In 1961 Shaw & Macmillan claimed that there was no doubt of the value of the day hospital as an “alternative to in-patient care and prophylaxis” for the elderly mentally ill (EMI). Thirty years later the day hospital remains central to many EMI services. During these years little has been done to evaluate this method of service delivery against other models of service provision.

The second European Trainees Forum (van Beinum, 1992) met in the Netherlands in March 1993. Training issues were discussed by delegates from the UK, Ireland, the Netherlands, Denmark, Sweden, Norway, Germany, Belgium, Finland, Portugal, and Switzerland. A number of training topics were specifically addressed by the Forum, and a statement unanimously agreed on each of these.

One of the most unpleasant things that can happen to the senior house officer or registrar on call alone in a psychiatric hospital is a “crash” call. He or she has to get to the patient, institute appropriate immediate management, arrange for disposal to a more suitable facility, and hand over to the responsible team. The problems facing the psychiatrist in this situation may be complicated by several factors, and these come under the following headings.

A recent paper by Lewis (1991) found authorship of a publication to be the only variable that significantly predicted whether applicants for a senior registrar (SR) rotation in psychiatry at a London teaching hospital were shortlisted. We have re-examined curriculum vitae (CV) predictors of shortlisting at SR level within a comparable London teaching hospital rotation (University College and Middlesex Medical School, UCMSM), and extended the study to examine applicants for the corresponding SHO/registrar (REG) rotation. We have also compared the two groups in terms of demographic data and academic achievements. Our intention was to replicate Lewis' findings, and to examine in more detail the possible predictive effects of academic achievement and ethnicity.

We were interested to read J. J. Hutchinson and A. Puranik (1992) on journal clubs at St Edward's Hospital, and would like to share our experience of running journal clubs in Sheffield. As stated, the College does not provide guidelines on the format of journal clubs, but they do provide a suggested reading list. While this contains interesting and relevant papers, it does not provide a good basis for a journal club programme.

A question asked by most children but avoided by adults is “Why am I me?”. It seems obvious and important when one is young but, to a grown-up, is too difficult and perhaps meaningless. Questions of this sort often have culturally sanctioned answers. For instance, “How did the world begin?” could have been answered (somehow) by any educated adult in any period of which we have records, and now the cosmologists are adding their own gloss to the replies.

The “new deal” for junior doctors is set to ensure reduction of hours worked to a maximum of 72 per week by the end of 1996. To facilitate this reduction, juniors with a higher workload are being asked to consider alternative working patterns to the traditional “on-call” total system, and either work full shift systems (e.g. as in casualty departments) or a partial shift system that falls between these two extremes.

In 1985, nearly two years after the announcement of the intended closure of Claybury and Friern Hospitals, the Team for the Assessment Psychiatric Services (TAPS) was set up to evaluate this policy. TAPS has now grown to a staff of six full-time researchers (three psychologists, a psychiatrist, a sociologist and a health economist) and is funded mainly by the North East Thames Regional Health Authority, but also by the Department of Health. This was the eighth annual conference, and the first since the closure of Friern Hospital in March 1993.

The widespread move to community care for people with a learning disability has caused a change in roles for both the psychiatrist and the general practitioner. The general practitioner is now widely recognised as the primary medical carer for people with a learning disability (Howells, 1991), with the psychiatrist providing specialist support.

In 1991 the Royal College of Psychiatrists organised two overseas teaching fellowships. In this paper we describe our visit to El Peral Hospital in Chile and discuss the value of our going there.

British Medical Association members are now able to use a new service to doctors which, until recently, has been largely exlusive to libraries in big hospitals and other institutions. At the time of writing, the BMA Library Dial-Up Medline Project has just completed its pilot stage and is due to be launched formally at the beginning of June. Trials started in November 1992 and the system is now up and running.

Charles Darwin (1809–1882) enjoys an uneasy position in the history of psychiatry. In general terms, he showed a personal interest in the plight of the mentally ill and an astute empathy for psychiatric patients. On the other hand, he has generated derogatory views of insanity, especially through the writings of English social philosophers like Herbert Spencer and Samuel Butler, the Italian School of “criminal anthropology” and French alienists including Victor Magnan and Benedict Morel.

The NHS and Community Care Act 1990 has been described as the biggest shake-up to the NHS since its inception. Most psychiatrists will by now be familiar with the new arrangements for community care, but what are the implications of the structural changes in the NHS for psychiatry?