Neuropsychiatric disorders account for 5 of the 10 most disabling medical disorders worldwide,1 and for a particularly large component of the burden of disease in South Africa.2 Unfortunately, as elsewhere, training and services in psychiatry have lagged behind those of other major disciplines, and much additional work is needed to achieve parity. We focus in particular on the status of psychiatric sub-specialties in South Africa, considering the pros and cons of their recognition in a developing country