This study provides further evidence of the association between primiparity and puerperal psychosis and suggests that complications during delivery may be associated with a severe post-partum episode.

Recent developments in postgraduate medical education for the training of junior doctors in the UK necessitate changes in all parts of the curriculum, including the assessment system. There is a move away from the limited, traditional one-off assessment towards multidimensional, broader assessments of a doctor's longer-term performance. This is accompanied by the rapid development of assessment tools, collectively termed workplace-based assessments, and is in keeping with an outcome-based approach to medical education and its increasing professionalisation. In addition to clinical skills, other aspects of being a good practitioner are being assessed, including team-working, working with colleagues and patients, probity and communication skills. Using a combination of tools gives the assessment process high validity. Of the many challenges posed by these changes is the need for data on their reliability in psychiatry. There must be a clear process for applying assessments, national standardisation and training for those using asessment tools.

Recent developments in medical education and in UK government policy for the training and service commitment of junior doctors have highlighted the need to examine clinical teaching. There is growing evidence of the effectiveness of more structured approaches to patient-based teaching. The scope of what can be taught includes the three domains of knowledge, skill and attitudes. There are proven models to deliver teaching not only of patient assessment and management but also of all aspects of the doctor-patient relationship. The application of patient-based teaching is entirely consonant with the rigours of the outcome-based approach to curriculum planning and delivery. The successful, thoughtful adoption of patient-based teaching is part of the 'professionalisation' of education in psychiatry that in turn begs questions about the learning, accreditation and reward of those involved as teachers at all levels.

Research involving general patients suggests that most patients agree to be involved in medical education but prefer not to discuss personal or stress related issues with/in front of medical students. We explore the opinions and experiences of mentally ill in-patients of their involvement in undergraduate medical education in psychiatry. The study shows that patients attach importance to students seeing real patients and that the patients are happy to be seen by medical students. Most patients benefit from seeing a student and few suffer detriment. They experience anxiety prior to the student-patient interview which dissipates during the interview. Mentally ill patients agree to see medical students for similar reasons to other patients. It is important to obtain full consent from patients who see medical students.