“These medications (antipsychotic drugs) were originally developed to treat not the mentally handicapped but the mentally ill; those, for example, with schizophrenia, paranoia and other specific conditions, but now the far wider use of these drugs has been challenged because there is evidence that they can produce serious side-effects in addition to the distress already suffered. Future changes in the use of antipsychotic drugs in the UK may come from the Royal College of Psychiatrists or from action in the Law Courts” (Public Eye, BBC2, 1.5.92).

Clinical skills in psychiatry are not best acquired in unsupervised practice or in learning by apprenticeship. In the past, it was reported that during the course of their clinical training, students' interviewing skills actually deteriorated rather than improved (Helfer, 1970; Maguire & Rutter, 1976), although recent research suggests that improved training is now having an impact (Davis & Nicholaou, 1992). The methods described below may be employed at both undergraduate and postgraduate level. Traditionally, psychiatrists have been actively involved, along with general practitioners, in the provision of communication skills training to undergraduates. In the future, this training will become a continuous process carried out alongside and within other teaching in all specialities (Gushing, 1996). One of the biggest challenges facing medical schools is how to engage and train clinical teachers from a range of specialities in facilitating students in the acquisition of clinical interpersonal skills.

There have been many changes in postgraduate education in psychiatry over the past 15 years. The Royal College of Psychiatrists was ahead of most other Medical Royal Colleges in organising supervised training schemes which took into account the educational needs of the trainee as well as providing an appropriate service to patients. The approval exercise, with inspection of both basic specialist and higher specialist training schemes, was introduced more than 20 years ago. Prior to the introduction of ‘Achieving a Balance’ – Plan for Action (Department of Health, 1987), the senior house officer (SHO) and registrar grades in psychiatry were more or less interchangeable, although those in registrar posts tended to rotate outwith their base hospital and gain experience in the sub-specialities.

In response to what are regarded as the two principal evils of the civil justice system, costs and delay, Lord Woolf, now Master of the Rolls, has presided over an inquiry which has resulted in some proposed reforms which should change radically the administration of civil justice. The implications for experts are best considered against the background of a brief overview of the proposed reforms. This paper then considers the role of the expert witness organisations and the medical version of ‘the model expert report’.

All forms of teaching, including giving a lecture or a seminar, are intended to fulfil one or more particular aims. In planning a presentation, it is helpful to begin by defining the intended aims of the presentation and associated objectives. The aims and objectives will help to determine what methods to use, and what teaching aids might be appropriate. For example, if the main aim of a presentation is to provoke thought and discussion among the audience on a controversial topic, a didactic talk in a large auditorium to a widely dispersed audience is less likely to fulfil this aim than a facilitated interactive discussion in a smaller room with seating not fixed in rows.

Clinical governance can be defined as: