A trend has been noted for trainee psychiatrists who obtain their College Membership to opt for staff grade and associate specialist grade (SAS) posts (Reference Vassilas and BrownVassilas & Brown, 2005). This contributes to consultant shortages (Reference Mears, Kendall and KatonaMears et al, 2002) and presents the Postgraduate Medical Education and Training Board (PMETB) with an opportunity to provide solutions.

Our survey of SAS psychiatrists in Birmingham (n=55) found personal reasons (62%) and wanting further clinical experience (45%) to be the most common reasons for taking an SAS post. Of those who have passed the MRCPsych part I examination, 69% and 50% respectively cited personal reasons and gaining clinical experience, but for those with College Membership, pay protection (75%) and additional clinical experience (75%) were the reasons.

It may be that SAS posts are considered more flexible in terms of personal and family life. With PMETB's proposal for two pathways to specialist registration, a run-through training programme and career posts, doctors might still be attracted to career posts with the incentive of pay protection, and endeavouring to keep trainees on the training path might prove difficult. None the less, the majority of those with MRCPsych part I (88%) and all with part II wanted to resume their training, therefore mechanisms need to be clarified for re-entering training systems.

The desire for additional clinical experience brings into question trainees’ perception of their basic training. This adds to concerns about reduced working hours and the development of specialised teams impinging on opportunities for experiential learning (Reference Brown and BhugraBrown & Bhugra, 2005). Could PMETB's more structured, focused and standardised approach to training be the answer?