Abstract
This article discusses the history of clinical attachments in psychiatry and recent changes in this area, including work permit regulations, which can make it increasingly difficult to obtain an attachment. The advantages and disadvantages of clinical attachments are considered for both the clinical attache and the UK health service. Good practice points for clinical attaches and their supervisors are presented. The future of the scheme is discussed and potential solutions to difficulties are suggested.
Highlights
What is a clinical attache¤ (sometimes known as honorary senior house officer (SHO), clinical fellow, or honorary fellow)? One commonly held view is that clinical attache¤ s are overseas doctors who gain unpaid work experience in the high-quality National Health Service, in the hope of gaining paid employment and training and skills to eventually bring back to their country of origin
Changes in registration procedures and to the Professional and Linguistics Assessments Board (PLAB) examination by the General Medical Council (GMC), and profits made by the GMC and some trusts may be factors in encouraging applications
Anecdotal evidence suggests that many aspiring clinical attache¤ s are unaware of the true picture in terms of how difficult it is to be successful; ‘failed’ doctors are reluctant to give the true reasons for their return home, and doctors may be blinded to the reality by their own hopes (Alcock, 2004)
Summary
This article discusses the history of clinical attachments in psychiatry and recent changes in this area, including work permit regulations, which can make it increasingly difficult to obtain an attachment. The exact number of doctors seeking clinical attachments is unknown, but many hospitals and consultants receive hundreds of applications annually This high figure is because of the potential rewards if successful, and perceptions abroad that the NHS is short of junior doctors (advertisements in foreign newspapers for doctors in the UK may encourage this view). They are opportunities to enhance curriculum vitae, thereby improving the attache¤ s’ prospects of getting paid employment (Berlin et al, 2002). The consultant refused to give me a reference, stating that he did not observe any clinical skills!
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