‘In fact I do not believe I have ever done so, not even when a patient came to see me in H … Street with his solicitor. He wanted to sue me for wrongful certification, but when I asked him if he was still Jesus Christ and he assured me that he was, his solicitor quietly took him away.’

In this paper I have outlined a model for the role of a Consultant Psychiatrist who is appointed for the purpose of providing ‘staff support’ in a Residential Caring Establishment. Some of the issues that arise are stated and discussed. The use of the model I propose leads to some recurrent, identifiable psychosocial phenomena which warrant further study and discussion.

Some years ago, I wrote an article about psychiatric residency training in the United States. As my own experiences on making enquiries in England had been that very few people knew what went on or was available in the US. I felt that it might help those who were contemplating taking some or all of their postgraduate training there. Also, that it might be helpful to those wanting to make some comparisons between the training they were receiving in England and that available in the US.

I believe it was Charles Kaleb Colton who wrote that: ‘Examinations are formidable even to the best prepared, for the greatest fool may ask more than the wisest man can answer.’ Few statements are both so true and so comforting to the examination candidate, and so usefully cautionary for the examiner.