Where I work, ECT is done quite often especially to those patients who have complicated medical histories who may not be good candidates for the usual antidepressants or who have had no sucess with antidepressants.
The patient is NPO after midnight and for the first few treatments, stays on the inpatient ward. Our ECT procedure is done under general anesthesia and only takes a few minutes to complete. Once they get down to PACU where the procedure is done, the IV is inserted, caffeine given through IV and the patient is fitted with the rubber strap with electrodes around the head and gel to conduct the shock. A BP cuff is inflated on one upper arm to 200 and clamped to prevent meds from getting through to the hand where the seizure is observed as a clenching fist. They are given meds (we usually use brevitol and succ) to paralyze and sedate. Once the shock is applied and the seizure is measured by sight and by EEG, ( trying not to forget to deflate the BP cuff) the patient quickly regains consciousness and returns to the unit for a few hours of recoop time then normal activity can resume. Generally, patients need 12-16 treatments (three a week) and some respond very quickly, others take the whole 16 treatments to respond. Once they have had a full course of ECT, we often see them once a month for maintenace ECT. I have seen it work very well. I know people think it is barbaric but for those who don't respond to any other treatment, it is a welcome last resort.
We always have quite a crowd during our ECT. There is the psych attending, psych resident, med students, anesthesia attending, anesthesia resident, psych nurse as well the whole PACU staff if we should ever need them (so far that has not happened). The worst incident that ever happened is that a patient received a small burn on her scalp from an arcing ECT machine. All in all, pretty boring. Lots of fuss for a clenching fist. First time observers always ask, "Is that it?"
As for where to get training, any teaching hospital around should have plenty of opportunity to do ECT. Any teaching hospital with a psych residency program and an inpatient psych ward. Where I work, there are a couple attendings who supervise it and a few resident who take a liking to it and always volunteer to take ECT cases.