There have been many changes in postgraduate education in psychiatry over the past 15 years. The Royal College of Psychiatrists was ahead of most other Medical Royal Colleges in organising supervised training schemes which took into account the educational needs of the trainee as well as providing an appropriate service to patients. The approval exercise, with inspection of both basic specialist and higher specialist training schemes, was introduced more than 20 years ago. Prior to the introduction of ‘Achieving a Balance’ – Plan for Action (Department of Health, 1987), the senior house officer (SHO) and registrar grades in psychiatry were more or less interchangeable, although those in registrar posts tended to rotate outwith their base hospital and gain experience in the sub-specialities.