Currently all psychiatric trainees have to participate in ECT as part of their training and cannot qualify as psychiatrist if they refuse.

In the meeting in March 2011 we decided to ask the Royal College of Psychiatrist to consider dropping the obligation for trainees to conduct ECT and sent the following letter to Dinesh Bughra, the president at the time.

Letter to President Royal College Psychiatry. March 2011

Dear Dr Bughra,

re: Experience of ECT for trainees

Members of the critical psychiatry network have recently been discussing the subject of ECT, and we would like to request that the College considers dropping the obligation for trainees to conduct ECT during their training.

The evidence that ECT is effective is weak. A recent review found that there was no benefit beyond the treatment period, but there was a risk of significant morbidity including memory impairment and increase risk of death (Read & Bentall, 2010). It is also disliked by a group of service users, and the new Mental Health Act and NICE guidelines discourage its use in all but emergency situations. The use of ECT has been decreasing for some time now, which may reflect these considerations and it appears to be becoming a specialist treatment.

For these reasons, there are some psychiatrists who have strong objections to ECT, and we feel that these should be respected. We have also encountered trainees who have objected to participating in this training because they feel the risks outweigh the benefits. We agree; we believe that trainees should still observe ECT, but that they should be able to opt out of actually administering it, if they feel strongly about it. We believe this would be consistent with growing reservations over ECT, as reflected in the NICE guidelines and Mental Health Act, and its gradual replacement by other approaches.

We look forward to your response.

Yours,

Joanna Moncrieff

Rhodri Huws

Read J. & Bentall R. 2010 The effectiveness of electroconvulsive therapy: A literature review.

Epidemiologica e Psichiatria Sociale


19

, 333-347

The

Response from the College

was that there were no plans to change.