This guide is intended for new
UK trainee psychiatrists. The information should be used as a guide
only and is not a substitute for professional advice. If you need
further advice and support, please contact the Psychiatrists’
Support Service or one of the other organisations listed at the end
of this guide.
Welcome to psychiatry from the
Psychiatrists’ Support Service
Welcome to psychiatry, a specialty
we hope you will find incredibly interesting and rewarding! Working
in psychiatry can be challenging, and this leaflet includes tips on
how to keep yourself healthy and happy, and keep your career on
track.
Day-to-day life as a CT1–3
INDUCTION
You should expect to attend an
induction programme, which is likely to include mandatory courses
specific to psychiatry, such as risk assessment, use of the Mental
Health Act and training in rapid tranquillisation. It is important
to note the differences in the policies and procedures at
psychiatric hospitals compared with acute hospitals, particularly
regarding the management of acute medical incidents.
TRAINING POSTS
Posts generally last for either 4
or 6 months. During your CT1 year, you can expect to have 6–12
months in general adult psychiatry, but it is also common to work
in old age psychiatry in this period. During your CT2 and CT3 years
you will typically work in more specialist posts, such as child and
adolescent psychiatry, learning disability psychiatry, forensic
psychiatry, liaison psychiatry, addiction psychiatry and
psychotherapy, as well as gaining further general adult psychiatry
experience. The process for allocation of training posts varies
between deaneries. If you want to work in a specific post during
your training, your training programme director is usually the best
contact.
SUPERVISION
You should have weekly supervision
from your educational or clinical supervisor. During this session,
you will have an opportunity to discuss cases, as well as your
career and opportunities for audit, research and teaching. You will
also join a case-based discussion group (sometimes known as Balint
group) to analyse the psychodynamic aspects of clinical cases.
ON-CALL
Your on-calls may involve covering
in-patient psychiatric units, providing psychiatric advice to
medical wards, and conducting psychiatric assessments in the
accident and emergency (A&E) department. For A&E department
and medical ward cover, responsibilities are often divided between
core trainees, liaison departments and crisis and home treatment
teams; the local protocols should be explained at induction.
Providing out-of-hours cover to
psychiatric wards is likely to incorporate the provision of both
psychiatric and acute medical care for patients, and the medical
registrar on call at the relevant acute hospital should be
available to advise on medical issues. You may be asked to carry
out assessments under the Mental Health Act; training on this
should be provided at induction.
Psychiatric registrars and
consultants are generally very approachable. It is important to
discuss relevant issues with your seniors and these discussions are
valuable teaching opportunities which can also be used as wworkplace-based
assessments (WPBAs).
ORGANISING YOUR WORKLOAD
Good organisational skills are
essential to avoid being overwhelmed by multiple demands on your
time. You will have to prioritise, delegate and manage your tasks.
Remember to make time for teaching, research and audit, which all
form an important part of your training. Administrative staff are a
crucial component of overall psychiatric care and are often an
important source of information.
The Royal College of Psychiatrists
It is mandatory for all psychiatry
trainees to join the Royal College of Psychiatrists, as specified
in the ‘Gold Guide’ (Modernising Medical Careers, 2010). You can
register
online. The College organises frequent educational events and
conferences, including many specifically aimed at trainees. Details
are publicised on the College website.
The Psychiatric Trainees’ Committee
(PTC) comprises trainees elected from every College division, and
has representatives on most College committees. Further details are
available on the PTC
webpages; you can contact the PTC by email at ptc@rcpsych.ac.uk
PORTFOLIOS AND PERSONAL DEVELOPMENT PLAN
All trainees are required to
maintain a portfolio and a personal development plan, with input
from educational supervisors. You can set up and manage your
portfolio at the College’s
Portfolio Online website.
EXAMS
The College’s membership (MRCPsych)
examinations involve three written papers and one clinical exam.
You will attend a local mandatory MRCPsych course as part of your
training. Further exam guidance can be found in the Psychiatrists’
Support Service guide number 10, ‘On dealing with exams’, and on
the exams section of the website.
WPBAs
Workplace-based assessments include
assessments performed as part of your normal day-to-day job, and
incorporate evaluation of your clinical, communication and teaching
skills as well as case and journal club presentations.
ANNUAL REVIEW OF COMPETENCE PROGRESSION
(ARCP)
These reviews usually occur
annually around June. At least three panel members will examine
your portfolio to determine if you have attained the required
competencies and have demonstrated them in an appropriate manner.
Further information can be obtained from the ‘Gold Guide’.
Tips for looking after yourself
PROFESSIONAL
- Be aware of your personal safety
at work
- Attend promptly to occupational
health requirements
- Participate in induction courses
and mandatory training
- Join the College as a
pre-membership trainee (PMPT), which will give you access to
Portfolio Online
- Look into the ARCP process and the
training requirements
- Maintain patient confidentiality
and keep good records; ensure appropriate entries are made in
clinical records whenever you see, or have contact with, a
patient
- Obtain professional indemnity
insurance by joining a medical defence organisation (some
organisations are listed at the end of this guide)
- Book study and annual leave well
in advance to allow you to swap on-calls if necessary
- Find out about annual National
Health Service appraisal procedures in your trust.
PERSONAL
- Try to maintain a healthy
work–life balance
- Keep in touch with family and
friends
- Keep interests outside work alive
and make time for hobbies
- Exercise regularly and eat
healthily
- Register with a local general
practice
- If you become unwell, seek help
and allow yourself time to recover
- Flexible training is possible if
you meet the criteria; your deanery can offer further advice.
What to do if things are not going so
well
Psychiatry involves dealing with
complex cases and hearing about difficult and emotional issues
brought in by patients. You may experience personal difficulties
yourself and, if things are not going well, please do ask for help
from family or friends, or from your educational supervisor,
training programme director or local College tutor. You may also
consider seeking help from your deanery. Experiencing some
difficulties at work is common and it is better to openly discuss
issues with your supervisor rather than ignore or minimise
them.
PSYCHIATRISTS’ SUPPORT SERVICE
The Psychiatrists’ Support Service
is a free, confidential support and advice service for members,
trainee members and associates of the Royal College of
Psychiatrists who find themselves in difficulty over issues such
as:
- bullying and harassment
- training
- exams
- mental health
- physical health
- serious clinical incidents
- internal and external reviews and
inquiries
- difficult working
relationships
- whistle-blowing
- career pathway
- GMC/NCAS assessments
- exclusion
The Service has senior trainee and
consultant doctor advisors who can offer confidential telephone
advice and support. The dedicated telephone line is only open
during office hours, Monday to Friday 09:00–17:00. Outside of these
hours you can leave a message or call the BMA’s Doctors for Doctors
line: 08459 200169.
Further sources of help and
support
British Medical
Association
BMA House
Tavistock Square
London WC1H 9JP
Tel: 020 7387 4499
Medical and Dental Defence Union of
Scotland
Mackintosh House
120 Blythswood Street
Glasgow G2 4EA
Tel: 0845 270 2034
Medical Defence
Union
230 Blackfriars Road
London SE1 8PJ
Tel: 08444 20 20 20
Email: mdu@the-mdu.com
Medical Protection
Society
33 Cavendish Square
London W1G 0PS
Tel: 020 7399 1300
Email: info@mps.org.uk
Psychiatrists’ Support
Service
Manager, Psychiatrists’ Support Service
Royal College of Psychiatrists
17 Belgrave Square
London SW1X 8PG
Tel: 020 7245 0412
Email: pss@rcpsych.ac.uk
Reference
© Royal College of Psychiatrists 2011
Back to PSS
home page
If you require advice and support about a particular issue then please contact the
Psychiatrists' Support Service at the Royal College of Psychiatrists on 0207 245
0412 or email
Please answer the following questions and press 'submit' to send your answers OR
E-mail your responses to pss@rcpsych.ac.uk
Your responses will be anonymised and confidential and therefore, it will not be
possible to identify you from the responses that you provide.
On each line, click on the mark which most closely reflects how you feel about the
statement in the left hand column.
Your answers will help us to make this leaflet more useful - please try to rate
every item.
Please provide us with the following information:
Thank you for providing your feedback on this leaflet.