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Junior psychiatrists’ electrocardiogram interpretation skills

^*Gordon Hospital, Central and North West London Foundation Trust, Bloomburg Street, London SW1V 2RH, email: noelcollins{at}nhs.net

Uttara Mandal, Staff Grade in Older Adult Psychiatry

St Ann’s Hospital, Barnet Enfield and Haringey Mental Health Trust

Gabrielle Pendlebury, Specialist Registrar in Child And Adolescent Psychiatry

South London and Maudsley Foundation Trust

Jenny Drife, Specialist Registrar in General Adult Psychiatry

South London and Maudsley Foundation Trust

Declaration of interest

None.

AIMS AND METHOD

We checked whether psychiatric junior doctors could identify common electrocardiogram (ECG) abnormalities. Participants were directly approached at three London sites during induction or teaching programmes.

RESULTS

The survey had a total response rate of 65% (36/55). Psychiatry junior doctors displayed an overall success rate of 97% in detecting whether an ECG is grossly abnormal, but were much less competent in specifying exact ECG diagnoses (success rate of 41%). Accuracy rates for some diagnoses (e.g. paced rhythm) fell to as low as 11%. General practitioners performed no better than psychiatry trainees.

CLINICAL IMPLICATIONS

There is little consensus about minimum acceptable standards in medical skills such as ECG reporting in junior doctors. These competencies are generally ignored in new curriculums. Questions regarding the appropriate remit of psychiatry doctors in this area are raised and the need for more monitoring and education of these skills is queried.

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