AN acute shortage of psychiatrists is looming after a struggle to fill training jobs left dozens of posts empty for a second year in a row.
In one of the worst recruitment rounds in recent history, just six out of 34 jobs for senior doctors specialising in general adult psychiatry were filled.
And for the second year running many higher-level training jobs for child, adolescent and old-age psychiatry were also left vacant.
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By mid-June just one doctor was recruited for nine training slots caring for people with learning disabilities.
Dr Alastair Cook, chairman of the Royal College of Psychiatrists in Scotland, said the situation was particularly critical outside the central belt.
He added: "Last year was bad, and this year is bad again. We are building up to a problem which is going to hit us in two or three years' time.
"The only way that services will be able to respond will be having much more of a team approach.
"More people will see nurses and other professionals with the doctors having to be spared for only the most complex and difficult cases."
Fears of a recruitment crisis in accident and emergency medicine were highlighted last week after just six out of 21 posts for on-the-job training in emergency medicine had been taken at the end of the annual recruitment round.
The problem has arisen because of a lack of middle-grade doctors - working medics who have started to specialise and need to complete the last years in their chosen field before becoming consultants.
In psychiatry they help run outpatient clinics and can often be the first point of contact on call at night.
In the most recent national recruitment round, for jobs starting in August, just five out of 13 higher speciality training places in child and adolescent psychiatry were filled, and six out of 34 posts in general adult psychiatry.
Dr Cook added that many young doctors who had done their initial training in Scotland left the country for other parts of the UK and further afield when they wanted to specialise. He believes psychiatry still tends to be perceived as a less attractive area than others in which to spend a career.
He said steps needed to be taken at medical schools to address this belief and more flexibility should be introduced into doctors' training schemes.
"We don't have enough training in psychiatry or mental health within our medical schools," he said. "Medical placements are still very much dominated by medicine and surgery, rather than the other specialities.
"We used to have a lot of people who had done GP training coming into psychiatry but that has not happened for a while as we now have a much more rigid training structure."
Neil Findlay MSP, Scottish Labour's health spokesman, said: "These figures are very concerning and raise serious questions about the availability of specialist treatment for patients.
"If these figures are maintained then they will undoubtedly significantly increase waiting times in the future."
Billy Watson, chief executive of the Scottish Association for Mental Health, said: "It is concerning to learn a number of positions have not yet been filled and we would hope more doctors consider this area of medicine as a career option in the future."
A spokesman for the Scottish Government said there had been an increase of more than 2,000 doctors working full time in the NHS since 2007.
He added: "While there are some issues recruiting in a limited number of specialities, this issue is not unique to Scotland, and we are working closely with NHS boards to support their staff recruitment efforts. Recruitment to training-grade posts is done as part of a regional or national exercise with candidates sought from both Scotland, the UK and abroad."