Concerns have been raised regarding the UK psychiatry curriculum (2022) relating to variability in workplace-based assessment (WBPA) and to the assessment of the autonomy, formulation skills and non-clinical competencies of resident doctors in training. The Royal College of Psychiatrists established a Formative Assessment Working Group with four Task and Finish Groups comprising resident doctors in training, trainers, educational leaders, patients and carers. Stakeholder consultation, educational literature, psychometric evidence, cross-specialty benchmarking and iterative consensus-building informed the resulting recommendations.

A five-point entrustability scale was introduced in end-of-placement reports to support judgements of the autonomy of resident doctors in training. A simplified WBPA rubric replaced the previous Likert scale. Formulation was embedded explicitly within case presentations, and structured patient and carer feedback was incorporated into portfolios. Direct observation of non-clinical skills was expanded to assess leadership, public mental health and system-level competencies aligned with curriculum’s High Level Outcomes.

The reforms enhance consistency of supervision, strengthen clinical reasoning and reflective practice, and improve alignment between assessment, curriculum outcomes and consultant-level responsibilities without increasing overall assessment load.

To characterise recent trends in retractions of publications in the psychiatric literature. We examined the Retraction Watch Database for publications with the subject term ‘psychiatry’ between 2003 and 2023. We then characterised publication type, subject, country of origin, reason for retraction and time between publication and retraction.

A total of 315 psychiatry publications were retracted; the annual number and rate (relative to publications) rose steadily across the study period. The median number of days from publication to retraction was 643 (interquartile range 223.0–2966.0). Reasons for retraction were unclear in 20 (6.3%) cases only; most commonly they were attributed to data error (42.5%) or problems relating to peer review (11.4%) – the period between publication and retraction was particularly long for the latter studies (median 3082 days, interquartile range 575–3364). A total of 4.4% were retracted because of falsification, and 6.32% because of plagiarism. Retracted items frequently focused on mood disorders (24.4%), psychosis (14.9%) and neurodevelopmental disorders (13.7%).

Clinicians and policy makers rely on academic literature, but should be aware of the ethical, legal, business and professional dilemmas often encountered, yet not reported, in the process of considering retractions of unreliable data. Contested and unreliable findings may persist in the scientific record, with potential negative consequences for evidence based-care and policy, including the erosion of public trust.

Psychiatry is a rewarding career, but many medical students have limited exposure to the specialty. Extracurricular enrichment programmes aim to provide early exposure to psychiatry, promote positive attitudes and encourage early career interest.

To systematically review literature on extracurricular psychiatry enrichment programmes for undergraduate medical students.

The review was registered with PROSPERO (CRD420251025990) and followed PRISMA guidelines. Four databases were searched using pre-determined search strings. Records were screened and data extracted independently by two authors. Quality was appraised using the Mixed Methods Appraisal Tool. A narrative synthesis summarised and consolidated findings.

Of 731 articles screened, 65 full reports were assessed for eligibility and 27 were included. These studies were conducted across 10 countries, most commonly the USA and UK. Programme duration and format varied from single-day events (n = 2) to longitudinal mentoring schemes spanning medical school (n = 5). Summer schools were most common (n = 10). Other schemes included mentoring, elective courses, special study modules, student-led clinics and film/media-based activities. Student feedback was positive, particularly for mentoring and film/media initiatives. Most studies reported improved attitudes towards psychiatry and mental illness, with several reporting statistically significant improvements using validated tools. Of 18 studies assessing career intentions, 16 reported increased interest in a career in psychiatry, and six studies reported higher subsequent match rates into psychiatry specialty training.

The available literature on voluntary extracurricular enrichment programmes suggests that they may provide positive student experiences and are associated with improved attitudes and early interest in psychiatry through meaningful learning opportunities. However, the evidence base is limited as most studies were small, self-selected samples with short-term follow-up and predominantly self-reported outcomes.

Attention-deficit hyperactivity disorder (ADHD) is associated with high risks of adverse academic outcomes. A major motivation for initiating pharmacological treatment of ADHD is to mitigate these risks; however, the evidence regarding its long-term effects is inconclusive.

Our objective was to investigate the long-term causal effects of pharmacological treatment of ADHD on school grades in Norwegian children and adolescents.

We analysed individual-level registry data of all Norwegians aged 5–15 years in 2009–2011 who were diagnosed with ADHD during this period (n = 6255). Treatment was measured as cumulative ADHD medication prescriptions from time of diagnosis to graduation from mandatory schooling (tenth grade). Outcomes included final grades in nine main school subjects, grade point average and non-assessment (exemption, no basis for assessment). We estimated ordinary least squares (OLS) and instrumental variable models. By exploiting naturally occurring variation in treatment practices, instrumental variable analysis can address residual confounding and estimate causal effects for patients ‘on the margin of treatment’, i.e. those prone to varying treatment practices.

OLS analysis indicated that pharmacological treatment for ADHD was associated with slightly improved grade point average (0.05, 95% CI 0.02–0.09; grade point average s.d. 0.94). Instrumental variable analysis indicated no causal effect of pharmacological treatment on grade point average (−0.01, Anderson−Rubin 95% CI −1.13 to 0.15), individual school subjects or non-assessment.

For children and adolescents on the margin of pharmacological treatment for ADHD, we found no causal effect of pharmacological treatment on any of our measures of academic performance. Although further research is needed, this finding should be considered in the context of clinical decision-making and treatment planning.

Burnout arises from prolonged, unresolved work-related stress and adversely affects professional performance and overall well-being. Resident doctors and medical students are particularly vulnerable because of the demands of balancing clinical, academic and related responsibilities.

This study aimed to assess self-reported burnout and related stressors among UK resident doctors and medical students, and estimate the economic impact of burnout-related absenteeism among resident doctors.

Self-report questionnaires assessing burnout and related stressors were distributed to UK resident doctors and medical students. A total of 2793 responses were received: 1439 (51.5%) from resident doctors and 1354 (48.5%) from medical students. Economic losses from absenteeism were calculated with a human capital approach.

Burnout was reported by 70% (n = 1008) of resident doctors and 65.7% (n = 889) of medical students. Notably, 56.8% (n = 573) and 79.3% (n = 705) of resident doctors and medical students affected by burnout, respectively, were unaware of available support services. Relocation stress (85.1% of residents and 62.6% of students), financial stress (53.9% of residents and 57.8% of students) and poor work–life balance (32.1% of residents and 20.7% of students) were commonly reported. The annual economic burden of absenteeism related to burnout among resident doctors was estimated to reach £251.5 million.

Burnout among UK resident doctors and medical students may reflect a combination of underlying factors, including financial strain, relocation stress and difficulties with work–life balance. These findings underscore the need for targeted interventions that support well-being and address financial and relocation challenges, which may, in turn, help prevent burnout and improve retention within the medical workforce. Reducing burnout and associated stressors may also help lessen its economic impact, allowing resources to be redirected towards patient care.

Explanatory frameworks for mental disorders influence stigmatisation and clinical attitudes. Mechanistic biological explanations often yield negative effects on prognostic optimism and empathy. Evolutionary framings might reduce stigma, but this has rarely been tested empirically.

To experimentally test whether a brief educational intervention presenting an evolutionary explanation of anxiety, compared with a genetic explanation, would influence clinicians’ attitudes in directions consistent with anti-stigma goals.

In this pre-registered, multi-site, cluster-randomised trial, 171 practising mental health clinicians across the UK and Ireland were randomised by session to receive a 30 min educational presentation on either evolutionary or genetic explanations for anxiety. Pre- and post-session questionnaires assessed clinicians’ optimism regarding patient recovery, perceived efficacy of psychosocial interventions, expected patient willingness to share diagnosis and seek help and perceived usefulness of the information. Data were analysed using Bayesian cumulative ordinal regression models.

In line with pre-registered hypotheses, clinicians rated evolutionary explanations as substantially more useful for patients (odds ratio 5.05, 95% credible interval [2.46, 10.28], latent standard deviation shift 1.07) and for clinicians (odds ratio 3.10, 95% credible interval [1.62, 5.81], latent standard deviation shift 0.76) compared with genetic explanations. Evolutionary explanations also resulted in higher anticipated public willingness to seek psychiatric help (odds ratio 1.79, 95% credible interval [0.93, 3.35]) and share a diagnosis (odds ratio 1.62, 95% credible interval [0.88, 2.97]); optimism about patient recovery (odds ratio 1.58, 95% credible interval [0.71, 3.46]); perceived effectiveness of psychosocial interventions (odds ratio 1.62, 95% credible interval [0.84, 3.10]); and belief in the functional usefulness of negative emotions (β = 0.25 s.d., 95% credible interval [0.01, 0.49]). These effects were driven by both positive pre–post effects of evolutionary education and negative pre–post effects of genetic education compared with pre-education baseline. Exploratory analysis showed further anti-stigma effects.

Framing anxiety through an evolutionary lens substantially improved clinicians’ attitudes on various measures of stigmatisation compared with genetic explanations, and was rated as highly useful for both clinicians and patients.