'An incredibly challenging yet rewarding job'

This blog post by Dr Aoife McMahon is part of the Thrive in Psychiatry campaign.

My name is Aoife McMahon and I am a consultant in old age psychiatry. I have been a consultant for over eight years and in my current role since September 2023.

I work in the North West of England and I currently work across an older adult CMHT (Community Mental Health Team) and MAS (Memory Assessment Services) within my area.

Finding a niche

I realised I had a passion for old age psychiatry as a CT2 doctor working in the field. I loved psychiatry, but didn’t find my niche within adult, CAMHS or substance misuse services.

I have always enjoyed practical aspects of medicine, and the interaction between medicine and psychiatry.

I realised that old age psychiatry was a good way of working within psychiatry but keeping up some physical health knowledge and skills (I have cannulated as a consultant!) alongside working with a genuinely lovely patient cohort, and within wonderful teams.

Initially I worked as an in-patient consultant, largely caring for people with advanced dementia.

This was an incredibly challenging yet rewarding job.

The impact of the pandemic

The Covid-19 pandemic however meant that the job changed significantly, and for a time, we largely provided palliative care and delirium management for men who were very unwell both physically and mentally.

Following the pandemic, the needs of our patient cohort were significant.

Patients presented with advanced dementia, significant associated psychiatric difficulties and multiple physical health problems. The Trust worked hard to provide appropriate support although the challenges were huge.  

Privileged

In my current role, I largely see patients within their homes or at clinics within the hospital where I am based. I feel privileged to be able to visit people within their homes, and to be allowed an insight into their daily living, alongside hearing their fascinating life stories.

My community role is to see patients with both functional and organic illnesses, and to support their mental health working alongside the CMHT and MAS teams. There is significant co-working with GPs, medical colleagues and local authority adult social care services.

Multi-disciplinary team working within old age psychiatry is key, and this is one of the most enjoyable aspects of my role. Daily, I work with nursing colleagues, psychologists, Occupational Therapists, support workers, physiotherapists and otherwise.

I regularly liaise with relatives and carers. We work with NHS and local organisations, such as Age UK and the Alzheimer’s Society to support older people with age specific problems such as loneliness, isolation and problems associated with reduced mobility, and frailty.

I worked as a locum consultant within my current role for several months, before becoming substantive. As such, I didn’t have resident doctors for whom I was a clinical or educational supervisor, which was a huge part of my previous role, and something I enjoy.

Making it easy to move between employers

Getting back on track with this has been paperwork-heavy and difficult to navigate in some respects (finding training courses and the correct paperwork to complete).

I have been well supported in this by my senior clinician colleagues and within the Trust although it would be helpful if there was a universal document or procedure that consultants could follow when moving Trusts to reduce paperwork involved in 'becoming' a supervisor in a new role.

Support from the Royal College about how to navigate this, considering some sort of transferable 'Supervisor Passport' or other such tools would help clinicians with a passion for education to thrive further. 

Dr Aoife McMahon,  Consultant in Old Age Psychiatry, north west England.