There is universal recognition of the need for developmentally appropriate supervised clinical experience in professional psychology training. University clinics were established to provide a bridging function for postgraduate clinical psychology students, assisting the integration of psychological theory and research into real-world clinical applications and professional identity development. The aim of training in university clinics is to provide opportunities for clinical practice and highquality supervision to monitor and shape clinical skills. The experiences gained in external practicum settings complement this initial training but cannot replace it. The recent introduction of Medicare rebates for psychology services has threatened the survival of university clinics because low-cost psychological treatment is now available from experienced practitioners. This paper provides data on Australian university clinics collected before the introduction of Medicare. Concerted efforts are needed to protect university clinics in order to maintain standards required for accreditation of clinical psychology training programs. The potential impact of the loss of university training clinics is discussed and strategies to ensure their survival are suggested.

Background Competency‐based training and assessment is considered the best practice internationally in postgraduate clinical psychology education. In Australia, there are still some ways to go as programmes begin to integrate competency‐based pedagogical models into clinical training and assessment. Further understanding of the strengths and challenges of these models will be useful to educators interested in developing a competency‐based approach. Methods A structured literature review was carried out using the databases PsychInfo, PubMed, and PsychArticles. Keywords were: competency, and “training” or “assessment” or “model” or “clinical” or “psychology” or “medicine” or “allied health.” Articles had to be written in the English language and published in peer‐reviewed journals. Relevant book chapters and web references from professional accreditation bodies were also assessed for inclusion. A total of 54 references were utilised in the review. Results The review supports the relevance of competency‐based learning and teaching. It draws on seminal benchmarking work from the international literature and considers the strengths and limitations of competency‐based approaches to clinical health training and assessment. The review provides support for the ongoing progression towards competency‐based training models in Australian postgraduate clinical psychology. Conclusions Competency‐based training and assessment methods offer educators sophisticated mechanisms for ensuring that clinical psychology graduates are prepared to meet the demands of professional practice and public accountability. Further efforts at integrating competency‐based training models into Australian postgraduate curriculum, and associated research into the outcomes, are necessary to ensure a pedagogical culture of best practice in this country.

If Canada is to enter the realm of public funding of private mental health services well prepared, psychology needs to draw on the experience of other countries to avoid known pitfalls and position the profession to best utilize its expertise in mental health. In Australia, the low training requirements that lead to registration of psychologists have provided a large workforce to meet the ever-expanding demand for mental health services, but have also led to the undermining, devaluing, further downgrading, and blurring of professional psychology standards and expertise. This positioning of psychology has fragmented the profession. A brief outline of key factors contributing to this diminishing of the profession and the high demand for low-cost services are outlined to demonstrate that similar parallel differentials and challenges are present for psychology in the Canadian context. To avoid similar impacts on psychology in Canada, the profession needs to unite and recognise that it is unable to meet the needs of the population for mental health services and to claim a role of expert in mental health to enable the public to make best use of the expertise of psychologists.

A 23 year old brain injured male developed a pathological gambling disorder in response to social isolation which resulted from frontal lobe disinihibitory behaviors. The case illustrates the difficulties encountered in management and treatment where an impulse control disorder is superimposed on, and compounded by, organic-based frontal lobe impulsivity.

The standards and training for practice in psychology involve multiple pathways that are not straightforward for the public or other health practitioners to understand. Most developed nations other than Australia require higher entry requirements into the profession. New national standards set by the Psychology Board of Australia, such as endorsed areas of practice, will lead to greater consistency in standards and make the task of referring to psychologists with the appropriate competencies more straightforward, allowing for greater collaboration between clinical psychology and psychiatry practitioners.