I was interested to read your article regarding pre-registration house officer training in psychiatry (Herzberg et al, May 2003, 27, 192-194). I am also interested and glad to hear of your findings regarding trainees' improved confidence and target skills as well as high rates of satisfaction.

In 1981, in Sheffield, I was involved in one of the first pre-registration house officer posts in psychiatry in this country. This pre-registration house officer training was reviewed by O'Dwyer (Reference O'Dwyer1999).

From my experience of doing the psychiatry 4-month post as the first in a rotation of psychiatry, medicine and surgery, I personally felt this was of great benefit - particularly in relation to communication skills and gaining a wider view of illness within the context of a person's life and family relationships. It also helped raise my awareness of the importance of appropriate settings and privacy when interviewing patients and discussing issues that are distressing. This was a help as well as a hindrance when I was subsequently to be a surgical and medical house officer, where one has to clerk in large numbers of patients within busy wards or Accident and Emergency departments with only curtains drawn and little privacy, e.g. prior to major surgery such as mastectomy.

The pre-registration house officer post helped me to gain further insight into and develop communication skills, to consider wider issues and to have a wider perspective when interviewing physically ill patients on medical and surgical wards. Therefore, this should be considered alongside the ‘target skills in psychiatry’ when planning pre-registration training.