This note is written for two reasons: the first is to thank Drs Ndetei, Karim and Mubbashar for their fine article (Ndetei et al, 2004) and for reminding the readers of International Psychiatry of the problems arising from the ‘brain drain’; and the second is to comment on the astonishing argument presented in the paper written in reply by Catherine Jenkins, of the UK Department of Health (Jenkins, 2004).

Human resources for mental health are a challenge in all countries. In countries rich and poor, there is a big gap between the need for mental health services and the availability of those services. In an unusual way, the barriers to mental healthcare appear to be universal, which is not true of non-psychiatric healthcare. Nonetheless, the World Health Report 2001 and the World Health Organization's Atlas project have recorded extremely low levels of service in most developing countries (World Health Organization, 2001a,b). The recruitment of consultant psychiatrists from low- and middle-income countries, discussed in the October 2004 issue of International Psychiatry (Ndetei et al, 2004; Jenkins, 2004), raises a number of challenges for both developing and developed countries.

The International Fellowship Programme (IFP) was launched in 2003 under the name of the International Fellowship Scheme, its title being changed in 2004 because it was causing confusion to US doctors, who interpreted the word ‘scheme’ as having Machiavellian implications.

The Korean peninsula is located between China and Japan. After the Second World War, the Republic of Korea was established in the southern half of the Korean peninsula. South Korea has a total area of 98 480 km2 and a population of 48 598 175 (July 2004 estimate). The per capita gross domestic product (GDP), in terms of purchasing power parity, is US$17 700 (2003 estimate) (Central Intelligence Agency, 2004). The illiteracy rate (among those aged over 15 years) is 1.9% (0.7% for males and 3% for females) (2003 estimate). Life expectancy at birth is 75.6 years (72.0 years for males and 79.5 years for females) and the infant mortality rate is 7.2 per 1000 births (2004 estimate). The unemployment rate is 3.4% (2003 estimate). The proportion of the population aged 65 and over is currently 8.7% (2004 estimate) (Korea National Statistics Office, 2003). Over 40% of the total Korean population (i.e. some 20 million) lives in Seoul and its vicinity. South Korea is highly urbanised and modernised. Besides central government, local government is based on seven metropolitan cities and nine provinces.

Romania is now in a period of transition from communism to democracy. Geographically, Romania, like other Eastern European countries, is on the border between the Western world and the Middle East and Asia; until December 1989 it was behind the ‘Iron Curtain’.

Uganda is a landlocked developing country in East Africa with an estimated population of 24.8 million people (2002 census). At independence (in 1962) Uganda was a very prosperous and stable country, with enviable medical services in the region. This, however, was destroyed by a tyrant military regime and the subsequent civil wars up to 1986, when the current government took over the reigns of power.

Culture is a socially shared, trans-generationally transmitted system of implicit values, beliefs and attitudes and explicit behavioural practices (Kroeber & Kluckhohn, 1952). It includes religion. Culturally based assumptions infiltrate the patient–doctor relationship.

The European Federation of Psychiatric Trainees (EFPT) is an independent federation of national trainee associations; it represents over 12 000 trainees in 19 member countries across Europe. It is run by an annually elected board, comprising the President, Secretary-General, Treasurer, President elect and past President, and is governed by a written constitution.