Opportunities for creative thinking and work-life balance

This blog post by Professor Nandini Chakraborty was written as part of the 2023 Choose Psychiatry campaign.

The trail started by farms with placidly feeding cattle and sheep. After an hour or so we entered a forest with gentle green light seeping through interlocking branches overhead.  

Another half an hour, the path opened on to a wide meadow surrounded by limestone mountains. Summer flowers dotted the slopes in patches of yellow and purple.  

A river sparkled in the sun, the blue contrasting with the green like a painting with bold strokes. Our group of sixteen could not help a gasp of wonder. This trail has brought many moments of wonder and beauty. 

This might look like a snapshot from a walking holiday, but this was very much a working day. I had joined other colleagues and a team of mountain leaders in supporting eight patients to complete a 10 km hike in the Peak District.  

Patients who were within three years of having experienced a first episode of psychosis, a frightening experience. Most of them or their families had never known psychosis beyond a vague term or a mention in a sensational media headline. Many of them had been detained under the Mental Health Act, relationships had been shaken, the way they viewed themselves had changed. 

But here in the Peak District it was changing again. They were rediscovering their fitness, a touch with nature.  

As other groups passed us by, there would be change of niceties, nothing to show that we were anything different from other hiking teams. Patients who were on antipsychotic medication, mood stabilisers, some on no medication- it did not matter. Every personal journey is different. A diagnosis and medication, given for the right reasons help recovery. 

This is what I love about my job, about psychiatry. The horizons of creativity, what you can bring into it are unbounded.  

I work in an early intervention in psychosis team and help people with first episode of psychosis. I know colleagues who are passionate about their particular streams- the challenges of forensic psychiatry, the boundaries between physical and mental health in liaison psychiatry, thinking about the needs of a new mothers in perinatal psychiatry, helping people have the right start in life in CAMHS, helping people and families steer through the challenges of dementia, working for vulnerable people with intellectual disabilities- the choices are wide: and that is a distinct understatement. 

It is not just about choices around 6 CCT specialties. There are dual training pathways. Psychiatry trainees can be supported to extend their interests through special interest sessions. Combine that with opportunities in research, management and teaching and you are in a colourful kaleidoscope of opportunities. 

I have certainly been grateful for the opportunities I have had in psychiatry. In my core training years, I worked part time (LTFT) to spend more time with my young daughter. As she grew older, I returned to full time work as a higher trainee. Taking into consideration that I already had substantial experience from India, my clinical supervisor and clinical director supported me to put in a CESR application in my ST5 year resulting in specialist registration 14 months ahead of my predicted CCT date. I have seen other doctors follow various paths.  

Do one specialty and then apply for CESR in another, take interesting career gaps to travel and get more life experience, go out of programme, and do research or expand on training experiences. There are no exit exams in higher training. Once you have the MRCPsych and enter higher ST4 you can concentrate on building on your interests with your heart in it, rather than stress on more tick-boxes. 

 After settling into my consultant job in 2009, I got involved in an international links project in my Trust. I have travelled to Nigeria to train primary care workers to deliver mental health care. The College has a vibrant VIPSIG.  

Being involved there has brought opportunities to teach medical students in Malawi, train colleagues in Uganda (online) and learn from the international experiences of wonderful colleagues passionate about global mental health. 

And then came the opportunity in 2021 from a network of early intervention in psychosis teams to join efforts in designing a sailing project around the British Isles.  

Our team sailed for a week, from Ipswich to London, on a sailing boat, ropes, and all, working with patients to learn new skills, find more confidence. The next year we decided to go hiking for 3 days in the Peak District. In 2023 we have done both a hiking and a sailing trip. We have joined forces with an organisation to offer monthly hiking trips to our patients.  

What I am telling you is a scratch on the surface compared to what is possible in psychiatry. We change lives in many ways. I must admit- being a psychiatrist has made me a different person, and I would not have it any other way. 

Professor Nandini Chakraborty, an Early Intervention in Psychosis consultant and the RCPsych National Lead for Recruitment.