This past summer I led a group of APA members to the annual meeting of the
Royal College of Psychiatrists in Glasgow, Scotland. The meeting afforded me
the professional and personal honor of getting to know the president of the
Royal College, Prof. Sheila Hollins. One outcome of the meeting is that we
agreed to work together on various issues of mutual interest and develop joint
presentations at each of our annual meetings.
The Royal College has 12,000 members worldwide, with divisions throughout
England and in Scotland, Wales, Northern Ireland, and the Republic of Ireland.
Joining me at the meeting were our immediate past president, Dr. Steven
Sharfstein; our medical director, Dr James Scully; and a number of APA
members, including Drs. Sidney Weissman, Ken Busch, Joan Anzia, and David
Lynn. Dr. Nigel Bark, also an APA member, joined us in another role as chair
of the Pan-American International Division of the Royal College.
APA President Pedro Ruiz, M.D., poses with Prof. Sheila Hollins,
president of the Royal College of Psychiatrists, at the college's meeting last
summer in Glasgow, Scotland. Joan Anzia, M.D.
Dr. Sharfstein made a presentation on APA's position statement on the
interrogation of prisoners (Psychiatric News, June 16). He reviewed
the process that took place as the statement was revised, reviewed, and voted
on by the Assembly and Board of Trustees. This action served as a stimulus for
the Royal College to develop a similar resolution, which was unanimously
approved by its members at its business meeting in Glasgow.
Drs. Weissman, Busch, and Anzia made presentations on various aspects of
terror and trauma and their effects on individuals and society at large. This
presentation emphasized the role of psychiatrists in helping individuals as
well as communities heal from terrorist attacks, disasters, and wars that have
become all too common throughout the world.
The time I spent at the Royal College meeting brought to the forefront of
my attention the many issues that both of our organizations face. Although the
American and British health care systems are different, we can learn from each
other as we work to achieve and implement reforms in similar areas. Both the
Royal College and APA are stepping up efforts to increase the number of
medical students who enter psychiatry. The Royal College is also considering
ways to increase the total number of medical students, in addition to the
increase that will result from the creation of new schools that the U.K. plans
to open by 2011.
Medical school education in Great Britain is now a five-year curriculum,
and students begin at age 17 or 18. In graduate medical education, the British
are making comprehensive revisions to the psychiatry training requirements
that are scheduled to go into effect in the near future. Prior to formal
training, each psychiatry resident will be required to spend 24 months in six
medical areas, which will expand the training length to six years. The British
are developing a set of core competencies similar to ours, although the
educational systems are quite different. On both sides of the Atlantic,
psychiatrists typically complete their training at age 29 or 30.
With regard to continuing medical education, the model that has been
developed in the United Kingdom is similar to our model of “lifelong
learning,” but there it is called “continuing professional
development.” The management of the National Health Service is changing
quickly, with more emphasis on the private sector and payment on the basis of
outcomes, similar to the “pay for performance” plans now being
developed in this country. With so many changes afoot, the British are
developing a plan to assess the competency of every physician at five-year
intervals. This plan is expected to be far more stringent than the
recertification process in this country.
I am grateful to Prof. Hollins and Dr. John Baird, chair of the meeting's
Organizing Committee, for their wonderful hospitality in Glasgow. We have a
lot to learn from and share with our colleagues in Great Britain. With that in
mind, I have appointed a Board of Trustees work group to help us foster a
closer relationship with the Royal College throughout the next year, and for
years to come. ▪