I elected to utilise my
foundation year 2 study leave allowance to complete a taster
session in psychiatry. I had done my undergraduate medical
elective and two undergraduate optional placements in forensic
psychiatry, and was keen to pursue a career in
psychiatry. Unfortunately, I was unable to secure a foundation
post in psychiatry and felt it was important to have some
postgraduate exposure to the field before applying for specialist
training.
I contacted Dr Agarwal,
director for medical education in psychiatry at Aintree University
Hospital, Liverpool, who kindly organised a 10-day placement for me
within five sub-specialties: community mental health, acute care
team (ACT), early intervention in psychosis (EIT), old age and
assertive outreach. I spent two days with each subspecialty.
Throughout the course of
the two weeks, I was afforded many opportunities to witness and
discuss different psychiatric presentations – ranging from the
psychoses to the neuroses. I learnt about the role of the
community mental health team, with an emphasis on trying to manage
patients in the community rather than as in-patients. I learnt
about how the EIT manages patients with first-episode of mental
illness, and continues to care for them for the next three years,
before their care is then transferred to the community mental
health team. I also learnt that those patients who are more
difficult to manage in the community, for example, because they are
poorly compliant with their medication(s) or poorly engage with
psychiatry services, are managed by the assertive outreach
team.
All five teams I was
placed with were very welcoming and keen to involve me in their
everyday duties. I was fortunate enough to be able to attend the
home assessment of a young man with likely first-episode of
paranoid schizophrenia, who was subsequently recommended for
sectioning for assessment in hospital. I was also able to
attend several home visits, where I witnessed first-hand how
patients are appropriately managed in the community. I was
able to attend the weekly teaching session that is run for the
psychiatry junior trainees. This provided me with
opportunities to speak with current junior trainees about the
specialist training application process and how to maximise my
chances of successfully gaining a training post in psychiatry.
I improved my knowledge
of the pharmacological management of patients with schizophrenia
and was given opportunities to discuss the potential diagnoses of
patients seen in clinic and how they should be managed – two skills
that are essential to learn as a junior trainee in
psychiatry. The term “Community Treatment Order” was
introduced to me – a concept that I knew had been introduced as
part of the amended Mental Health Act, but of which I knew little
more.
My overall impression of
my two-week placement was that it was varied, thoroughly enjoyable,
interesting and very educational. Most importantly, however, it
served to strengthen my desire to pursue a career in psychiatry, a
field that I find to be more fascinating than any other in
medicine. The placement certainly served to confirm my decision to
apply to specialist training in psychiatry. I am most grateful to
Dr Agarwal for taking the time and making such great effort to
accommodate me.
To any foundation doctors
who are thinking of arranging a taster session in psychiatry, the
best piece of advice that I could provide would be to be
organised. Find out who is responsible for organising
placements and contact them at an early stage as it can take
several weeks for a placement to be arranged. I had to complete a
CRB check before being allowed to start my placement (even though I
had completed one at the beginning of foundation
year 1). This increases the likelihood of you being
allowed the time off to accommodate the taster session. When doing
your taster session, be pro-active. Try to involve yourself in the
life of the junior trainee as much as possible and utilise
available opportunities to talk to both trainees and consultants
about the pros and cons of a career in psychiatry.
Declan Hyland, foundation
year 2 doctor, Aintree University Hospital, Liverpool
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Page last updated on 5
June by E Baker-Glenn