Postgraduate Psychiatric Education.

NEARLY 20 years ago the Goodenough Report, reviewing the future of psychiatric education in Great Britain pointed out that 'the major and most urgent need is the training of specialist psychiatrists and particularly of teachers of psychiatry' (H.M.S.O., I944). The Report went on to indicate the special place to be occupied during the postwar period by the Maudsley Hospital Medical School, which shortly afterwards became the Institute of Psychiatry within the British Postgraduate Medical Federation in close association with the Maudsley and Bethlem Royal Hospitals. Events have justified the planners. While other centres have made useful contributions to postgraduate psychiatric education, for the past I5 years the Institute of Psychiatry has organised a major training programme whose comprehensive structure and objectives have been clearly outlined by Professor Sir Aubrey Lewis (I949). In this short time a 'Maudsley training' with its formal stamp, the University of London Academic Diploma of Psychological Medicine, have come to guarantee a high standard of professional competence for psychiatric specialists in this country. The wider significance of this training can be assessed from the findings of the recent follow-up study tracing the careers of 274 men and women who left the junior staff of the joint hospitals between 1946 and 1958 (Davies and Stein, I963). At the same time it is already clear that what has been accomplished represents only a beginning for the country as a whole. Some doctors can now receive a sound postgraduate training in London; the new generation of teachers in the recently created provincial university departments of psychiatry is starting to take a share of the load; and in some areas collaboration has begun between the universities and the regional boards. Yet for some time to come it seems probable that the systematic postgraduate instruction afforded to the junior staff of many mental hospitals will remain exiguous. This deficiency poses an urgent problem. It is no longer reasonable to expect the old educational diet of a D.P.M. course, a handful of textbooks and clinical responsibility for several hundred patients to nourish a budding consultant psychiatrist. One remedy could lie in clinical tuition, a form of instruction which has been widely acclaimed in other branches of medicine (Lancet, I962), but whose application to psychiatry has been limited by a shortage of suitably trained men to act as clinical tutors. For this reason particular interest attaches to the tutorial system of instruction developed …