COVID-19: guidance for UK psychiatric trainees 

Explore our most up to date guidance and information for trainees during the COVID-19 pandemic. 

A message from College Dean Dr Kate Lovett:

Thank you for all you are doing to support patients during the COVID-19 coronavirus pandemic. It will be a deeply challenging time not only personally but for our colleagues, our healthcare systems and patients.  In what is a rapidly evolving situation, your skills of sophisticated team working, managing complexity and uncertainty will be highly valued across the system. Thank you in advance for your ongoing leadership to make a difference to the lives of patients. 

I wanted to reassure you that I am working closely with the Psychiatric Trainees’ Committee (PTC) and Heads of School as the situation develops as well as bodies including the Academy of Medical Royal Colleges, GMC and NHS bodies. The College team have pulled together a range of information and links so that you can access these easily and quickly via the website. These will be updated regularly and we plan to add a series of frequently asked questions (FAQs) as more queries arise. 

Please contact us through your PTC Regional Representatives, directly to us via email ptcsupport@rcpsych.ac.uk or via twitter @RCPsychTrainees (please note this is only generally monitored 9am-5pm weekdays).  You should also seek guidance through your local deanery/health board and via your Trust Postgraduate Medical Education Officer and Director of Medical Education. 

There will be many questions over the forthcoming weeks as well as the developing of new knowledge, skills and solutions. I am very proud of each and every one of you.  As your Dean I will make every effort to make sure you are kept informed and that your training and progression is not compromised as a result of the current pandemic.  

Please do contact us if you have any queries.

Dr Kate Lovett

College Dean

Guidance and updates for trainees

We understand that during these challenging times, you may feel more overwhelmed and stressed than usual. We are here to support you and are in the process of expanding our Psychiatrists Support Service (PSS). The PSS provides free, rapid, high quality peer support by telephone to psychiatrists of all grades who may be experiencing personal or work-related difficulties.  Please email PSS@rcpsych.ac.uk if you have any queries.

Due to the National Emergency resulting from the Covid -19 pandemic there have been temporary changes to the national recruitment process, which is led by HEE North West for England, Scotland & Wales and NIMDTA for Northern Ireland.  

The information regarding the changes to the process can be found here

Trainees are requested to discuss any concerns about their personal situation arising from these changes with their educational supervisor or their  training programme director via their local deanery who will be able to advise on individual circumstances. Please refer to all the available information on the relevant psychiatry recruitment sites (England, Wales and Scotland and Northern Ireland ).

 

A letter from the Chief Examiner, Dr Ian Hall

Many thanks to all the candidates who have got in touch with us about the CASC exam this September. It is really gratifying to hear how much the College’s efforts to deliver a clinical exam during the pandemic are appreciated. We are pleased to say that nearly 98% of candidates managed to complete the examination. We are very glad that this will allow the trainees who pass to progress in their careers.

We piloted our new systems thoroughly and extensively, but nevertheless some candidates experienced technical issues and consequent delays. We acknowledge that this was a very stressful experience for everyone involved in using the new system, but particularly for candidates taking the examination.

We would like to reassure candidates that the stations were standardised with the examiners and role players on the day of the exam for the video consultation format. In addition, the examiners collectively set the pass mark (using borderline regression) taking into account the video consultation format. It does of course remain the case that to pass the examination, candidates must achieve the passing standard, as agreed with the General Medical Council.

We were also as usual able to implement reasonable adjustments for candidates with specific conditions such as dyslexia, or for people who were pregnant.

Implementing new systems is an iterative process and feedback from all stakeholders, particularly candidates is integral to this. We are very grateful for all specific feedback we have received and we are already using this to improve our systems so that we continue to improve on the experience for candidates, role players, examiners and invigilators in forthcoming diets.

There were no significant differences in the pass rates on different days of the examination.

The pass rate for the exam was 67.7%, an improvement on previous years and we are immensely grateful to candidates for embracing the new system during the pandemic. 

Dr Ian Hall

Chief Examiner

 

 

In response to the Guidance from COPMeD and the Gold Guide Derogation the College has written a companion document for trainees and trainers to guide the ARCP during COVID-19.

ARCP Decision Aid (PDF)

Video guide for Psychiatry ARCPs in Summer 2020

The above guidance is subject to GMC approval.

Appendix B: Reflective Report (COVID-19) - Training Example (PDF)

We recognise it is currently very challenging to meet all the requirements of the curricula to ensure trainee progression. Many educators continue to review how education and teaching can be delivered more flexibly and virtual, for example via e-learning or virtual BALINT groups. 

The Academy of Medical Royal Colleges has set up a specific web page for COVID-19 related announcement where there is information regarding management of ARCPs, management of rotations and exams.

Health Education England also have specific information and guidance on their website for trainees as do the General Medical Council.

The GMC have extended the deadline for the submission of curricula and we have updated our information about the curricula review.

Other resources

Due to the current situation with COVID-19, the College has made the difficult decision to cancel or postpone many events. Read the full list of effected events. 

We hope to hold the Trainees’ Conference on the 2 and 3 September 2020 following advice on COVID-19.

We appreciate as we face the COVID-19 coronavirus pandemic that work place based assessments are unlikely to be able to be prioritised by trainees and trainers in demanding clinical situations where patient care is needing to take precedence.

During the COVID-19 Pandemic we strongly encourage trainees to continue to reflect on these new experiences as well as connect with peers through virtual Balint groups where possible. Supervision during these times remains very important. However, it is likely trainees will find it difficult to fulfil normal WPBA requirements. Trainees should be reassured that they will not be disadvantaged at ARCP if they cannot complete all the WPBAs usually expected.

We understand that updating educational portfolios may not be easy or straightforward due to clinical pressures brought about by the COVID-19 pandemic. Some trainees may find it helpful to capture actions and work they have done to support the COVID response. However trainees’ progression in training will not be disadvantaged as a result of the impact of the pandemic and ARCP panels have been instructed to take the impact of the evolving situation this into account.

We recognise that this is a very anxious time for all and that keeping up with psychotherapy training requirements may feel like an additional burden for trainees at a time when they may be having to cope with looking after very unwell patients, as well as themselves and their families in a time of great uncertainty.

The following guidance has been drawn up in collaboration with the RCPsych Specialist Advisory Committee to provide some clarity and guidance to core psychiatry trainees, their clinical and educational supervisors, psychotherapy tutors, training programme directors, Directors of Medical Education and Heads of Schools.

Heads of Schools are fully aware of the current difficulties and are committed to ensuring that no trainee who was on track to meet their psychotherapy competencies prior to the outbreak of the Covid19 pandemic in the UK in March 2020 will be held back from progression at ARCP.

We recommend that Psychotherapy Tutors are fully consulted on this aspect of training by educational supervisors and Training Programme Directors in order to make pragmatic and considered recommendations to ARCP panels.

Where a trainee has not completed a case they had already started but would otherwise have been on track to complete all psychotherapy competencies we recommend that they are awarded an outcome 10.1 if they are otherwise considered to have met all CT3 competencies. A comment should be made on the ARCP form to this reflect this.

Trainees who are in this situation and subsequently entering ST4 will be given the opportunity to undertake further psychotherapy training to ensure they have gained sufficient psychotherapy experience as recommended by the current curricula during the course of their training. We recommend that this is reviewed at their first ARCP during ST4.

In some situations it may be possible to continue working psychotherapeutically with patients where trainees have already started. In the situation where a trainee has already started working with a long or short term psychotherapy patient who has engaged in their psychotherapy this may be continued by phone or other suitable confidential video streaming platform where possible. Arrangements for this must be discussed and agreed with the clinical supervisor for the patient and have the agreement of the psychotherapy tutor.

The supervisor or psychotherapy tutor will be required to support the trainee in making adjustments to working over the phone or digitally and supervise adjusting clinically to the platform and also considering the governance as well as safeguarding aspects for both the patient and themselves.

The Medical Psychotherapy SAC will be circulating further written guidance about remote working with patients in due course.

Supervision is an essential part of psychotherapy training and this should be provided by phone or via digital video meetings including using digital group meetings e.g. using Zoom, Microsoft Teams or other suitable platforms provider by the local educational provider.

Where trainees have not yet started psychotherapy with a patient but were about to this should be postponed in discussion with the psychotherapy supervisor and psychotherapy tutor.

It is more important than ever during this time of great strain on communities and NHS services, that trainees continue to have the opportunity to discuss the emotional impact of their work and are able to explore all aspects of this in a safe and contained setting using group video streaming platforms to host Balint groups and Case Based Discussions. Directors of Medical Education and trainees are asked to prioritise this aspect of their training and make every effort to ensure that it continues to be supported by local educational providers.

So to summarise:

  • Where a trainee has not completed a case they had already started but would otherwise have been on track to complete all psychotherapy competencies we recommend that they are awarded an outcome 6 where all other core competencies are considered to have been met.
  • In the situation where a trainee has already started working with a long or short term psychotherapy patient who has engaged in their psychotherapy this should be continued by phone or other suitable confidential video streaming platform where possible.
  • Supervision is an essential part of psychotherapy training and this should be provided by phone or via digital video meetings.
  • It is more important than ever that trainees continue to have the opportunity to discuss the emotional impact of their work and are able to explore all aspects of this in a safe and contained setting using group video streaming platforms to host Balint groups and Case Based Discussions wherever possible

We understand that for some higher Forensic trainees that the response to COVID-19 has resulted in the cancellation of attachments to secure units. We want to assure you that the lack of a secure unit placement will not delay a CCT. A secure placement is not an explicit requirement of the curriculum. Trainees should be able to demonstrate that they are able to demonstrate curriculum competencies of assessing patients in high security, that they can refer patients to high security from medium secure care or from prison, and that they have the necessary knowledge about the different levels of security, in terms of physical, procedural and relational security, to be able to effectively manage a patient’s care pathway. Supervisors reports, CBDs and other WPBAs, and reflective notes can all be used to evidence this.

Please refer to HEE guidance for Management of Less Than Full Time Trainees to assist trainees and trainers in the changing workforce. 

Don't forget to visit the College's e-Learning Hub which includes a selection of RCPsych CPD Online modules/podcasts, webinars and external resources, which are currently free to access. 

The RCPsych curriculum allows for higher trainees (ST4-6) to undertake 1 day per week (pro-rata for LTFT trainees) as special interest or research sessions. During the initial stages of the COVID-19 in some places these were suspended where there was a need for redeployment or pressing service delivery. As the situation changes we would expect these sessions to be negotiated locally according to local service need and geographical challenges. It is likely that wherever possible these will be reintroduced as soon as practically possible to support trainees meeting the curriculum requirements.

A recording of the first of the Training Matters Webinars is available online, including the responses to the Q & A session.

Check here for upcoming webinars you may be interested in.

The national training survey is now live.

The 2020 national training survey is open between 22 July and 12 August. Doctors in training and their trainers can take part. This year's survey includes questions on how the coronavirus (COVID-19) pandemic has affected working experiences, training and wellbeing.

Take part in the survey now