Abstract
In most parts of the country today it is often difficult or impossible to fill consultant vacancies in mental handicap. According to the DHSS there were 146 consultants in mental handicap in post in 1978 compared with 102 in 1968, an overall growth of 43 per cent, compared with 34.7 per cent in general psychiatry. Nevertheless nearly one quarter of posts were vacant on 30 September 1978. The number of new consultants in mental handicap required to replace losses from death and retirement is about 6 to 10 per year. If an expansion of 10 is to be achieved some 16 to 20 fully trained senior registrars will be required each year. For this 60 senior registrar posts will be needed, assuming that senior registrars have three to four years training. At the end of September 1978 there were 34 established senior registrar posts of which 9 were vacant.
Highlights
In most parts of the country today it is often difficult or impossible to fill consultant vacancies in mental handicap
At present there is the attrac tion of plenty of vacant posts and good promotion prospects compared with some other specialties where a doctor's duties are predetermined and inflexible,work in mental handicap is to a considerable degree what the consultant makes it
The consultant in mental handicap will see fewer patients than his colleagues in general psychiatry, and many of them will have long-term problems which he will be helping over many years, especially as the pattern of service moves away from crisis intervention model
Summary
In most parts of the country today it is often difficult or impossible to fill consultant vacancies in mental handicap. If an expansion of 10 is to be achieved some 16 to 20 fully trained senior registrars will be required each year. About 30-35 per cent of mental handicap hospital residents, and many of the cases referred to psychiatrists in the community, require specialist services. These are needed for such problems as physical handicap, epilepsy, visual and auditory defects, severe behaviour and conduct disorders, communication difficulties and lastly mental illness, which affects 6-14 per cent of the mentally handicapped in hospital, in addition to those who show severe psychoneurotic dis orders. There are the problems of the elderly mentally handicapped, the profoundly mentally and physically handi capped and those with neurological abnormalities, and the wider questions of epidemiology, aetiology and prevention
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