A postal survey of psychiatric trainees (n=52) based on the Keele rotational scheme in the West Midlands deanery was conducted using a 19-item questionnaire to establish the extent to which the workload and support for trainees comply with the College guidelines (Royal College of Psychiatrists, 2003). Thirty-two trainees (61%) responded, of which 14 (43%) always discussed patients seen in out-patient clinics with their consultant during weekly supervision which should be used for educational rather than clinical purposes. However, 28 (87%) trainees indicated that they had no formal training in writing letters to general practitioners and 21 (65%) had not received any supervision. Although the College guidelines specify that trainees should not be expected to perform duties beyond their competence without adequate supervision, about 50% accepted that they sometimes deal with too complex cases for their level of experience without sufficient help. Alarmingly, 9 (28%) trainees indicated that supervision for new patient clinics was rarely available, out of which 5 (15%) trainees had less than 1 year's experience in psychiatry which raises concern. This survey illustrates the importance of adequate supervision in out-patient clinic settings and emphasises the need for trainees to use weekly supervision to enhance their clinical skills and theoretical knowledge to enable them to discharge their duties effectively.

More needs to be done to change the allocation of complex patients with no supervision to trainees with limited level of experience.