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The Royal College of Psychiatrists Improving the lives of people with mental illness

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12/09/2014 11:13:44

Mind the Gap


Newcastle University Students’ Union’s first ever mental health project and conference - 3 May 2014


Newcastle University Students’ Union’s first ever mental health project and conferenceIt had been a long nine months but finally the day was here! After months of planning, hours of stress and litres of caffeine the day of our first ever mental health conference had arrived!


Nine months ago, the student’s union decided that it is about time that this historical educational institution should probably host a conference that helps promote knowledge and understanding of mental health, whilst tackling the negative stigma behind mental health and those who suffer from mental health problems. After all, why is it ok talking about a broken arm or taking time off,  but not ok saying you have depression?


The strands

There were four strands to this project:


  • Local Schools,
  • Diverse Communities,
  • Wider Student Body,
  • Local Businesses and GPs.


Each strand has a chair and I was lucky enough to be elected Chair of the Local Businesses and GPs strand. Each chair has a working group who were responsible for targeting the different groups of people to try and get them involved in our project. The project is entirely student led and each working group is made up of students from all walks of life. My working group were made up of medics from all years (who I had never met prior to this project!) and psychology students; any one could sign up to be in any of the working groups.


The group got to know each other through various meetings of which we had 'weekly' in one of our favourite local teashops. Whilst sampling the extensive menu of amazing teas and cakes the café had to offer, we were busy coming together with ideas of what events we would run for the conference and how we were going to reach our target groups.


We were also very keen to get our schools at the University involved in the project so we managed to arrange meetings with staff from our departments to get their ideas on the project and any thoughts that they had on what we should do.


For the medics in the working group, having the support of the medical school throughout the project has been fantastic. It indicated to us that they felt strongly about changing the negative stigma surrounding mental health and people who suffer from mental health problems.



GPs and promo video

After talking to the medical school and our local GP tutors, we managed to get a slot during the GP study day to talk to local GPs about our project and invite them to our conference. GPs are usually the first point of contact for patients with mental health problems, and the care that a patient receives initially from their GP could be the difference between them accepting help or shying away from it further and suffering in silence.


Shortly after this we began to film our promo video in and around Newcastle for the run up to the Conference. We were surprised to see how many different students around campus and members of the public were keen to get involved with this!



The big day

After a sleepless night, our morning began early… 7am! Where we headed off to the Union with bags under our eyes and strong coffees in hand! We were so excited yet so nervous about how the day would run. There were a few last minute touches to be done to the venue and the strand sessions.


The conference began at 10am with an introduction from all the strand leaders and talks from the wonderful Dr Tom Brown (RCPsych) and journalist Emma Woolf. We had excellent feedback for our guest speakers and can’t thank them enough for coming along to help us with our first ever mental health conference! 


After these very interesting and mind-opening talks, it was time for our guests to explore other strand events. The Student’s Union was very busy and the atmosphere was amazing! We tried to lure our guests into our strand’s session by coming up with fun names for our sessions; (thanks to the café for fuelling us with inspirational ideas with its vast selection of cakes and tea).


The three sessions were ‘knowledge’, ‘reducing stigma’ and ‘wellbeing’. 'Knowledge' was based on a pub quiz (‘Pub Quiz with a Twist’) with questions that ranged from simple ‘true or false’ to ‘the history of psychiatry and mental health’. There were complementary mocktails for anyone who participated. We did role play and group talking session (‘Reducing the Gap’) as our ‘reducing stigma’ session where we asked people to pair up and pretend to be a doctor or a friend with a mental health problem. Lastly we did a meditation session (‘Alice in Wonderland’) with a local Buddhist meditation leader. This proved to be very popular! The room was scented with incense, and tea and cakes were offered for after the session.


There were also some fascinating and educational sessions from the other strands of the Conference with speakers from local charities and mental health sufferers. It was just such a shame that we and our volunteers didn’t have the opportunity to see each other’s’ sessions! 


We also had a ‘Sensory Room’ which was kitted out with things like fun house mirrors. This was a place where mental health sufferers tried to physically show what their mental health problem looks like to them. It was such an evocative way of exhibiting how we can feel.  We also had stalls from our local charities where people could go talk to some of the volunteers. An endless supply of tea, coffee and biscuits were supplied in the ‘relax area’. This allowed our guests to recharge.


One of the positive things about the event was the atmosphere which was both open and supportive. Our guests seemed so relaxed and everyone appeared to have been having a good time. We really didn’t want the day to end!



The Future

The success of the ‘Mind the Gap’ project last academic year and the amazing turnout at the Conference in May, has helped to establish ‘Mind the Gap’ into a society –  it’s here to stay!


We have combined all four strands from the project together so that we can work with and involve everyone in our projects and events. As a society we are here to promote knowledge and understanding of mental health and tackle the stigma that sounds mental health. There will be two overall strands to the society; general and medical.


As a society we will aim to work with local schools to build knowledge and understanding of mental health in our younger population.Events in the past have proven to be popular with schools, and they’re very exciting and enjoyable for us to do too! The medics in the society are also working hard alongside the medical school, our local GPs and mental health trusts to promote knowledge and understanding in professionals who work in healthcare. We are currently in talks with them about up and coming events. Watch this space!


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28/02/2014 15:14:10

Fantastic first year


Opened my eyes

Liana Romaniuk: Pathfinder Fellowships

The first year of the Pathfinder Fellowship has been fantastic: I’ve had many opportunities to increase my exposure to psychiatry and neuroscience, and pursue my own interests to greater depths.

The opening symposium of the Anne Rowling Regenerative Neurology Clinic opened my eyes to new ways of understanding and treating brain disorders.

The College’s own International Congress gave me a solid appreciation for psychiatry’s inspirational quality. While good progress is being made, there’s still so much more to be done, clinically and academically.


Superb elective

The fellowship also made it possible for me to go on a superb elective.

Here the stories people tell are startling; a window into the lives of others that were completely removed from my own experience.

I spent the first four weeks at Scotland’s maximum security psychiatric facility, The State Hospital, Carstairs. Here the stories people tell are startling; a window into the lives of others that were completely removed from my own experience. 

There was a strong sense of partnership between the medical and psychological approaches: one addressing the neurobiological basis of the illness through tailored medication, the other taking this improved neural foundation and building better awareness and coping strategies. Equally, social work tried to make sure the patient has a chance to put things into practice by securing a decent environment with some hope.

The second four weeks were spend conducting research at the Translational Neuromodeling Unit in Zürich, which was a wonderful experience, taught me a great deal, and will hopefully lead to a publication.

Finally, I attended the Oxford Psychiatry Autumn School, which gave me a chance to explore a deanery I’d be interested in applying to for my foundation training.


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16/01/2014 14:54:21

Applying for a Pathfinders Fellowship with a research project


Sleeping on the job

Alex Berry on applying for Pathfinders fellowships

I’m currently a final year student at Brighton and Sussex Medical School (BSMS), and have been interested in psychiatry since my second year of medical school. I have been involved with the medical student psychiatry society at BSMS, undertaken an intercalated BSc in neuroscience, and I spent my elective attached to psychiatry and neurology teams in India.


I’m interested in biological psychiatry and sleep medicine, and am currently trying to explore these areas further.


Don’t be afraid to admit possible shortcomings in your project design.

When I applied for the Pathfinder Fellowship, part of my application involved including a proposal for a research project I was hoping to undertake, which looked at poor sleep as a predictor for depressive disorder in patients receiving interferon-α-based treatment for chronic hepatitis C infection.


I used the funds from my Pathfinder Fellowship to present these results on a poster last summer.



Advice on applying

For anyone considering applying for a Pathfinder Fellowship with a research project, my advice would be:


  • Ensure you’re able to explain what you intend to do in your project clearly and concisely. I would recommend practising this, as whilst some concepts may be clear in your head, explaining them clearly to others is a skill.


  • Make sure that you have a clear idea about what it is you are investigating. This sounds obvious, but for some projects (particularly those involving lots of data) it can become confusing. If your project requires you to make a hypothesis about something, be clear on what your hypothesis is, and why you’ve decided on that particular hypothesis.


  • Be prepared to justify why you’ve decided to research the particular area that you’ve chosen.


  • Don’t be afraid to admit possible shortcomings in your project design.


  • Importantly, think about what you would use the Pathfinder funds for specifically.


  • Finally, remember that the Pathfinder Fellowship is meant to fund you, rather than just your project/elective, and try and enjoy the interview!   


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12/11/2013 10:59:19

So What Do You Want To Be?


Innocent question

So What Do You Want To Be?

‘So what kind of doctor do you want to be?’


It’s an innocent enough question and, after six years at medical school, one I have grown very familiar with. It can be applied to conversation with a medical student in any kind of social situation: friends and family over rarefied Christmas get-togethers; friends at university when the well of discussion pieces dries up; doctors of every speciality, peering at you with the ill-concealed desire that you want to follow their illustrious footsteps into their chosen speciality.


I have always disliked the inquiry because I have never had a good answer.


For the first five years or so, I would mumble that I didn’t really know, that I enjoyed every field of medicine I had tried so far, that I hadn’t had enough experience to make a decision yet.


But with the spectre of FPAS looming and the prospect of being a doctor becoming frighteningly real, this cop-out of an answer increasingly fails to impress. When I was younger, it showed openness and eagerness. Now it shows a lack of direction, and people follow my reply by listing the specialities, trying to find one that fits on the spot.


Thankfully, I was blessed with a very informative fifth year. Having had a series of attachments on a diverse range of specialities, for the first time, I can actually refine my tastes. I know that in specialities like obstetrics or orthopaedics, I would fit in as well as a mosquito at a malaria clinic. Conversely, I can see myself working in, and importantly, enjoying myself in other specialities.



Thought you wanted to be a real doctor

So now when I am asked what I want to be when I grow up, I can confidently claim that I like the cut of paediatrics’ jib. It appeals to the generalist in me and I enjoy working with children. When I explain this to people, they all nod and smile approvingly. Everybody likes a paediatrician. By whatever metric they use to judge me, taking care of sick children is a ‘good’ job. 


...every presentation of issues of mental health is as unique as the patients they affect. I like that...


However, I still dislike being asked the question because, even though my answer is honest, I feel like a fraud.


I do really like paediatrics but it comes second in my affection after psychiatry. While I find paediatrics interesting, I find psychiatry fascinating. Tenderness in the right iliac fossa can only prove novel so many times but every presentation of issues of mental health is as unique as the patients they affect. I like that, if I am able to help someone, my impact on them could be equivalent to treating meningitis. Psychiatry also offers a generalist approach in its holism.


But when I try and explain this to people, they nod curtly and the conversation wilts. Or they look at me askew and ask, ‘don’t you like medicine any more?’ or ‘I thought you wanted to be a real doctor?’


Trying to reach someone with suicidally deep depression or attempting to help a person with schizophrenia live a stable life is, to most people, a waste of my talents. Psychiatry is a bad job.



Myths and assumptions

Why is this speciality, under-appreciated and under-subscribed, so maligned? Is it because psychiatrists are considered by some to be agents of social control, policing the norms and enforcing rightspeak? Is it because they dole out powerful psychotropic medication (which is, at the same time, equally criticised, equally unjustly, as being no better than placebo) like candy for what is just a case of feeling a bit sad or a rowdy child with bad parenting?



We need to end the medical school cliché that psychiatry is a career for the crazy, eccentric and weird.


The Time to Change campaign aims to end the stigmatisation of issues of mental health, something I am so very keen on. Having witnessed the reality of mental health issues, both professionally and privately, the myths and assumptions I see stagger me. On the eve of my psychiatry attachment, my mum asked me if I was worried about catching schizophrenia from the patients. Yes, she thought it was contagious.


I think we need a parallel campaign to de-stigmatise psychiatry. We need to end the misinformation and hearsay that the likes of Giles Fraser and Ruby Wax replicate in the Guardian and on BBC Radio 4. We need to end the medical school cliché that psychiatry is a career for the crazy, eccentric and weird. We need to change things so that when asked what they want to do, a medical student can proudly reply, ‘Psychiatry.’


With the response, ‘Cool. Good for you.’



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14/10/2013 12:14:48

An elective in psychiatric research


Zurich study

An elective in psychiatric research

As I write, I’m just coming to the end of a seven-week elective spent in Zurich working with Professor Jules Angst. 


Professor Angst is an enormous figure in epidemiological and clinical psychiatry and has hundreds of prestigious publications, so it’s been very exciting to learn from him.


One particular contribution he has made to the field has been the celebrated Zurich Study. Whereas most prospective enquiries seem to last for about five years (or less) before funding dries up or people feel a point is proved and move onto something else, the Zurich Study has followed subjects up for three decades now – with fascinating results. 


When I came, I had the impression that the data collected were largely psychometric with a few demographic details, but in fact the scope is much larger than that, covering somatic symptoms, personality, family characteristics and coping resources, as well as diagnostic information. Numerous analyses have then arisen from these data, tackling questions as diverse as conversion from unipolar to bipolar depression and whether smoking is associated with mental illness.



Building a strong case

Most of the work I’ve been doing has focused on quality of life, an increasingly important metric in medical research. We were interested in how aspects of demographics, personality and somatic symptoms are associated quality of life. In particular, are the relationships any different in a group with high psychopathology compared to a more representative sample? 



The first lesson I’ve learnt from my stay here has been not to make your research or clinical interests too narrow, especially when you’re starting out...


I’ve also had the chance to get involved with some work on suicidality and learn a bit about postpartum psychiatric disorders, so it’s been quite varied.



Enjoy the process

The first lesson I’ve learnt from my stay here has been not to make your research or clinical interests too narrow, especially when you’re starting out: you don’t know how the scientific landscape is going to change, so don’t put all your eggs in one basket. 



Finally, it’s been really instructive to see someone who is still humble in accepting other people’s ideas, despite his own vast experience.


Also, when looking at research findings, don’t just focus narrowly on p-values: examine effect sizes and evaluate whether there is anything interesting happening. 


Finally, it’s been really instructive to see someone who is still humble in accepting other people’s ideas, despite his own vast experience.


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19/08/2013 11:19:15

Process of Applying


The application - drawing on experience

New online resource to help people return to work after mental illness

When I was emailed the advert about the Pathfinder Fellowship from our undergraduate psychiatry course administrator I decided to apply for it although I did not think I would stand a chance of getting it. 


The elective bursary was an attraction but I had already set plans I was excited about which were located in the UK and so money was not my biggest concern. I was more interested in the mentorship scheme on offer and that the fellowship sounded like it would be brilliant in helping me achieve my goal of specialising in psychiatry. 


Although I had only recently decided that psychiatry was the career for me, I felt I had some experience I could draw upon to put into my CV. I felt one of the biggest strengths I could offer was that I had taken a year out doing a BMedSci degree which I had chosen to do in the field of psychiatry, specifically looking at auditory hallucinations in the healthy population. From this I was also able to attend the international congress in Liverpool to present a poster on my study which had stimulated my interest in psychiatry further.



Good links with the psychiatry clinical lead

My advice when writing your CV for the application would be to just consider any experience you have had that has been related to psychiatry. Hopefully you would have done your psychiatry rotation by the time you apply so at the very least you have some experience to dwell upon there. 


I would also suggest that your elective plans should be psychiatry related, but then if you want to become a pathfinder I would expect that that is what you would choose to do anyway. If you have time it may be also worth contacting the psychiatry lead at your university and asking for any additional experience or if there is any research they are doing you could get involved in.  Even if these are for future plans by the time you apply, it will all look good and show your interest in psychiatry and your willingness to go above and beyond your colleagues; and will help your future career as well. To be honest, I would recommend anyone who is interested in psychiatry to get in touch and make good links with the psychiatry clinical lead at their university. I find psychiatrists are often very happy to hear from and help out any student interested in their specialty who is willing to get some further experience. 


In addition make sure to include on your CV any of your other achievements during medical school; academic and non-academic, for example, if you are in any societies showing leadership or teamwork etc as this all shows you are a well-rounded person which is essential to becoming a balanced doctor.



The interview - relax

When it comes to the interview just try and relax as much as possible. The interviewers are not there to scare or intimidate you but want to see what you are like and your motivation for psychiatry. 


For preparation my advice would be to have a think about answers to the obvious questions you may be asked, for example, what it is about psychiatry that interests you, why you’ve chosen to do what you have for your elective/research plans and what it was about your previous psychiatry experiences you enjoyed (and what you didn’t enjoy about them). They are also likely to be keen to hear about your views on what could be done to stimulate interest in psychiatry amongst medical students and why many students are put off going into the specialty, and also about how you think we could reduce the stigma of mental health illness amongst the general population. Apart from that maybe have a read of some current psychiatric research/issues you are particularly interested in. 



It is not often you have the chance to talk to fellow students who are as interested in psychiatry as you are...


On the day on the interview its worth getting there a bit before you are due to go in so you can relax after the stressful London commute and it is also nice to have the opportunity to speak to some of the other applicants waiting. It is not often you have the chance to talk to fellow students who are as interested in psychiatry as you are and it is good to hear about others’ experience and future plans.



Why it's worth applying?

If you are thinking psychiatry is the field for you then I would whole heartedly recommend applying to become a Pathfinder Fellow. I am loving it and already finding it very useful. 


As I said at the start, I applied thinking I did not stand a chance of getting it, but in medicine you have to go for what you want - you may surprise yourself. At the very least it is an opportunity to see the Royal College, meet some like-minded students and eminent psychiatrists, and practise being interviewed; and if you do get awarded one of the fellowships you will have a wealth of opportunities opened up to you. 


If you have any questions then please do not hesitate to get in touch with me. Good luck to you all!



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05/08/2013 14:56:11

Becoming a Pathfinder Fellow


Too good to refuse

RCPsych Informatics Committee: survey

I decided to apply for a Pathfinder Fellowship because I was interested in Psychiatry and liked what the opportunity offered:


  • elective funding,
  • free journals
  • the potential to meet like-minded people. 

I started thinking about my application about a month before the deadline, but ideally it’s probably best to give it some consideration as soon as possible, so you can try to get any additional experiences that might be helpful.



Building a strong case

Essentially, I was trying to prove two things: firstly, that I was interested in Psychiatry and, secondly, that I was a good medical student. When putting together your CV and cover letter, it’s worth brain-storming everything you’ve ever done that might be relevant – from school onwards. 



Look through your application again, because you’ll be asked about what you’ve written.

In terms of your academic profile, think of any special study modules or SSCs you may have done that are related to Neuroscience, Psychology or Psychiatry. Consider any areas of your course that have particularly interested you and ask why that was. If you’ve won any prizes or earned special recognition for some piece of work, it’s worth mentioning. 


Outside of your course, think about extra-curricular activities where you’ve displayed leadership, imagination or drive. If you’ve been to any conferences, consider how they have informed your thinking and your practice.  When you’re putting all of this together, try to form it into some coherent structure, grouping activities by category and showing that they have a particular purpose and importance.



Enjoy the process

If you’re offered an interview, enjoy it!  You’ll be talking with people who are just as interested in Psychiatry as you – they just know a bit more.’s worth brain-storming everything you’ve ever done that might be relevant – from school onwards.

Look through your application again, because you’ll be asked about what you’ve written. Make sure you can concisely explain any research or publications you’ve undertaken in an enthusiastic but coherent way.  It’s worth asking a supervisor or friend if they can do a practice run with you as well. 


It’s a good idea to keep up-to-date with any Psychiatry issues that may have arisen recently in the media and reading a few articles in good journals in the weeks before the interview is helpful.


If you have any questions, feel free to get in touch at Good luck!



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10/07/2013 16:15:50

5 Children, 2 Husbands, 2 Dogs & 1 Fantastic Job


Not following the traditional approach

5 Children, 2 Husbands, 2 Dogs & 1 Fantastic Job

So the title is somewhat misleading; sorry to disappoint but please read no further if you were hoping for an intriguing insight into the life of a polygamist!


We are in-fact, two higher trainees in Intellectual Disability Psychiatry and we have had the privilege of job-sharing for the past 5 years.


Fortunately there are lots of opportunities to work ‘differently’ within medicine these days. Be it working reduced sessions, slot-sharing, less than full-time supernumerary posts, availing of career breaks – there are options!


People have a variety of reasons for seeking a shift from traditional working patterns; including disability, ill-health, responsibility for caring for young children or responsibility for caring for ill/disabled partner, relative or other dependant. Other reasons can include, for example; those who have unique opportunities for personal/professional development (e.g. national/international sporting events), religious training commitments, or non-medical professional development such as management courses, law courses, fine arts courses etc. (NIMDTA, 2013).



Why do we do it?

For us it was a personal choice because of decisions we have made mainly around childcare options, which were necessary because of needs specific to each of our families.  


We are highly motivated trainees, passionate about our specialty and focussed on our career aspirations. We are also busy mums to small children with significant childcare commitments.


However, we feel strongly that our greatest asset was actually the shared investment to make this arrangement work.

Like many in our situation we also hold the lofty leadership role of home-manager where we get to be our own boss in co-ordinating the posts of chief dog-walker, dinner-maker, homework facilitator, house-worker, laundry lady, school runner and bed-time officer. We should add that all of the afore-mentioned would also fall apart in the absence of two equally hard-working and perhaps exceptionally patient husbands.



How did we do it?

In the beginning all we had was an earnest desire to make a success of the chance to work as a slot-share. We had both previously had experience of working full-time and working less than full-time in full-time posts.


For us personally, neither had enabled us to give 100 % to both our occupational  & our family commitments. We wanted to strike a balance that would afford us the ability to be both the dedicated doctors we have worked so hard to become while also allowing us to fulfil to our satisfaction our very important functions within our family and home lives.



How did we start?

We knew each other before we commenced the job-share and we are in no doubt that this was a help.


However, we feel strongly that our greatest asset was actually the shared investment to make this arrangement work. It was fairly straightforward – we were being handed an opportunity. We could both get on board and commit to making it successful in every sphere of our working lives so that the arrangement would be sustainable and enable us the security of knowing that we could continue working less than full time for as long as was necessary……..or we could risk losing the opportunity of a long-term fantastic working schedule and therefore work-life balance.


What makes it work?

We figure that at this stage we are probably very alike in terms of our clinical practice and colleagues would support this. We suppose this is not surprising as we have come though much of our training at the same time, attended many of the same courses etc. 


Overall, in keeping with the social science literature, we imagine that we work well together more because of similarity than complementarity.  That said, over time we have learned each others’ fortes and this comes in useful in allocating tasks, particularly within our non-clinical workload.



How does it work practically?

For most of our higher training we have each worked 6 sessions (3 full days) per week amounting to 1.2 whole time equivalent. The 0.2 is funded by our local deanery. We understand that the slot-share option is much preferred by them as they can then fund a much higher number of trainees to work less than full time than, for example in supernumerary posts.


We typically overlap on one session per week (often when there are academic activities which we can both benefit from) and use this time to catch-up with each other on clinical work, hand-over anything that is necessary and keep on top of tasks for our special interest and research activities.


We sincerely hope that in the future we may have the option to apply for a substantive post in a job-share capacity

On commencing each new training post we have generally met with the supervising consultant in advance to talk through the weekly duties and timetable and then organised between ourselves how we think we could then divide the week. We would then seek agreement from the consultant.


In most cases it has been very straightforward. On a couple of occasions we have modified our timetables slightly a month or two in order to even up either our work-loads or our clinical experience.


We have been involved with public education through our local college division for a number of years and have worked with colleagues on a number of projects with school children that have expanded and been used to develop similar models in other parts of the UK. We are both co-ordinators of a psychiatry student selected component at our local medical school and we share a variety of other teaching roles with both undergraduate and post-graduate students.


We were delighted by the central college’s decision to appoint us as a job-share to the role of Student associate Editors.



What does the future hold?

We are currently acting-up in a consultant post, each covering 0.5 WTE. This has been a great opportunity to translate our experiences to date into the consultant role. We sincerely hope that in the future we may have the option to apply for a substantive post in a job-share capacity.


Our experience has ben incredibly positive. We feel that the job-share has enhanced our ability to thrive in our clinical training and enabled us to attain vastly more than we could have done individually in our special interest work.


If like us, you’re not a person that does things by halves – perhaps something less than a full job could be just what the doctor ordered!



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06/06/2013 12:31:20

What I Wish I’d Known As A Medical Student


Work it out

What I Wish I’d Known As A Medical Student

We are taught a whole system of treating patients: diagnosing, giving interventions such as medication, our assumptions of the primacy of our opinions and status in all situations. We aren’t taught critical thinking to properly evaluate the strengths and weakness of our ways of doing things.


Obviously our medical system is tremendously successful at helping people. However it does rest on certain assumptions that we are not trained to evaluate or recognise. This means we often react defensively when people challenge these assumptions. What we should be doing instead is to understand our system properly.



It gave me a much better understanding of how difficult it was for them to change their lifestyles to improve their health outcomes (as well as seeing someone’s Elvis tribute shed).

So how do we understand our system properly?  You can study others’ opinions but they often tend to be written by people who only understand a bit but convince themselves the bit they know explains the whole.


The best way is to read a bit of philosophy and then try and work it out yourself.



Degrees of separation

Another shortcoming is that we separate the illness from the person (for good reason I know) in order to better use our scientific medical knowledge. I remember seeing heart attack patients in their own homes as part of research I was doing. It gave me a much better understanding of how difficult it was for them to change their lifestyles to improve their health outcomes (as well as seeing someone’s Elvis tribute shed). was a fresh amazing thing to talk to patients and our lack of perfectly practised medical histories meant that we got more information and related better.

As our scientific medical abilities progress we seem to be losing touch with the powerful but static human healing qualities of medicine. “Der Arzt hilft” (the Doctor helps) said the poster of my German colleague.


Patients want us to help them and sometimes that involves being interested in them as a person and putting their goals first rather than abstract disease management. As medical students I think we had these qualities, it was a fresh amazing thing to talk to patients and our lack of perfectly practised medical histories meant that we got more information and related better.


I wish I’d known as a medical student that the “art of medicine” skills that I had were as good as they would get and that was what patient’s appreciated. The scientific knowledge could be acquired but the skills needed constant practise.



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06/06/2013 10:48:33

The Power of Emotional Intelligence


Wish list

The power of emotional intelligence

It was a strange experience being a medical student who already knew that psychiatry was the only career on my wish list. I was also lucky enough to have studied at a medical school where psychiatry was respected and which produced more than the typical 4% of students who went on to be part of this stimulating discipline. 


Having said that, there is much that I would like to have been told when I look back on the days where I was enthralled by the challenge of eliciting psychopathology, making a diagnosis and learning that there is much that can be done to improve mental health and reduce mental suffering.



Only 20%

Writing this after 15 years as a consultant, I honestly believe that only about 20% of the skills that are taught in medical school equipped me for the rigours of being a consultant psychiatrist.


During my first week, echoes of my first consultant during my training telling me, "things will be very different when the case notes have your name on the front", rang in my ears. My first reaction was ‘help!’ Like most jobs, a lot of what you learn will be on the job, but there are certain things that I wish that I had known at an earlier stage.



Mental stamina

Psychiatry is not just about ‘chatting to people’. It is both an art and a science and any budding psychiatrists out there need to know that it takes immense mental stamina to use your knowledge and to communicate this in a form that engages the patient, generates a therapeutic relationship and uses all your powers of deduction to make a diagnosis and plan treatment. 


I remember a consultant surgeon once telling me that managing situations effectively means having to deal with ambiguity and also knowing when not to say anything.

Just remember that it takes incredible resolve and resilience to have the energy and enthusiasm to carry out an assessment that may last over an hour after being woken up in the early hours of the morning, only to face a hostile patient who is restless, irritable, disinhibited or aggressive. You need tact, patience and the clinical encounter will demand your full concentration.


Probably the most important skill to have (which I really wish someone had told me about) is emotional intelligence. I remember a consultant surgeon once telling me that managing situations effectively means having to deal with ambiguity and also knowing when not to say anything. I have been a consultant for long enough now to know that a considerable proportion of being an effective psychiatrist is being to lead and manage your team. You will almost certainly find all the defence mechanisms that you learn about in medical school in full flow within teams in which you will work. It is up to you to have the knowledge, skills, attitudes and emotional intelligence to manage complex situations.



A voyage of discovery

Now to rewind the clock, back to my psychiatry firm. I would really like to have been told more:


  • about leadership and its different styles;
  • about how to deal with complex encounters involving  both patients and relatives;
  • about the importance of seeking support from peers and seniors (doctors are only human, no matter how we think that we can do it alone)
  • and learning from serious untoward incidents.


Above all, I wish I had known that it is alright to feel uncertain and apprehensive in the face of situations that are unpredictable, knowing also that you working in a world where there are few people who are going to pat you on the back or give you wine and chocolates for the time that you invest in carrying out your everyday work to a high standard.


...there are few people who are going to pat you on the back or give you wine and chocolates for the time that you invest in carrying out your everyday work to a high standard.

Psychiatry is still an expanding field where the world is your oyster. Never a minute has gone by when I have regretted it as a career choice. I just wish that I could have been better prepared for developing myself as ‘whole person’ before embarking on my chosen career path, in being able to think, reflect, learn and develop from clinical experience with both patients and colleagues.


It would have been even more fulfilling than it already has been and voyage of discovery rather than one of uncertainty.


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