EDITORIALSThe Royal College of Psychiatrists and the speciality of psychiatry has a long history of support for part-time or flexible training. The motivating factors for this support were a recogni tion of the demand for flexible training among the trainees themselves, a large proportion of whom were women, and an acknowledgement that psychiatry was a shortage speciality and needed to recruit and retain the best possible doctors. The College, working together with the Department of Health, was enabled to set relatively high quotas for part-time trainees and thus psychiatry be came known as a speciality in which young doctors could, if they so wished, train on a parttime basis. Those hospital specialities which have encouraged flexible training have a higher propor tion of women doctors than those which do not. In a survey in 1994 of career destinations of doctors who graduated in 1983 (Lambert et al 1996), the most common career destinations for women were general practice, followed by psychiatry. In both general practice and psychiatry the percentage of women training in these specialities exceeds that of men. Doctors who anticipated that they might wish at some stage to work on a flexible basis have known that this is a strong possibility in psychiatry, provided that they meet the required standards.

This article outlines the findings of a study which indicate that flexible training in psychiatry was considered adequate to prepare doctors for both full-time and part-time work and that those wishing to work part time had no difficulty in finding jobs after accreditation. However, there was evidence to suggest that part-time consultants experienced more problems and less job satisfaction and that part-time training and working may restrict opportunities for an academic career.

This paper compares the opportunities for flexible (part-time) specialist training in the UK and elsewhere in the EU in the overall context of the rising numbers of women doctors across Europe. Few other EU countries appear to provide the same opportunities for flexible training as the UK, despite high percentages of women medical students and women medical graduates. There are important differences in training patterns across the EU and some reasons are proposed for why flexible training may be more difficult to implement or may not be required elsewhere in the EU. Reasons include less centralized health care systems and more rigidly structured training programmes. In the context of four main factors affecting medical manpower--medical unemployment, contracted working hours, maternity provisions and duration of training--both the health authorities' need to implement flexible training and the trainee doctors' demand for it would appear to be greater in the UK than in other EU countries.

Aims and method To review the experience, examination success and career progress of trainees on the flexible scheme in psychiatry in the North and South Thames region. Trainees in psychiatry who enrolled on the flexible training scheme 1993-1997 were included in the retrospective survey of flexible training records. Results Traineeson the flexibletraining scheme had gained experience in a broad range of posts before entering psychiatry for a mean time of 14months. Fortynine per cent entered flexible training during basic specialist training and 41% during higher specialist training. Thiscohort of trainees performed better in the MRCPsych examinations than the national average. Forty-nine per cent of the trainees intended to become child and adolescent psychiatrists. Flexible trainees' progress to consultant status was slower. Implications The flexible training scheme attracts trainees of comparable quality to full-time trainees and encourages their retention in the workforce.

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