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In North America, the psychiatric workforce while relatively large, remains insufficient for the population needs. Specialist training opportunities in psychiatry continues to grow, reflected in both increased recruitment and competitiveness. Furthermore, the iterative process of curriculum development and standardisation of training encourages greater educational consistency. There is an ongoing growth in subspecialty training opportunities, however access varies across centres and curriculum gaps remain. The diverse demographic characteristics and requirements of populations also play a role in educational needs, such as youth mental health, tele-psychiatry, cultural, rural and addictions psychiatry. Advances in science such as genetics, and the use of technologies and digital media also invite innovative approaches to knowledge acquisition. Overall, training needs to be matched by sufficient numbers of experienced and skilful trainers, mentorship and leadership in psychiatry with awareness of physician wellbeing and the risks of burnout. In the USA and Canada, the growing prospect of fellowships in leadership and administration lay important foundations for the growth of psychiatry, driven by high quality education for the mental health professionals and leaders of tomorrow. [ABSTRACT FROM AUTHOR]

Measurement of BCR activator of RhoGEF and GTPase -ABL proto-oncogene 1, non-receptor tyrosine kinase (BCR-ABL1) mRNA levels by reverse transcription quantitative polymerase chain reaction (RTqPCR) has been critical to treatment protocols and clinical trials in chronic myeloid leukaemia; however, interlaboratory variation remains a significant issue. Reverse transcriptase droplet digital PCR (RTddPCR) has shown potential to improve testing but a large-scale interlaboratory study is required to definitively establish this. In the present study, 10 BCR-ABL1-positive samples with levels ranging from molecular response (MR) 1·0 -MR 5·0 were tested by 23 laboratories using RTddPCR with the QXDX BCR-ABL %IS kit. A subset of participants tested the samples using RTqPCR. All 23 participants using RTddPCR detected BCR-ABL1 in all samples to MR 4·0 . Detection rates for deep-response samples were 95·7% at MR 4·5 , 78·3% at MR 4·7 and 87·0% at MR 5·0 . Interlaboratory coefficient of variation was indirectly proportional to BCR-ABL1 level ranging from 29·3% to 69·0%. Linearity ranged from 0·9330 to 1·000 (average 0·9936). When results were compared for the 11 participants who performed both RTddPCR and RTqPCR, RTddPCR showed a similar limit of detection to RTqPCR with reduced interlaboratory variation and better assay linearity. The ability to detect deep responses with RTddPCR, matched with an improved linearity and reduced interlaboratory variation will allow improved patient management, and is of particular importance for future clinical trials focussed on achieving and maintaining treatment-free remission., (© 2021 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)