How to become a psychiatrist: A guide for A-Level and GCSE students

Psychiatry is a medical specialty dealing with people with a huge range of mental health conditions. As a psychiatrist, you’ll help people to manage, treat or recover from them.

As a psychiatrist, you will have a real opportunity to change people’s lives for the better. You will be at the forefront of treating people’s mental health, drawing on a combination of your scientific knowledge, medical expertise and interpersonal skills. Psychiatry offers flexibility, career progression and the ability to shape a career pathway around a wide variety of other interests. You can work anywhere in the world in a range of settings, from hospitals to people’s homes.

Psychiatrists face new and interesting challenges every day but are well supported by their medical colleagues and mental health teams. You are always learning as a psychiatrist and there is still much of the brain that is undiscovered and unexplored. This means there is scope to conduct cutting-edge research and to develop and devise treatments and therapies.

To become a psychiatrist you must first study medicine and then choose psychiatry as your specialist field. 

The standard training path into a senior psychiatry post is as follows

• 4-6 years in medical school
• 2 years foundation training
• 3 years core training
• 3 years higher training
• senior post.
  

Standard entry into medical school is entry directly from A-Levels. You’ll need at least three good A-Levels, including one or more science subjects (chemistry is required for most medical schools).

It’s common knowledge that medical training can cost a lot of money. However, this doesn’t mean that you need to be rich to start a career in psychiatry. There are a number of organisations which offer loans and grants to help you pay your way:

1. Student Finance Wales: This is a really useful website and gives details of what support you can apply for, how much financial support is available and how and when you’ll repay your student loan.
2. The Student Loans Company is the organisation that pays loans and grants to students.
3. The Money4MedStudents site is pretty good and gives specific information on finance for medical students.
4. BMA Cymru Wales periodically publishes a Finance Guide for Welsh Domiciled Students. It gives quite detailed financial guidance for Welsh students studying medicine and provides links to further information. It’s well worth a look.
5. Student Finance: medical degrees are usually longer than degrees undertaken by other students and because of this, the funding arrangements normally change after the first three years. You will need to apply for an NHS Bursary. 

1. Gain work experience: When applying to study medicine it is advisable to have some experience in working in a related field. This shows your interest and dedication. Saying that, this doesn’t mean that you need to have experience in a doctor’s surgery or hospital, taking on a caring role for a family member or friend can also count as experience, as can volunteering in a care setting.
2. Visit universities: Going to look at different universities will give you a better idea of what it’s like to live and study there. This will help you to decide whether you’d like a campus or a city university, as well as finding out more about the course’s structure.
3. Join clubs and societies: It’s always a positive to show that you have extracurricular interests, this shows that you are a well-rounded individual. Joining a sports club, doing volunteering, or being a part of a society are all great ways to show off your interests.
4. Have an insurance choice: On the off chance that you don’t get into medical school, having a different degree as your fifth choice is good insurance. Choosing a medicine-related degree, such as biomedical sciences, means that you still have the option of joining a graduate entry medical course.
5. Look at the course requirements: Different universities have different course and entry requirements. Familiarise yourself with these so that you can ensure you meet the criteria. 

Some medical schools require you to do an admission test so you may need to sit either the UKCAT and/or BMAT.

A common myth is that 'you can’t revise for the UKCAT/BMAT'. This really couldn’t be further from the truth - with knowledge of the test, some useful time-saving techniques, and plenty of practice, you can dramatically boost your score.

Once you’ve practised and know how to answer the questions, the clock is your biggest enemy. This seemingly obvious statement has one very important consequence. The way to improve your UKCAT + BMAT scores is to improve your speed. There’s no magic bullet, but there are a great number of techniques that, with practice, will give you significant time gains, allowing you to answer more questions and score more marks.

it is usually best to pace yourself very steadily, aiming to spend the same amount of time on each question and finish the final question in a section just as time runs out.

Those who prepare more thoroughly do better on these tests. Use every resource available to you, such as BMAT past papers, courses, and textbooks. Although these tests are designed to be difficult, they are by no means impossible to pass.

Interviews are a university’s opportunity to see how you perform under pressure and whether you display the skills required to succeed at medical school, and ultimately practice as a doctor.

These could include communication skills, honesty, empathy, problem-solving, reasoning and listening skills. They are also an opportunity for the panel to gauge your knowledge about medicine as a career, topical issues and what motivates you to want to become a doctor in the first place.

You may want to consider the following questions:

• Who are you and what you are doing now? Don’t assume they have your UCAS form in front of them. Sometimes they don’t. Assume they know nothing but your name.
• Why do you want to be a doctor/how did you come to your decision to be a doctor?
• What you have done to find out if medicine is the right career for you?
• What did you learn during your work experience?
• What aspects of the course/university particularly appeal to you?
• Do you have a realistic understanding of what a career in medicine involves?
• What are your other interests/are you an active participant in school/university life?
• Do you have good communication/interpersonal skills and enjoy working with people?
• Can you demonstrate an active interest in health and medical news stories and talk about what you have read/ heard/seen recently?

 

Some medical schools offer medicine with a preliminary year. This course is designed for students who achieved highly in their A-Levels but do not have the subjects required for entry directly into the course.

If you didn’t gain the grades to enter straight into medicine there is always the option of graduate-level entry to medical school. Courses such as a medical science BSc can allow you to gain solid grounding and experience in a related field. It may add time onto an already lengthy medical degree however completing a related degree can get you used to the demands of medical school. 

You don’t have to be a psychiatrist to work in mental health. If you decide that a medical degree isn’t for you, these resources can help you find an alternate path into mental health:

• NHS Health Careers
• British Psychological Society
• United Kingdom Council for Psychotherapy
• British Association for Behavioural and Cognitive Psychotherapies

Child and adolescent psychiatrists focus on improving the mental wellbeing of young people and their families by thinking about their illness in the context of their social and environmental settings. They may see children in inpatient settings, on wards, as well as arranging consultations with children in school too.

Our child and adolescent psychiatrists are passionate about young people’s mental health and often work with us on initiatives that extend beyond the clinical setting to improve the ability of schools to improve the mental wellbeing of young people.  

Many eating disorders psychiatrists are also child and adolescent psychiatrists because these disorders usually begin in adolescence. This also means you might often work with young people’s families, too. Physical complications and other psychological difficulties are common comorbidities of eating disorders, and these psychiatrists need to safely assess and manage medical risk. It is said to be a massively rewarding discipline and one that allows continued learning.  

Forensic psychiatrists specialise in the care and treatment of mentally disordered offenders and have a detailed knowledge of relevant law and the criminal justice system. Forensic psychiatrists visit prisons and offer expert advice on the wellbeing of inmates. They sometimes offer advice to criminal trials as to the mental wellbeing of an offender or might be asked to assist coroners in determining a cause of death.  

Genera adult psychiatrists treat working-age patients with severe and enduring chronic mental illness across a broad spectrum. Working in general adult psychiatry is varied but with lots of opportunity to specialise further. It is the largest specialism in psychiatry and is a rapidly developing subject with lots of opportunity for personal development.  

Rehabilitation psychiatrists work with people with long term mental health problems to help them improve the quality of their lives rather than just treat symptoms. They focus on promoting integration and reintegration into communities, and helping people where possible, to build their independence.  

Addictions psychiatrists help people to manage, stop or reduce their reliance on harmful substance and then maintain a healthier lifestyle. This means that as an addictions psychiatrist you would also have a good knowledge of physical health issues along with both psychological and physical treatment approaches. Addictions psychiatrists work with individuals, courts, probation services and social and children’s services. 

Perinatal psychiatrists treat new parents and look after new-born babies, supporting partners and families to develop healthy relationships between parents and children. They work out of Mother and Baby Units and with specialist community mental health teams.  

Learning disability psychiatrists work with people with learning disabilities, who are much more likely than the general population to experience mental health conditions. These psychiatrists not only treat severe mental illness but also neurodevelopmental disorders, Autism Spectrum Disorder and anxiety disorders. 

Old age psychiatrists work with patients who have mental disorders and illnesses that are more common with old age, but they may still see people with early-onset dementia, for example. Old age psychiatry is also about the complex interplay between the physical, psychiatric and social problems that often occur with older age. It’s a collaborative profession that requires psychiatrists to think and work holistically.  

This discipline transcends all others and is all about the relationship with the patient and learning more about their illness through talking therapies. We don’t have many medical psychotherapists in Wales, but its an incredibly important and emerging field. There are many types of psychotherapies and medical psychotherapists are likely to specialise in just one of these.  

In Wales, our academic psychiatrists are operating in totally new territories making discoveries which are changing the way we think about the world. There are lots of different areas of academic research in psychiatry from social psychiatry which looks at how people’s environments determine their mental health, to neuropsychiatric genetics which considers how genetics determines mental illness. It is without a doubt one of the most challenging but rewarding disciplines within psychiatry that also comes with a lot of freedom to pursue your own interests.  

If you were to present in A&E with a mental illness, you might be treated by a liaison psychiatrist. Likewise, if you’re in hospital for any physical health reason and your mental health deteriorates because of it, you may see a liaison psychiatrist. This field is complex, and every day brings a new challenge. You’re not just a doctor but a teacher, helping doctors of other specialisms to understand the mental health comorbidities of the illnesses they treat.  

Neuropsychiatry sounds technical, but its about treating cases that originate from a brain malfunction. If you’re ever seen those beautifully colourful images of brain scans (or some of those black and white ones) and wondered what they mean, you could find out if you became a neuropsychiatrist.  

Patients will always need good doctors. Good doctors make the care of their patients their first concern: they are competent, keep their knowledge and skills up to date, establish and maintain good relationships with patients and colleagues, are honest and trustworthy and act with integrity. 

Good psychiatrists aspire to deliver leadership, accountability and manage complexity. They demonstrate resilience in adversity and maintain a constant drive for quality in mental health services for the benefit of patients.  

A career in psychiatry is full of opportunity for development and is hugely rewarding. Psychiatrists are always learning. In medical school, you will learn to develop the clinical skills and professional attitudes you need to help and treat patients. 

Moving into two years of foundation training, you will rotate between a number of other disciplines including psychiatry. Once you have completed your foundation training, you have to apply to do your core training in psychiatry in order to specialize in psychiatry. At this stage, you are well on your path to becoming a consultant psychiatrist. The next three years will take you into higher training, after which you will be eligible for a consultant post.

• Medical school – 4-6 years of training 
• Foundation training – 2 years 
• Core training (CT1 – CT3) – 3 years 
• Higher training (ST4 – ST6) – 3 years 
• Consultant post 

Consultant psychiatrists are medical experts, good communicators, collaborators, managers, health advocates, scholars, and professionals. It is a hugely diverse job. The primary duty is to care for the patient and a major advantage of psychiatric training is learning about psychological and social causation in addition to medical knowledge.

This is what makes them different from other disciplines. In addition to the primary care duties, consultants may conduct research, challenge stigma and lead others. The consultant underpins their team members and is the key driver of a safe and quality mental health service.  

Many people choose not to become consultants and instead choose to become SAS doctors, or Specialty Doctors and Associate Specialists. SAS doctors are a diverse group of clinicians with varying levels of knowledge and clinical skills, many have extensive postgraduate qualifications and are working at a very senior level. 

SAS doctors mostly direct their time towards patient care but they might also fulfil senior leadership and management roles, or teach, or research or service improvement or auditing. There are lots of opportunities for you to develop the role around what it is you like to do.