Career info for school leavers
Why become a
Psychiatrists are medically qualified doctors who look after
patients with mental health problems, such as depression,
schizophrenia, eating disorders, anxieties, phobias, and drug and
alcohol abuse. Psychiatrists work in a number of different places
including hospitals, people’s own homes, residential centres for
older people and people with special needs, and even in
Did you know that one in four of the population suffers from
mental health problems? This kind of illness ranks with heart
problems and cancer among the nation’s biggest health
Psychiatry is one of the most varied, interesting and
rewarding specialties in medicine. There are excellent
opportunities for those who wish to progress to the most senior
positions. As a career, psychiatry attracts as many women as men
and it can particularly appealing for those interested in flexible
“I have never once regretted my decision
to train as a psychiatrist.
The combination of different scientific
disciplines covering areas as diverse as neuroscience, psychology,
and social science, all brought together within a person-centred
approach, is hard to beat within medicine. In psychiatry you can
really make a difference to people struggling with the most
devastating illnesses and can help them to return to satisfying and
fulfilling lives. No two people with mental health problems are the
same and the privilege of being trusted with the most intimate
aspects of a person’s experience and being able to offer real and
lasting help is uniquely satisfying. Psychiatry may be frustrating
and utterly challenging at times, but it is never boring, and a day
rarely ends when you do not feel you and your team have done
something both fascinating and amazingly worthwhile. If you want to
treat people as individuals and use the best of scientific
knowledge to help them make a massive difference to their lives,
then psychiatry might be for you.”
Alan Lee, Consultant
How do I become a psychiatrist?
All psychiatrists are qualified doctors, so first you must
first gain a place at medical school.
Academically, you will need good passes in 3 A Levels, at
least one of which must be a science subject (chemistry is
compulsory at some medical schools). There is a lot of competition
for places at medical school. Successful candidates need:
• good academic qualifications
• enthusiasm with good interpersonal skills
• a wide range of outside interests
• some interest in a caring profession.
What is the career pathway of
Medical degree (usually 5 years)
provides students with some exposure to the different specialties
Foundation Year 1 and Foundation Year 2 (2
After medical school you will spend 2 years
working in a hospital as ‘foundation programme trainee.’ This will
extend the knowledge and skills you have gained as a medical
student. The foundation programme will help you understand the
important qualities that you will need to develop to be a
successful doctor. The second year of foundation programme will
extend your knowledge and give you opportunities to experience
working within different specialties.
Specialty training (usually 6 years)
Once you have completed the foundation programme you will be able
to apply for specialty training in psychiatry. This will last for
around 6 years and will include assessments through out the six
On successful completion of speciality training, you will be
able to apply for a consultant post.
What makes psychiatry
As a doctor specialising in this area, you really could make a
difference to someone’s life, and help them regain their
self-respect and happiness. Psychiatry is an excellent career
choice for anyone interested in how the mind works, and someone who
enjoys working as part of a team. There is real variety in
psychiatry. Every day can be different and every person you see
will be unique. Psychiatrists work across a person’s lifespan, from
childhood to old age. There are a number of different areas in
which you can specialise, including child and adolescent psychiatry
(working with young people up to school-leaving age), forensic
psychiatry (working with people with mental illness who commit
crimes), psychotherapy (using ‘talking treatments’, rather than
prescribing medicines, to help people) and the psychiatry of
learning disability (what used to be called ‘mental
General adult psychiatry
This involves looking after working age adults with a wide
variety of mental health needs. These problems include depression,
schizophrenia and anxiety disorders. Treatment involves using
medication as well as trying to influence psychological and social
Old age psychiatry
This involves working with adults over the age of 65. They may
have any of the mental health problems encountered in general adult
psychiatry. In addition, a major part of the work involves the
diagnosis and management of dementia.
Child and adolescent psychiatry
Psychiatrists who work in this specialty assess and manage
emotional and behavioural problems of children and adolescents to
school leaving age. This involves team work between different
professionals such as social workers, psychologists and education
Commonly psychotherapy involves working with people with
personality disorder, interpersonal problems, depression and
anxiety. It is about using talking treatments rather than
medication. A key component is building a therapeutic relationship
between doctor and patient.
This specialty covers the interaction between psychiatry and
the law. It involves treating people who have committed crimes
whilst mentally ill or people who become unwell in prison. Forensic
psychiatrists also write court reports and give evidence in court.
They work in secure hospitals and prisons.
People with learning disability may have conditions such as
Down’s syndrome. Psychiatrists who work in this area are involved
in the prevention, diagnosis and treatment of mental health
problems which occur in people with learning disability.
Would you make a good psychiatrist?
- Are you a ‘people’ person, with a genuine interest in how other
people think and feel?
- Would you make a good detective and enjoy investigating complex
- Are you bright, patient and tactful?
- Do you want to put your science into practice?
- Are you interested in finding out what ‘makes people
- Do you have the personal strength to face the difficult
problems people tell you about?
If the answer to these questions is ‘yes’, then psychiatry
could be the medical specialty for you
Try being a psychiatrist
You are called to A+E to assess a 70
year old man who has taken 50 paracetamol and his supply of
antidepressants. He has had depression for many years. He had been
saving the tablets for some time and left a suicide note. He tells
you he does not want to go on since the death of his wife from
cancer. He is medically stable following his overdose.
What is his risk of a further suicide attempt?
a) low risk
b) high risk
c) no risk
Which of these factors contribute to an increased risk of
b) male gender
c) older age
d) all of the above
What would you do?
a) give him another supply
b) send him home and write
to his GP
c) admit him to the
1. The risk is high
2. His risk is increased by:
- being male
- being an older adult
- having a diagnosis of depression
- having suffered a recent bereavement
- having planned his suicide attempt (saving
- having thought he would succeed in killing
himself (leaving a suicide note)
3. The best course of action would be to
admit this gentleman to the psychiatric ward for assessment and
further management. You should not give him another supply of
antidepressants to take home as he could overdose with them again.
He should not be sent home as he could harm himself before you can
contact his GP.
You are asked to visit a 76 year old lady at
home who is having problems with her memory. Her memory has been
deteriorating for several months and she is forgetting important
dates and names. Sometimes she gets lost when she is walking back
from the shops.
What is the likely diagnosis?
a) old age
What information would you like to confirm the
a) history from a relative
b) memory testing
c) physical examination
and blood tests
d) all of the above
What other professionals may be involved in assessment and
a) social worker
b) community psychiatric
d) all of the above
Most people with dementia live:
a) at home
b) in a residential
c) in a nursing home
1. The most likely diagnosis is
c. dementia. People can become more forgetful in old age but
this is much less severe than in dementia. Anxiety can make it
difficult to concentrate and therefore make people feel that their
memory is terrible but it would be unlikely for them to lose their
2. d. It is important to do all
three. Information from a relative or friend of the patient is
important as they may have noticed additional symptoms or may
remember things that the patient has forgotten. A formal memory
test should be carried out to determine the nature and degree of
the memory loss. A physical examination and blood tests are
important as physical conditions can cause or have an influence on
dementia, for example a stroke can affect people’s memory.
3. d. Assessment and management of
a patient with dementia involves the whole multidisciplinary team.
A psychologist may perform special memory tests. A social worker
may be involved in assessing whether the patient needs to move to
more suitable accommodation. A community psychiatric nurse may
monitor the patient in the community and help educate their family
4. a. The majority of patients
with dementia live at home. However, when some patients deteriorate
it is necessary for them to have more support and help and this can
be provided in a nursing or residential home.
You are a recently qualified doctor, and are
currently in your Psychiatry rotation. You are asked by the staff
in Accident and Emergency to see a 20-year-old woman, who has taken
an overdose of paracetamol, though has no significant physical
complications as a result.
When you arrive in A and E you are told she has recently split
up with her boyfriend and drank a bottle of vodka before taking the
How do you approach the situation?
- Tell her everything’s going to be alright
and arrange for her to go Home: this is just a “cry for help”
- Immediately arrange for her to be admitted
to hospital after spending 10 minutes talking to her
- Tell her that she has wasted the doctors’
time, and that she should behave better in future
- Take a full history of events prior to the
- Take a medical history and personal
history, trying to understand how she copes with life
- Ask about symptoms of psychiatric illness,
eg depression and further thoughts of suicide
1. A number of healthcare staff have this
attitude regarding self harm, and though this may be a cry for
help, and a direct result of her getting drunk in he context of a
life stressor, it is important to rule out any evidence of
psychiatric illness (eg underlying depressed mood) that pre-dated
the overdose. She may have done this before, and is at a
considerably higher risk of committing suicide than other members
of the population (up to 50 times)
2. Arranging for her to come into hospital
may well be necessary, but bear in mind that it may be equally
detrimental. You need to take a good history from her to see if
this would be useful, and if you are going to admit her to hospital
what are you going to offer her?
3. Believe it or not, this is still a
response of some staff. Do you really think this is going to help
her, or help in the doctor-patient relationship?
4. This is useful: did she take the overdose
in secret, did she write a will, did she regret taking the overdose
afterwards, was she intoxicated, was she hearing voices telling her
to kill herself?
5. Again, this would aid you in finding out
precisely why she took the overdose, does she react to all life
stressors in this way, has she had a difficult upbringing, has
there been a recent bereavement, does she have a medical condition
that would predispose her to depression, eg epilepsy?
6. Yes, this is necessary: is she suffering
from a depressive illness that has resulted in her feeling low in
mood, made her energy levels lower and meant that she couldn’t
enjoy things she used to? Did this cause her relationship
to end? Does she have plans to commit suicide at the moment, and
does she have the necessary means?
She tells you she has felt low since the
death of her grandmother a year ago, who brought her up following
her parent’s messy divorce, her father being an alcoholic. She
recently lost her job as a hairdresser, feels “low” most of the
time and does not enjoy things she used to, like playing tennis.
Her energy levels are low, she does not eat and has dropped down 2
dress sizes to an 8. She feels “silly” about the overdose, which
she took after her boyfriend left her. Her boyfriend turns up, and
explains how she has become more irritable, but now wants her to
come back home. She relates well to him, and says she does not want
to come into hospital but would happily go to an outpatient
There are no other symptoms of psychiatric
What do you do?
- Give her an antidepressant prescription and arrange an out
- Detain her under the Mental Health Act and bring her into
hospital against her will?
- Arrange counselling for her at her GP practice
- Ask her to go see her GP when she leaves hospital
- Explain to her that you think she is depressed, and explain the
factors that cause depression, using this as a model for treatments
that can include antidepressants, talking therapies and involving
family members and close friends
1.You could consider this, but do you not
think option 5. looks better? Also, all antidepressants take at
least 2 weeks to work, and have side effects: they should not be
started without careful thought and without involving the patient
in their own treatment
2. Given the description above, you would
be on shaky ground here: depending on where you live in the UK
there are different rules governing detention. However, if the
patient does not pose a serious risk to themselves or others and
you think they could be looked after in the community detention
would not be warranted (or appreciated by the patient)
3. This may be useful for her though
given her symptoms and story, it would be better for her to receive
a more focused treatment for depression, which might include other
forms of talking therapy and/or medication
4. Again, this may be all that is
required: should speak to her GP about her case, or send a
prompt letter telling them about her case, and then make a joint
decision about how best to arrange follow-up care. The GP may well
have seen her with these symptoms before, or equally may not have a
lot of experience with mental illness and value a further
5. This seems like a sensible approach
doesn’t it? Depression has a number of different causes, that
usually interact with one another to produce a depressive episode:
biological (eg certain genes types, certain illnesses affecting
hormones in the body), psychological (people’s ways of looking at
situations are shaped by their life experience and certain ways of
thinking can predispose one o depression) and social (bereavements
and different types of abuse make depression more likely to occur).
Targeting treatment at these factors can not only treat depression
but also prevent it recurring.
How much do you know
1. Do you believe that people who are depressed?
a. Should pull
c. Need help
d. Have only
themselves to blame
2. To become a psychiatrist, which of the following
must you study after A levels?
3. How many people on average will experience a problem with
their mental health at some point in their life?
a. 1 in 2
b. 1 in 4
c. 1 in
d. 1 in
4. Which of these would a psychiatrist not
b. A heart
5. Where can psychiatrists work?
e. Courts of
f. All of
6. How long does it take to train to become a psychiatrist
after medical school?
a. About 3
b. About 5
c. About 8
d. About 10
7. What qualities does a good psychiatrist need?
interest in how people think and feel
e. All of the
8. Which of these would a psychiatrist not treat?
9. In terms of public health, which psychiatric disorder is
10. Which of the following categories of person are
vulnerable to developing mental illness?
a. People of low
b. People with weak
c. Older people
How much will I earn?
Salaries change slightly each year and the following
information is only an estimate. When you begin speciality training
as a psychiatrist your basic salary will be approximately £24,000.
This is supplemented by a payment for the out of hours work which
you are involved in. The more out of hours (or on call) work you do
the higher this payment will be.
At present an average trainee may get a 50% multiplier for on
calls and so their salary would be approximately £36,000. Your
basic salary will generally increase each year you are employed, so
your overall salary including multiplier may be £45,000 after a few
years. A consultant psychiatrist earns between £70,000 and £90,000
Are there opportunities for psychiatrists wishing to work in
the Armed Forces?
Yes. Psychiatrists are recruited into all three of the UK
Armed Forces, The Royal Navy, The Army and the Royal Air Force.
They provide help with mental health problems to about 500,000 men,
women and children in the UK and overseas. In addition to Service
personnel, those entitled to benefit from the Defence Medical
Services include civilians employed by the Ministry of Defence
overseas (such as schoolteachers, welfare professionals,
shopkeepers and administrative staff) and the families of Service
personnel and other entitled civilians.
Military psychiatrists are trained as general adult
psychiatrists, but there are opportunities to dual train, in a
subspecialty useful to the military e.g. liaison, forensic. They
may have a special interest in the maintenance of fitness and
morale, and in the study of combat stress, both physical and
psychological. Service psychiatrists are based primarily in the
community, and are supported by community psychiatric nurses or
social workers as part of a multi-disciplinary team. Currently,
Service personnel requiring in-patient treatment are admitted into
the private sector or an NHS facility.
All doctors working within the Armed Forces enlist as military
personnel, and undergo some general military training. Before
starting specialist psychiatric training, it is usual for Service
doctors to spend one or two years undertaking general medical
duties to enable them to acquire an understanding of the conditions
of life and the culture within the Armed Forces.
There are also career opportunities for civilian psychiatrists
within the Defence Medical Services, to work alongside uniformed
consultants, who take care of military personnel, but do not have
an Operational Role.
Information on work experience
Work experience is a great way to improve your
knowledge and understanding of psychiatry and also:
- Gives you the opportunity to develop skills and qualities which
are needed to become a psychiatrist.
- Provides solid experience to offer on application forms and
interviews and helps improve prospects for entry to higher
- Increases self-understanding, maturity, independence and
self-confidence, especially in the workplace.
- Provides the opportunity to develop networks.
- Improves the understanding of the work environment and
- Gives you the opportunity to develop and practice key skills
that employers are looking for e.g. communication, teamwork and
- Increases awareness of how the NHS works.
There are many hospitals throughout the UK
which offer work experience to Year 10/11 students, sixth formers
and medical students. The Royal College of Psychiatrists is not
responsible for organising work placements so please
contact your local hospital directly for further
What if I
already have a degree?
You will still need to apply for medical school even if you
already have a degree in another subject. A number of medical
schools however offer graduate-entry programmes to candidates who
already have degrees – usually, but certainly not exclusively, in
scientific subjects. These courses are shorter (usually 4 years)
than the traditional 5 years. Students work in a variety of areas,
To apply for these graduate entry courses you will need to
Further information is available from UCAS
: UCAS GAMSAT Office,
Box 28, Cheltenham GL52 3ZA. Email: email@example.com; tel.
the difference between psychology and psychiatry?
Psychiatrists, psychologists and psychotherapists are
professionally trained people who see and help those suffering from
psychological problems. The main difference is that psychiatrists
are all medically qualified doctors, and as doctors can prescribe
medication. Psychologists are non-medically trained professionals
who are primarily concerned with how people think, act, react and
Please note that we are unable to offer advice on individual cases. Please see our
advice on getting help.
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