Electroconvulsive therapy training in Canada: A call for greater regulation

Objective: A national survey of senior psychiatric residents' experience of electroconvulsive therapy (ECT) training was undertaken in Canada in 1989. Since then, guidelines have been published in Canada and the US with respect to ECT training in psychiatry residency programs. This study examines whether there has been any change in the Canadian resident ECT training experience through a second national survey. Methods: Confidential questionnaires assessing the training in and the attitudes toward ECT were sent to all 133 psychiatric residents in their final year of training in Canadian medical schools. Results: We attained a response rate of 68.3%. Of respondents, 88% felt that theoretical and practical ECT training should be a mandatory component of psychiatric residency programs. No marked improvements have occurred with respect to didactic and bedside training in ECT, compared with the original 1989 study. Only 18% of respondents reported that they feel completely competent administering ECT. Despite this, 59.3% anticipate working in an inpatient setting. Conclusions: The publication of training guidelines has made little impact on training in and attitudes toward ECT in senior psychiatric residents in Canada. Despite senior residents' acknowledgement of ECT's value, few feel competent to administer ECT after completing their training.