We broadly support Dr Dave’s point concerning the need for closer working with primary care. Invariably, this will help prepare medical students for the reality of clinical practice post-qualification and additionally expose them to a less complex patient group. However we fall short of agreeing with the radical solution proposed.

The purpose of the editorial ^{Reference Abed and Teodorczuk1} was to draw attention to the challenges faced by clinical psychiatry teachers in the context of the changing educational landscape and pressures. We have not suggested that the solutions proposed are sufficient alone. Rather, we contend that increasing transparency of funding, specifically developing learning opportunities in community teams and innovating undergraduate curricula, are especially timely and relevant given the ongoing challenges facing undergraduate psychiatry education delivery and its central importance as a ‘shop window’ for our profession.

Today’s psychiatrists increasingly work in a supervisory capacity with team members, for example in community teams, and hence we propose there is an essential need to include undergraduate education within the design of new service delivery arrangements. Organisations with a focus on learning perform more effectively in terms of patient experience outcomes ^{Reference Berwick2} and, therefore, bringing undergraduates into our psychiatry team settings may ultimately benefit not only students, but also mental health trusts and patients. Creating an expansive learning culture with an emphasis on undergraduate teaching can only be positive.

With this in mind, we cannot support the radical solution proposed to transfer the majority of, if not all, undergraduate psychiatric education to primary care. Ultimately such a move would do medical students a disservice as they enter mental health rotations with a keenness to learn about psychiatry.

A primary-care-focused approach has the potential to undermine psychiatry as a profession by reinforcing stereotypes about the role of the psychiatrist being separate from medicine. Furthermore, undergraduate psychiatry attachments have been shown to be influential in improving medical students’ attitudes and career intentions regarding psychiatry. ^{Reference McParland, Noble, Livingston and McManus3} It is unclear from the suggestion who would lead the teaching, how receptive primary care would be to such an imposition and importantly whether they have the skills or expertise to deliver our specialised outcomes as defined in the College’s undergraduate curriculum. ^{Reference Wilkinson4}

Rather than transfer psychiatry teaching to primary care, we advocate adopting a more integrated approach to teaching mental health, within both psychiatry rotations and the broader undergraduate medical curriculum. Integrated approaches have the additional benefit of aligning psychiatry teaching with mental health content that precedes or follows it. Importantly though, integration should not exclusively be with primary care. Joint teaching of delirium in hospital medicine rotations ^{Reference Fisher, Gordon, MacLullich, Tullo, Davis and Blundell5} is another example of a focus of potential horizontal integration.

In summary, we thank Dr Dave for drawing attention to the importance of working closely with colleagues from other professions. However, before taking any radical steps there is an urgent need for improvements in the delivery of teaching in mental health settings and specifically in integrating psychiatry across the whole curriculum.