychotics. Documented reasons for combination therapy increased to 87%, and to 67% for patients on high-dose antipsychotics.

We need robust clinical trials, overcoming the problems of clinical effectiveness and clinical efficiency, to establish the merits of preferred antipsychotic combinations, as combination and high-dose antipsychotic treatments are unlikely to be eliminated in clinical practice in the foreseeable future.

This study analyses whether there is a relationship between a psychiatry placement during the UK Foundation Programme and appointment to psychiatry training. A survey was distributed to all foundation year 2 doctors in the UK to determine how many have exposure to psychiatry before specialty applications and whether such exposure correlates with choosing psychiatry as a career.

The study showed that 14.6% of foundation doctors had exposure to psychiatry prior to specialty applications. Of these, 14.9% chose psychiatry as a career in contrast to only 1.8% of those who did not have psychiatry exposure (χ2P = 0.0008; risk ratio 8.19).

This study adds weight to calls to increase the proportion of psychiatry posts in the Foundation Programme as part of a broader strategy to improve recruitment. To answer this question categorically, we suggest a prospective cohort study looking at how attitudes and career preferences change with exposure to psychiatry posts.