On reading the article by Barras & Harris, ^{Reference Barras and Harris1} I recognised one of the trainee's comments as my own. This comment was written merely weeks into my core trainee year 1 and related to the reaction of hospital consultants to my choosing psychiatry as a career (during my foundation 2 year, FY2). I would like to elaborate further on my experience as a foundation trainee in acute hospital medicine relating to psychiatry, and suggest what improvements could be made to the current system to boost recruitment and retention.

When I was an FY2 trainee, I was keen for the opportunity to undertake a 4-month rotation in psychiatry. Despite stating this preference, I was not allocated to the specialty and instead I completed FY2 jobs in accident and emergency, orthopaedics and intensive care. Although I was initially disappointed with this combination, it proved to be an extremely valuable learning opportunity which enabled me to realise and understand the vast overlap between psychiatry and acute hospital specialties. I observed trauma patients during my orthopaedic job who had sustained massive injuries from ‘failed’ suicide attempts. I saw numerous psychiatric presentations in the accident and emergency department. Even intensive care provided me with chances to understand the consequences of psychiatric illness, ranging from irreversible hypoxic brain damage following hanging in a patient with depression to endstage liver failure in a patient with alcohol dependence.

Many medical students and foundation doctors who have enjoyed the acute hospital setting during their foundation years may be reluctant to consider a specialty such as psychiatry. This may be particularly true if they have not worked in a psychiatric specialty during this time. Perhaps a solution would be to encourage deaneries to provide 3-month foundation posts instead of 4-month posts, so as more foundation doctors are exposed to psychiatry. It would also be worth considering whether these posts should be partly hospital based and have a particular emphasis on liaison psychiatry, so that foundation trainees can observe directly the important role of the psychiatrist in working collaboratively with medical colleagues. Barras & Harris noted that 5.0% of trainees had stated they had considered leaving psychiatry because they wished they worked in a different specialty. ^{Reference Barras and Harris1} At this time when retention rates are falling, perhaps enabling foundation doctors to see for themselves the diversity of psychiatry and how it integrates with acute hospital medicine is key.