Higher specialist training in psychiatry requires the development of a broad range of knowledge and skills in a short space of time. However, a brief national survey of programme directors confirms reports from peers that structured, targeted teaching tends not to continue beyond completion of College Membership examinations. Exceptions to this rule are child and adolescent psychiatry and to a lesser extent psychotherapy, which reflects requirements laid out in the Higher Specialist Training Handbook (Royal College of Psychiatrists, 1998). Specialist registrars must therefore, using limited study time and funding, attempt to acquire knowledge from local and national courses. These, however, are usually aimed at more generic groups: for example, all health service specialist registrars or at consultants for fulfilment of continuing professional development.

Following the National Service Framework (Department of Health, 2004) recommendation of extending the age range of child and adolescent mental health services to 18 years there is an increasing expectation that these generic services will provide the comprehensive care for severe mental health problems in areas where specialist teams do not exist. Services have responded to this with a variety of teams from generic adolescent teams to smaller first-onset psychosis or assertive outreach teams.

The proposal that management training should be integral to the training of all doctors, including psychiatrists, is not new (Gadd, 1990). The Child and Adolescent Psychiatry Specialist Advisory Sub-Committee (CAPSAC) training guidelines (1999) recognise that future consultants will need sufficient management skills to be leaders in service development as well as effective clinicians, and outline the knowledge and experience to be gained during higher professional training (Box 1). This paper describes the Yorkshire scheme's approach to supporting trainees to achieve these objectives and highlights the need to engage trainees, trainers and managers in taking forward this important agenda.