The Elective Year: It's Far Too Short!

The first few weeks are spent with your supervisor discussing a suitable project. The College recommends that your elective year be planned in advance, but most of this time is spent preparing for examinations. I had a general idea of what I wanted to do but until I got the green light from the Committee for Examinations, I did not overly concern myself with details. I was keen to do an elective combining research and forensic psychiatry; however, there was no academic forensic springboard to propel me forwards. After much debate, the investigation of homicide offenders in Western Australia was decided upon. Then followed an intensive literature review to clarify what aspect to research. After much reading, I decided on the subject of the ‘phenomenology of homicide’. My supervisor agreed and now after much delay I could submit my ethics application.

After many drafts and re-drafts and time my application was accepted and my research could begin. Homicide is a rare event and to get sufficient numbers, a retrospective approach was used. I had read papers telling me of the feasibility of extracting information from case notes [1] and also of some of the pitfalls [2]. After some delay I was now ready for some ‘hands on’ study.

Having identified the homicide offenders from the admissions book, I requested the case notes. The delay in the notes arriving on my desk did not slow me up (fortunately analysing the notes took time) and so when I had finished one set, a new one arrived. As I started collating information a new dilemma arrived. What do you do with all this information? Unfortunately, having no background in computing, I had to undergo crash courses in Access and Excel, both of which entailed a steep learning curve. However, I was able to collate and analyse the data with greater ease.

Extracting demographic details about the offenders was straightforward and usually very well documented. Information on the victims was usually available from the police statement of material facts (if available). Details of the mental state at the time of the offence was harder to extract. I had based my dissertation topic on my forensic psychiatry training and having co-written many court reports with my supervisor I was confident that there would be more than sufficient information to examine. Homicide is a serious offence and I assumed that the case notes would reflect this by having extensive formulations.

When a court report was available (in 17 out of 45 case notes), information about phenomena was well recorded. Court reports were not available for a number of reasons including pre-trial cases, not getting a pre-trial psychiatric assessment, court reports not being filed in the case notes and patient transfers from other areas.

Having ploughed through all the data, which was an extremely laborious and emotionally draining experience (some of the descriptions of the offences were extremely harrowing), I set about analysing the data. It soon became obvious that I was going to have insufficient information to produce statistically significant data. Following discussion with my supervisor, we felt that there was sufficient information gleaned to form the basis of a good discussion. My experience also allowed us to better plan our future research in the unit.

Examining the history of individuals should not be belittled, individual characteristics and patterns may be predictive of future behaviour feelings or attitudes [3]. Examining large groups of subjects may not always be applicable to the individual since psychological causation is always personal and never actuarial [4]. Examining smaller groups in detail may uncover serendipities, which maybe overlooked in larger studies. They may, also, indicate routes for further research.

My research could have had greater power by using different methodologies, such as, enlarging the group by using all violent offenders and not restricting myself to homicide offenders, or comparing the group with matched non-violent offenders. However, my elective year was coming to an end. To re-submit further ethics applications, construct a control group or extend the group examined would also extend my elective year. Through my ‘retrospectoscope’ it was easy to suggest how I should have commenced my research but we had felt that the chosen subject and the approach to this would suffice.

I now come to the stage of writing up the dissertation. The College guidelines suggest between 10 and 20 thousand words (the word count tool is essential for this task). This is a time-consuming task when you can only use one finger to type and an expensive and complicated task if you give it to a professional (I can't see anyone being able to dictate a dissertation straight off and handwriting it would take just as long).

Next comes the numerous re-drafts and suggestions from one's peers of which methodology I should have used. Then comes the $600, the College grade and further suggestions on how my year could have been more fruitfully used.

Should the elective year be longer? No, but ground-breaking research is unlikely to come out of this year. For research to flourish, I would suggest that it could occur earlier in training in order that projects can develop over time. To make this an attractive alternative to trainees I suggest this ‘early research’ would replace some of the case histories for those who choose this path.