Contents:
- Editorial
- Message from the Dean
- The future of the medical
workforce
- Out of hours experience for higher
trainees
- Trainees’ day at the College annual
meeting
- Undergraduate recruitment
campaign
- Volunteer programme
- Exam eligibility update
- Psychiatrists’ support
service
- Trainee registration
- PTC Newsletter Editorial
Team
1)
Editorial
Clare Oakley, Chair, PTC
The Psychiatric Trainees’
Committee continues to work closely with the Dean on the College’s
undergraduate recruitment campaign, which you can read more about
in this newsletter. I am delighted that we will shortly be
co-opting a second Student Associate onto the PTC. Professor Howard
also writes in this edition about his vision for his time as
Dean.
The PTC has made
considerable progress with two key issues that we highlighted in
our last newsletter: the future of the medical workforce and out of
hours working for higher trainees. Medical workforce issues were
discussed at the College’s Central Executive Committee and the PTC
has produced a position statement in opposition to a sub-consultant
grade and responded to a related NHS Employers paper. Out of hours
experience for higher trainees was discussed at the College’s
Education, Training and Standards Committee and we were able to
obtain support for our document which emphasised the essential
nature of out of hours experience and outlined what the experience
should consist of. Further details about both of these important
issues can be found below.
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2) Message from
the Dean
Professor Rob Howard
I have always been
interested in postgraduate training in psychiatry largely because I
believe that the delivery of adequate numbers of well-trained and
enthusiastic specialists is the most important single contribution
that our profession can make to the mental health world. I’d like
to think that the UK has always trained the best psychiatrists in
the world, but I worry that things have been going badly wrong in
recent years - and not just because of MTAS. I was motivated to
stand to be the Dean because of what I saw as an opportunity to
stop worrying and start doing something to put back some of the
good things that I received as part of my training but many of you
aren’t getting, and to add many of the great things that have
emerged since my generation of psychiatrists trained but which
aren’t yet made available to trainees. I wanted to use this piece
in your newsletter to tell you exactly what I want to achieve in
the next five years and to explain why I believe that your
contributions – both as an enthusiastic and powerful group in the
College and as individual trainees – can make a big difference to
the kind of training you and those who follow you will receive.
Perhaps most importantly
and, you might think, most obviously – I want us to drive up
standards of training within psychiatry. I see two components to
this: recruitment of a larger cadre of good-to-excellent medical
graduates to psychiatry and improvements in the quality of what we
deliver to trainees and to consultants engaged in CPD and
revalidation. We have to convince larger numbers of UK medical
graduates that psychiatry represents a respectable, intellectually
challenging and worthwhile career destination. At the moment, too
many undergraduates and foundation trainees see psychiatry as a
career choice for lazy and incompetent losers. Of course, we know
how wrong they are – but medical schools are not doing a great job
at selling an alternative vision of the specialty at the moment. If
we’re not careful, a negative feedback loop establishes itself
within which a lack of talented and inspirational trainees and
consultants unsurprisingly fails to convince even the most
potentially sympathetic bright young students to come and join us.
I’m delighted and impressed by the amazing work that Clare and her
colleagues on the PTC have already done to lead the College
recruitment campaign – but we all need to remember that everything
we do that is observed by medical students and all the interactions
that we have with them are potentially important in their choice of
a future career. Try and be a mentor to any that you meet who show
some interest in psychiatry – there’s nothing more rewarding than
meeting a younger colleague later in life who can say that your
interest in them was pivotal in their decision to become a
psychiatrist.
PMETB are charged with
ensuring that your specialist training equips you with the
knowledge and competencies necessary to work as a consultant, but I
think you should both expect more from your postgraduate training
in psychiatry than this and be prepared to take some
responsibility and initiative yourselves for what is included in
your training. It’s true of almost everything in life that you get
as much out as you put in and I would urge you all to think about
the extra and unusual things that you might like to do that will
make you better and more interesting psychiatrists. Have a go at a
piece of research or sign up for personal psychoanalysis if you can
afford it. Even if you don’t complete what you’ve begun, I
guarantee that you’ll be glad that you tried it.
I’ve got my own views
about the direction that psychiatry training should take and the
things that we need to do to drive up the standards of
psychiatrists practising in the UK – but I don’t believe that I
have all the answers and I am always happy to have my opinion
changed. You are the current experts on what is happening with
training and I want you to let me know as much as possible how
things are going. Not just the grumbles and the difficulties, but
also what is working well and seems useful. Please keep me
informed. Don’t worry that the Dean is an important and potentially
scary person – I’m just another psychiatrist who happens to be a
bit older and less lively than yourselves. The best way to get hold
of me is by email: robert.howard@iop.kcl.ac.uk
and I promise that I will always respond – even if I don’t agree
with you. If you don’t feel able to contact me directly, do it
through Clare and her colleagues on the PTC: ptc@rcpsych.ac.uk
I am looking forward to
working with
you.
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3) The future of the medical workforce
There is an urgent
need to consider the future of the medical workforce. NHS Employers have published documents entitled:
“Medical training and careers – the employers’ vision” and “The
Future of the Medical Workforce” which threaten the current
training structure and suggest a sub-consultant grade is a
necessity. These documents and the PTC
responses can be found by clicking here.
In summary:
- The PTC is strongly opposed to a
sub-consultant grade.
- The attainment of a CCT should
result in the creation of autonomous practitioners who are employed
in that capacity.
- There is no evidence to suggest
that a new psychiatry consultant today is less competent than in
the past.
| |
- The training time of a psychiatric
trainee has not been reduced.
- The introduction of
competency-based training and workplace-based assessments should
lead to improvements in the standard of postgraduate
training.
|
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4) Out of hours experience for higher trainees
College guidance on out of hours
experience for core trainees is given in Occasional Paper 65 which
states that trainees should undertake “a minimum of 55 nights
on call during the period of basic specialist training” and
see “at least 50 individuals with a range of diagnosed
conditions and with first line management plans conceived and
implemented”.
However, no such guidance
existed for higher trainees in the new training system. Therefore
the PTC proposed the following guidance:
“During advanced
training, trainees should undertake a minimum of 50 out-of-hours
cases supervising core trainees/ other members of the Multi-Disciplinary Team, and 30
complex assessments (which may include assessments for detention
under the relevant legislation). These cases should be
included in a College-approved log-book and cover a range of
clinical experience and competencies.”
This has now been
approved in principle by the Education, Training and Standards
Committee and has been sent to each Faculty for any necessary
specialty specific modification. Further information can be viewed
by clicking here.
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5) Trainees’ day at the College annual meeting
The Trainees’
Institute day at the Royal College of Psychiatrists’ Annual Meeting
in Liverpool will take place on Wednesday 3rd June
2009. A varied programme has been planned for the trainees’
day, including lessons on leadership from a European perspective, a
debate on the sub-consultant grade, a question and answer panel on
challenges to future training in psychiatry with key leaders in the
field and an update on the use of portfolios for trainees and
consultants. For further information and details of the speakers,
please visit:
http://www.rcpsych.ac.uk/training/trainees/events/traineesinstituteday.aspx
Details of other conferences that may be of
interest to trainees
can be viewed on our website.
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6) Undergraduate recruitment
campaign
The campaign to
improve undergraduate recruitment into psychiatry is progressing
well and the Student Associate grade was successfully launched in
December. It is free for medical students and foundation doctors to
join and so far over 200 people have registered. Please encourage
interested medical students to register to be Student Associates of
the College. The registration form can be viewed at:
http://www.rcpsych.ac.uk/training/students/studentregistrationform.aspx
There is also now a new medical student
area of the College website which can be found at http://www.rcpsych.ac.uk/training/students.aspx
At present, student
psychiatry societies are being set up in many medical schools
around the country. We have a network of trainees willing to assist
students with these initiatives and are keen to hear what is
happening locally, so please contact us at: ptc@rcpsych.ac.uk
if you are involved in a student society or would like to be.
The Institute of
Psychiatry (IOP) is running a summer school for medical students at
their London location (Monday 20th to Friday
24th July 2009). It is hoped that this will provide an
opportunity to showcase the advantages of a career in psychiatry.
It will take the form of a series of talks from senior clinicians
and a number of visits to the departments of different
specialties. There will also be varied social events. It is
hoped that approximately 30 medical students will attend. The
College Dean is leading on the project and more details will follow
as it develops.
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7) Volunteer programme
Dr Deji Oyebode –
Deputy Director of Board of International Affairs and Chair of
Volunteer Sub-Committee, Royal College of
Psychiatrists
Overseas volunteering is
increasingly seen as a way for health professionals to get involved
in improving global health. The World Health Organisation,
Department of Health and British Medical Association all
advocate sharing the skills of UK-based health professionals with
developing countries.
The challenge is in
turning these recommendations into a reality. Creating an effective
model for overseas assignments - which promotes consistency
and sustainability in the developing country and provides financial
support, training accreditation and personal development for UK
volunteers – requires the commitment and vision of a number of
people and institutions. The Royal College of Psychiatrists,
in partnership with South West London and St George's Mental Health
NHS Trust and Challenges Worldwide, an international development
charity specialising in overseas assignments for volunteers, has
achieved this by implementing 3-month placements in Ghana which
have been successful.
The project has set up
the appropriate back-up for volunteers, including arranging
accommodation, transport and temporary medical registration as well
as making a work plan for the assignments and establishing a
professional peer group for the doctor to join. Supervision is
organised regularly, both locally in Ghana and by internet through
a Supervisor in the South West London and St George’s Mental Health
NHS Trust. The post is most importantly recognised as a valid
training experience for higher specialist trainees in terms of
achieving CCT.
Sadly, psychiatric care
in Ghana is a last resort for families, often sought many years
after the patient first shows symptoms. Retaining doctors is
also a major problem. The position of a medical assistant, nurses
with an extra year of general medical training, has been introduced
to help cater more effectively for rural medical needs.
Recruitment of doctors in
the UK to take part in the project has been carefully managed.
Applications are submitted to the Trust Human Resources Department.
Interviews and assessments are conducted by the Trust, the Royal
College of Psychiatrists and Challenges Worldwide.
There have been three
assignments to date. These have been higher specialist
trainees from the Trust. The placements have been agreed by Dr
Akwasi Osei, acting Chief Psychiatrist at Accra Psychiatric
Hospital.
Challenges
Worldwide helped to establish a partnership with the
Ghana Health Service. Dr Osei helped the charity identify
areas where specialist registrars could offer sustainable support
through short-term assignments.
The placement
Placements have been at
Accra Psychiatric Hospital and Pantang Hospital, near
Accra. The trainees performed a number of tasks focusing on
the training of medical assistants and development of ward systems.
Protocols were developed for various problems including emergencies
and rapid tranquillisation. Supported outreach clinics did take
place on the first placement but lacked the sustainability to
continue. Some direct clinical work does take place, but
always with a view to support systems in a sustainable way and
train Medical Assistants.
Balancing books
The model was designed to
be cost neutral for everyone involved. It was approved as part of
the accredited training (as an out-of-programme experience). The
trainee was paid two months' salary (minus London weighting and
on-call allowance) for the three-month placement. The last four
weeks of the term were granted above and beyond the contractual
annual leave.
One month's salary was
paid to Challenges Worldwide for development, training and
management costs. Assignees are required to cover the cost of
professional indemnity insurance, flights and their personal
spending, but some funding is available to contribute to these
costs through the College or sponsorship deals.
Training accreditation
was achieved through the provision of a mentor in Ghana, Dr Osei,
and a UK mentor, Dr Peter Hughes, Consultant Psychiatrist in
General Adult Psychiatry at Springfield University Hospital, London
and Training Programme Director.
Ongoing e-mail and
telephone support, including a 24-hour emergency contact line has
been provided by Challenges Worldwide during the assignments. A
post-assignment debriefing and feedback session allowed all
involved to assess the assignment and plan for the
future.
The programme is aimed at
focusing on organisational development and capacity building,
rather than service delivery or emergency response. Assignment
vacancies will be available for specialist registrars, ST4s and
above, for similar three-month placements. The plan is to
expand the programme to include more Trusts and additional
countries.
More information
For further information, please contact:
Or visit:
8) Exam eligibility update
As we reported in our
last newsletter, there have been recent changes to the criteria for
obtaining MRCPsych and trainees are no longer required to have
completed a 6 month post in learning disability or child and
adolescent psychiatry. However, in order to be eligible for the
CASC exam, trainees are required to demonstrate competencies in
these specialties in addition to psychotherapy. It has been decided
that, for the March CASC exam, these competencies can be
demonstrated by appropriate workplace-based assessments, so it will
not be necessary to have completed ACEs. However, ACEs in
psychotherapy and child and adolescent psychiatry or learning
disabilities will be required for subsequent CASC exams. If
trainees have any questions or concerns about fulfilling the
requirements to be eligible for the CASC exam they should discuss
them with their supervisor and contact the Examinations department.
Please click here to view the full
criteria.
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9) Psychiatrists’ support service
The Psychiatrists' Support
Service is a free of charge confidential support and advice
service for members, trainee members and associates of the Royal
College of Psychiatrists who find themselves in difficulty over a
range of issues including training concerns and exams. For further
information, please see:
http://www.rcpsych.ac.uk/member/psychiatristssupportservice.aspx
The contact number for the service
is: 020 7245 0412.
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10) Trainee registration
In January 2009 it became mandatory
for all trainees to be registered with the College,
as per the recommendations in the Gold Guide.
Information on the benefits of
registration and links to the applications forms are
available on the College
website.
The cost of registration is £118
per year and, in order to access Assessments Online, trainees will
have to be registered with the College. It is essential for
trainees to be registered with the College for every year of their
training from now on in order to be eligible for their CCT.
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top
11) PTC Newsletter Editorial Team
Clare Oakley, Chair
Elena Baker-Glenn, Vice Chair and Website
Editor
Mark Tarn, Honorary Secretary
Arpan Dutta, Deputy Website Editor
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Back to trainees'
home page
Page last updated 26th
January 2009 by E Baker-Glenn