Psychiatric Trainees' Committee

Newsletter March 2008

  1. Editorial
  2. The PTC
  3. 2008 Recruitment
  4. Allocation from ST3 to ST4
  5. WPBAs and HcAT
  6. New Ways of Working
  7. Tooke Review
  8. IMG Issues

 

 

Editorial

 

Welcome to the first e-newsletter of the Psychiatric Trainees’ Committee (PTC) of the Royal College of Psychiatrists.  We are aware of the need to improve the two-way communication between the PTC and local trainees and these newsletters aim to keep both trainees and trainers up to date with our activities within the College and wider organisations on behalf of psychiatric trainees. 

 

This newsletter gives an overview of the PTC and the work we are doing.  The Tooke report and the 2008 recruitment process are discussed and some of the specifics of the new training structure are explored: the results of an online survey regarding trainees’ views about ST3 to ST4 speciality allocation and an update on WPBAs and HcAT.  The PTC’s work exploring the interactions between training and New Ways of Working (NWW) is outlined, including suggestions of how to ensure training develops alongside the various ways in which NWW is implemented.  

 

Further information about training issues can be found on our website pages www.rcpsych.ac.uk/training/traineessection.aspx.  Please feel free to email us at ptc@rcpsych.ac.uk about any training issues – we would also appreciate any feedback about this newsletter so that we can improve subsequent editions.

 

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The PTC

The Psychiatric Trainees’ Committee consists of 40 elected members representing all the regions of the UK and Ireland and the armed forces.  At least one member per division must be a pre-membership psychiatric trainee. Elections are held in half of the Divisions every year, with members serving a two-year term with the possibility of being re-elected for a further two years. The Committee meets at the College four times a year and has an annual residential meeting for the new Committee members.  The agenda of meetings are focused on various training issues and working groups of four or five members are frequently formed in order to formulate ideas about particular training issues.

  

The PTC sends a representative to almost every Committee in the College, including the Central Executive, the highest College Committee.  Trainee representatives do far more than observe the workings of these Committees, and take an active role in influencing College policy.  The PTC is represented at the Academy of Medical Royal Colleges via the Academy Trainees Group and a representative attends the Junior Doctors Committee of the BMA.   Committee representatives also attend meetings of the European Federation of Psychiatric Trainees and are involved in various working groups looking at training issues across Europe.  Promoting psychiatry as a career is an important part of our work and Committee members frequently attend careers fairs and respond to specific career enquiries.

 

Membership of the PTC provides a range of valuable opportunities for trainees, and fulfils an important function of the College. The last year has clearly demonstrated the need for the profession’s active involvement in determining our future.  Working within the committee also allows the opportunity to experience first hand the challenges that the profession is facing as a whole. There are also significant opportunities to work alongside those who are charged with improving postgraduate medical education and help to raise the standard of training.  Details of how to become involved are available on our webpages - we would recommend this to any interested trainee.

 

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2008 Recruitment

For 2008, recruitment into psychiatry is being managed by local deaneries. The process runs between 5th January and 16th May 2008 for entry into specialty training on 6th August 2008. Trainees can apply for as many posts in as many deaneries as they like and are advised to check deanery websites for up to date job adverts and information.  The British Medical Association (BMA) has already warned it expects the recruitment situation to worsen this year, with three applicants set to compete for every post in 2008, up from two applicants in 2007.

 

You can find further information about recruitment in 2008 here: www.mmc.nhs.uk/default.aspx?page=315.

 

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Allocation from ST3 to ST4

The original structure of Modernising Medical Careers (MMC) was based on run-through training for all specialities.  For specialities such as medicine, surgery and psychiatry, training continued to be divided into core training for 2 or 3 years followed by specialist training in one of the various CCT specialities.

 

Trainees who secured a run-through training post in 2007 have been appointed to train in a specific deanery until ST6, subject to satisfactory progress. However, there was little consideration about how trainees will be allocated into CCT specialities at the end of the ST3 year (ST2 for medicine and surgery).

 

In order to ascertain the views of psychiatric trainees the PTC conducted an anonymous nationwide online survey in November 2007.  627 trainees responded. Key results include:

 

  • 22% wanted to move deaneries due to geographical reasons (eg personal circumstances).

  • 82% would be unhappy to select their future CCT speciality at ST1 level.
  • 56% stated geography as the priority when choosing ST4 posts whilst 44% stated speciality as the priority.
  • 45% stated a preference for closed deanery allocation, 14% for full national allocation and 41% for a hybrid model whereby some posts are kept for local allocation and the remainder placed into a national allocation pool.

 

A more detailed report of the survey can be found here.

 

Although it was difficult to draw specific conclusions, these findings were presented to the College and also to the MMC Programme Board via the Academy Trainees’ Group.  The Board decided that CCT speciality allocation should occur within deaneries, but with the provision that if a trainee receives an allocation which is not a preferred choice they may provisionally accept the offer and retain this while attempting to gain their first choice specialty as part of an open national competition process.  Interviews to rank trainees are currently occurring in deaneries – please contact us if you have any concerns about this process.

 

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WPBAs & HcAT

Workplace-based assessments (WPBAs) are now compulsory for all trainees in ST1-6. They form part of the eligibility requirements for the New MRCPsych exams and will be considered at each trainees’ Annual Review of Competence Progression (ARCP).  Their introduction requires a steep learning curve for both trainees and trainers and a shift in culture.  It is hoped that they will prove to be valuable tools for directing trainees’ learning and development.  Further information about WPBAs and the practicalities of using them can be found here.

 

The College have introduced an online system for delivering WPBAs in collaboration with Healthcare Assessment and Training (HcAT).  This allows permanent secure storage of assessments and the production of summary reports of completed assessments.  Over 2000 trainees have registered with the College to use HcAT so far. Any trainees who have not yet registered for HcAT should do so at www.rcpsych.ac.uk/training/e-formsforwpa.aspx.

 

The PTC have successfully argued that there should be no charge to trainees for this service until January 2009 while development of the system is ongoing. We are aware that some people have experienced difficulties with the system and we are working closely with the College and HcAT to rectify these problems and improve the usability of the system.  There is extensive guidance on completing the WPBA at www.rcpsych.ac.uk/training/wpba.aspx but if this does not resolve your query then please contact: hcat@sheffield.ac.uk

 

Please continue to send your feedback and comments to rjackson@rcpsych.ac.uk to enable effective development of the system.

 

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New Ways of Working (NWW)

New Ways of Working is a joint collaboration between several bodies including the College, several other professional bodies, and the Department of Health via the Care Services Improvement Partnership (CSIP) and the National Institute for Mental Health in England (NIMHE).  NWW was initiated from the concern that consultant psychiatrists are overworked and burnt-out, resulting in recruitment difficulties.  It has developed into changing the practice of all members of the MDT, but particularly psychiatrists, with the emphasis on reducing caseloads and routine reviews of patients by providing more of a consultative role to team members.  Further details can be found at: www.newwaysofworking.org.uk/

 

NWW has been implemented in various ways throughout England and whilst it has been successful in several areas there are also many who believe that it is undermining the role of the psychiatrist and are concerned about patient safety and lack of continuity of care.

 

The potential conflict between New Ways of Working (NWW) and postgraduate psychiatric training is becoming increasingly recognised.  There are two areas of concern: firstly, the role that trainee psychiatrists are training for is changing under NWW.  The content of training therefore needs to reflect this changing role to ensure that future consultant psychiatrists have the necessary skills to be successful practitioners.  Secondly, NWW has contributed to changes in mental health service provision, alongside other policies including the European Working Time Directive (EWTD) and National Service Framework (NSF).  One of the effects of these changes in service provision is a significant change in the way trainees work, as roles traditionally undertaken by junior psychiatrists are now completed by other members of the multidisciplinary team.

 

The changes resulting from NWW coincide with Modernising Medical Careers. The fact that these changes are occurring within the same time frame presents an opportunity to analyse the training of psychiatrists and ensure that there are opportunities for the achievement of competencies that are required for the modern day consultant psychiatrist.  The PTC is represented on the College’s NWW Steering Group and has helped to ensure these training implications are recognised.  Steps are being taken to ensure that sufficient competencies of leadership, management and supervision are included in the core and generic components of the new postgraduate curriculum that is being developed by the College.

 

The interaction between NWW and psychiatric training also needs to be considered on the local level, particularly as there are variations in the way NWW is being implemented.  The role of trainees in the MDT, ensuring exposure to routine cases, out of hours working and the utilization of consultants time for training all need thought both in the implementation of NWW and the planning of postgraduate psychiatric training.

 

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The Tooke Review

The final report of the independent inquiry into Modernising Medical Careers (the Tooke Review) was published in January 2008.  It states that the introduction of Modernising Medical Careers (MMC) had been rushed and lacked cohesion.  Recommendations include widespread changes to the structure of postgraduate medical education, with the removal of the Foundation Year 2 and the reinstatement of core and higher training for many specialities.  The report also recommends that the government should cease its responsibility for overseeing the training of junior doctors and calls for an independent body to control the recruitment of junior doctors, arguing the Department of Health should not be in charge of funds for their training. Included is a recommendation for the formation of NHS: Medical Education England (NHS:MEE), which will be able to articulate the principles of postgraduate training and help to ensure successful implementation.  The report warns that training could suffer when the European Working Time Directive comes fully into force next year.  There is a suggestion to enable doctors to continue to work legally for more than 48 hours a week by separating work on the wards from training time.

 

You can read the final Tooke report here (please note: this links to a PDF file which will open in a new window).

 

You can read the College’s response to the Tooke report here.

 

The Department of Health have responded to Sir John Tooke’s independent inquiry into MMC. Their response can be viewed by clicking here (please note: this links to a PDF file which will open in a new window).

 

The press release by Sir John Tooke can be viewed here (please note: this links to a PDF file which will open in a new window).

 

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IMG issues

The PTC and the wider College realise that, while this is a difficult time for all trainees, those of you who are International Medical Graduates are having to cope with the added stress of the Department of Health’s continued drive to take away your eligibility to apply for training posts.  The government have appealed the recent court ruling that those with HSMP visas have equal rights of application as European Area applicants.  The most up to date information on this can be found at: www.dh.gov.uk/en/News/Recentstories/DH_082728.

 

The College recognises what a large contribution IMGs make to psychiatry in this country and continues to support the ongoing ability for HSMP holders to apply for training posts.  Full details of the College response can be viewed at: www.rcpsych.ac.uk/pdf/RCPsych%20view%20IMGs.pdf. (Please note this is a PDF file and will open in a new window).

 

The most up to date pragmatic information on applying for training posts can be found at www.nhscareers.nhs.uk/img_qa.shtml.

 

One particular issue, whether IMGs can apply for training posts if their HSMP expires prior to the expected end of the training post, is not clear from the official guidance. The College’s position on it, however, is:

 

‘The guidance on HSMP remains subject to a legal process. Currently the deaneries are appointing trainees whose HSMP does not cover the entire duration of the contract.  There is however a possibility that this may be reviewed and IMGs should keep an eye out for information in the medical and education press and the Home Office website’

 

The Board of International Affairs are keen to gain a better understanding of the reasons IMGs leave their countries of origin. They have put together a questionnaire to better understand this. It can be found at:

www.rcpsych.ac.uk/college/internationalaffairsunit/questionnaireforimg.aspx.

 

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PTC newsletter editorial team

Christian Hosker, Newsletter editor

Elena Baker-Glenn, Website editor

Ollie White, Chair

Clare Oakley, Vice Chair

Paul Henderson, Honorary Secretary

 

 

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Page last updated on 1st March 2008

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