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Royal College of Psychiatrists - Celebrating 180 years
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  • Become a psychiatrist

    Become a psychiatrist

    • Choose Psychiatry

      Choose Psychiatry

      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students

      Medical students

      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors

      Foundation doctors

      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry

      Help us promote psychiatry

      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
    • Choose Psychiatry
      • What is psychiatry?
      • How to become a psychiatrist
      • Why choose psychiatry?
      • Career essentials
      • What next?
    • Sixth formers and school students
    • Medical students
      • Becoming a student associate
      • Psychiatry attachments
      • Awards, prizes and bursaries
      • PsychSocs
      • National conference
      • Summer and autumn schools
      • FuturePsych – the student associate magazine
    • Foundation doctors
      • Foundation doctor associates
      • Making the most of your psychiatry placement
      • Opportunities for foundation doctors
      • FuturePsych - the associate magazine
    • Help us promote psychiatry
      • How can I help?
      • Ideas to inspire you
      • Resources to help you promote psychiatry
      • Our strategy
    • Choose Psychiatry: Guidance for Medical Schools
  • Training

    Training

    • Curricula and guidance

      Curricula and guidance

      • GMC approved curricula
      • Curricula review project
      • Specialty guides
    • Your training

      Your training

      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams

      Exams

      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training

      Neuroscience in training

      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates

      International Medical Graduates

      • Shortage Occupation List
    • Quality Assurance in Training
    • Curricula and guidance
      • GMC approved curricula
      • Curricula review project
      • Specialty guides
    • Your training
      • Psychiatric Trainees Committee: supporting you
      • Time out of training
      • Training resources
      • Run-through training
      • Prizes and bursaries for trainees
      • Leadership and management training
      • Training less than full time
      • Routes to Registration
      • Cost of Training
    • Exams
      • Can I take an exam?
      • Contact the exams team
      • Preparing for exams
      • Applying for your exam
      • Exam results
      • Special notices
      • Exam FAQs
      • A fair exam
      • MRCPsych examinations and COVID-19
      • Webinar: MRCPsych Exam - Changes to exam delivery this autumn
      • Capacity reached for September 2020 CASC
    • Neuroscience in training
      • About the project
      • Neuroscience events
      • Who is on the commission?
      • Latest news from the neuroscience project
      • Neuroscience history
      • Neuroscience videos
      • Neuroscience resources
    • Information for Local Education and Training Boards (LETBs)
    • Medical training initiative (MTI)
    • Undergraduate education forum
    • International Medical Graduates
      • Shortage Occupation List
    • Quality Assurance in Training
  • Members

    Members

    • Supporting you

      Supporting you

      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD

      Submitting your CPD

      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership

      Membership

      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties

      Your Faculties

      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations

      Devolved Nations

      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions

      English Divisions

      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members

      International members

      • International strategy
    • Special Interest Groups

      Special Interest Groups

      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter

      Your monthly eNewsletter

      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
      • RCPsych eNewsletter March 2019
      • RCPsych eNewsletter February 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors

      Specialist and Associate Specialty Doctors

      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures

      President's lectures

      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries

      Obituaries

      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
    • Supporting you
      • Psychiatrists Support Service
      • New consultants (StartWell)
      • Mentoring and coaching
      • Revalidation
      • Assessing and managing risk of patients causing harm
      • Leadership and management
      • Working less than full time
      • If a patient dies by suicide
      • Writing clinic letters
    • Submitting your CPD
      • CPD Submissions FAQs
      • Alterations to CPD during coronavirus pandemic
    • CPD Online
    • Membership
      • Members login
      • Receipts
      • Pay Your Subscription
      • Direct Debit
      • Your subscription
      • Grades of membership
      • Benefits of membership
      • Fellowship and other Honours
      • Applying for Fellowship
      • Nominations for Honorary Fellows
      • Nominations for National Honours
    • Your Faculties
      • Academic psychiatry
      • Addictions psychiatry
      • Child and adolescent psychiatry
      • Eating disorders psychiatry
      • Forensic Psychiatry Faculty
      • General adult psychiatry
      • Intellectual disability psychiatry faculty
      • Liaison psychiatry faculty
      • Medical psychotherapy faculty
      • Neuropsychiatry faculty
      • Old age psychiatry faculty
      • Perinatal psychiatry faculty
      • Rehabilitation and social psychiatry faculty
      • Faculty job descriptions
    • Devolved Nations
      • RCPsych in Scotland
      • RCPsych in Wales
      • Coleg Cymraeg
      • RCPsych in Northern Ireland
      • Executive Committee job descriptions
    • English Divisions
      • Eastern
      • London
      • Northern and Yorkshire
      • North West
      • South Eastern
      • Trent
      • West Midlands
      • South West
      • Executive Committee job descriptions
      • NW and NY mentorship
    • International members
      • International strategy
    • Special Interest Groups
      • How to join a SIG
      • Adolescent forensic psychiatry
      • Arts psychiatry
      • Evolutionary psychiatry
      • History of psychiatry
      • Neurodevelopmental psychiatry
      • Occupational psychiatry
      • Philosophy
      • Private and independent practice PIPSIG
      • Rainbow SIG
      • Spirituality
      • Sport and exercise
      • Transcultural psychiatry
      • Volunteering and international
      • Women and mental health
      • Special Interest Group Job Descriptions
      • Digital psychiatry
    • Committees of Council
    • RCPsych Insight magazine
    • Publications and books
    • Your monthly eNewsletter
      • RCPsych eNewsletter February 2021
      • Members' update 11 February 2021
      • RCPsych eNewsletter January 2021
      • Members' update 14 January 2021
      • RCPsych eNewsletter December 2020
      • RCPsych eNewsletter November 2020
      • Members' update 12 November 2020
      • RCPsych eNewsletter October 2020
      • Members' update 8 October 2020
      • RCPsych eNewsletter September 2020
      • Members' update 11 September 2020
      • Members' update 1 September 2020
      • Members' update 14 August 2020
      • RCPsych eNewsletter July 2020
      • Members' update 10 July 2020
      • RCPsych eNewsletter June 2020
      • Update 12 June 2020
      • COVID-19 Update 29 May 2020
      • RCPsych eNewsletter May 2020
      • COVID-19 Update 7 May 2020
      • COVID-19 Update 1 May 2020
      • RCPsych eNewsletter April 2020
      • COVID-19 Update April 2020
      • RCPsych eNewsletter February 2020
      • RCPsych eNewsletter January 2020
      • RCPsych eNewsletter December 2019
      • RCPsych eNewsletter November 2019
      • RCPsych eNewsletter October 2019
      • RCPsych eNewsletter September 2019
      • RCPsych eNewsletter July 2019
      • RCPsych eNewsletter June 2019
      • RCPsych eNewsletter May 2019
      • RCPsych eNewsletter April 2019
      • RCPsych eNewsletter March 2019
      • RCPsych eNewsletter February 2019
    • Posts for members
    • Public members list
    • Jobs board
    • Specialist and Associate Specialty Doctors
      • A message from the Chair
      • Who are SAS Doctors?
      • How to enter the SAS grade
      • SAS career development
      • SAS doctors resources
      • College SAS training and events
    • President's lectures
      • Declaration of competing interests (President's lectures)
      • List of president's lectures competing interests
      • Past President's lectures
    • Retired members
    • New Members Ceremonies
    • Obituaries
      • Submit an obituary
      • Remembering Dame Fiona Caldicott
    • About CPD Online - elearning
  • Events

    Events

    • Conferences and training events

      Conferences and training events

      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training

      In house training

      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series

      Highlights from International Congress 2020 - Webinar Series

      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021

      International Congress 2021

      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • Key dates
      • IC21 Keynote speakers
      • Poster Presentations 2021
      • Programme
    • Free webinars

      Free webinars

      • Free webinars for members
    • Speaker guidance for online events
    • Conferences and training events
      • Faculty of intellectual Disability Spring Conference 2019
      • Faculty of Forensic Psychiatry Annual Conference 2020 - Register your interest
      • Section 12 and AC – Update for Trainers - Training Day Course Resources
      • Resilience & Wellbeing Course for SAS Doctors
      • Present State Examination Course 17 April - Register your interest
      • Present State Examination Course 1 September - Register your interest
      • Section 12 and Approved Clinician Training
      • Perinatal Psychiatry Masterclasses
      • Women and Mental Health Special Interest Group Annual Conference
      • Faculty of Medical Psychotherapy Annual Conference 2021 - Register your interest
      • Register your interest - Clinical and Educational Supervisor Training future dates
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trainee)
      • Register your interest - Leadership & Management Fellow Scheme 2021/22 (Trust)
    • Events held by other organisations
    • Terms and conditions
    • In house training
      • In house training: working with us
      • Health of Nation Outcome Scales
      • Competing interests
    • Highlights from International Congress 2020 - Webinar Series
      • Registration
      • Programme
      • FAQs
    • Accommodation List
    • Recruitment events
    • Claiming Expenses
    • International Congress 2021
      • Congress FAQs
      • Exhibition Opportunities 2021
      • Registration
      • Key dates
      • IC21 Keynote speakers
      • Poster Presentations 2021
      • Programme
    • Free webinars
      • Free webinars for members
    • Speaker guidance for online events
  • Improving care

    Improving care

    • College Centre for Quality Improvement (CCQI)

      College Centre for Quality Improvement (CCQI)

      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy

      Campaigning for better mental health policy

      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce

      Planning the psychiatric workforce

      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates

      Physician Associates

      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health

      National Collaborating Centre for Mental Health

      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably

      Sustainability and working sustainably

      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation
    • College Centre for Quality Improvement (CCQI)
      • What we do in the CCQI
      • Quality Networks and Accreditation
      • National Clinical Audits
      • Multi-source feedback
      • Using quality improvement
      • CCQI resources
      • CCQI Who we are
      • Research and evaluation
    • Campaigning for better mental health policy
      • The Mental Health Act (MHA)
      • Five Year Forward View
      • Integrated care and mental health
      • Children and young people's mental health Green Paper
      • RCPsych in Parliament
      • Join our Research Panel
      • College Reports
      • Position statements
      • Process for College publications
      • Other policy areas
      • Mental Health Watch
      • COVID-19: Guidance for clinicians
      • The Mental Health Act White Paper 2021
    • Planning the psychiatric workforce
      • What we do
      • Job planning and recruitment
      • Our workforce census
      • Campaigning for the mental health workforce of the future
      • Workforce strategy
    • Physician Associates
      • About Physician Associates
      • Employing Physician Associates
      • Becoming a Physician Associate
      • Support for Physician Associates
      • Physician Associates network
    • National Collaborating Centre for Mental Health
      • About the NCCMH
      • Mental health care pathways
      • Mental health quality improvement programmes
      • Other programmes
      • Reducing restrictive practice
      • National suicide prevention programme
      • Sexual Safety Collaborative
      • COVID-19 Mental Health Improvement Network
      • RCPsych Enjoying Work Collaborative
    • Invited Review Service
    • Public Health and its role in mental heath
    • Sustainability and working sustainably
      • In your community
      • In your practice
      • In your trust
      • Green care
      • Sustainability scholars
      • About sustainability in mental health care
      • Sustainability resources
      • Working sustainably (old)
    • RCPsych Course Accreditation
  • Mental health

    Mental health

    • Problems and disorders

      Problems and disorders

      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Memory problems and dementia
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Personality disorder
      • Postnatal depression
      • Physical illness
      • Postpartum psychosis
      • Problem gambling
      • Post Traumatic Stress Disorder (PTSD)
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
      • Perinatal OCD for carers
      • Postpartum Psychosis in Carers
      • Postnatal depression key facts
      • Postnatal depression: information for carers
    • Support, care and treatment

      Support, care and treatment

      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations

      Translations

      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
    • Mental health FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd: web tools for those working with young people
    • Order mental health packs for schools
    • Audio resources
    • Problems and disorders
      • ADHD in adults
      • Alcohol and depression
      • Alcohol and older people
      • Anorexia and bulimia
      • Anxiety, panic and phobias
      • Bereavement
      • Bipolar disorder
      • Cannabis
      • Club drugs
      • Coping after a traumatic event
      • Debt and mental health
      • Delirium
      • Memory problems and dementia
      • Depression
      • Depression in older adults
      • Depression and men
      • Eating well and mental health
      • Feeling on the edge
      • Feeling overwhelmed
      • Feeling stressed
      • Hoarding
      • Learning disabilities
      • Medically unexplained symptoms
      • Obsessive-compulsive disorder (OCD)
      • Perinatal OCD
      • Personality disorder
      • Postnatal depression
      • Physical illness
      • Postpartum psychosis
      • Problem gambling
      • Post Traumatic Stress Disorder (PTSD)
      • Schizoaffective disorder
      • Schizophrenia
      • Seasonal Affective Disorder (SAD)
      • Self harm
      • Shyness and social phobia
      • Sleeping well
      • Perinatal OCD for carers
      • Postpartum Psychosis in Carers
      • Postnatal depression key facts
      • Postnatal depression: information for carers
    • Support, care and treatment
      • Alzheimers drug treatments
      • Antidepressants
      • Antipsychotics
      • Being sectioned
      • Benzodiazepines
      • Bipolar medications
      • Cognitive Behavioural Therapy (CBT)
      • Complementary and alternative medicines: herbal remedies
      • Complementary and alternative medicines: physical treatments
      • Depot medication
      • Deprivation of Liberty Safeguards
      • Electroconvulsive therapy (ECT)
      • Electronic health records in mental health services in England
      • Guide to mental health tribunals
      • Liaison psychiatry services
      • Mental capacity and the law
      • Mental health rehabilitation services
      • Mental health services and teams in the community
      • Planning a pregnancy
      • Psychotherapies and psychological treatments
      • Spirituality and mental health
      • Stopping antidepressants
      • Talking to your GP
      • What to expect of your psychiatrist in the UK
      • Antipsychotics in Pregnancy
      • Lithium in Pregnancy and Breastfeeding
      • Mother and Baby Units (MBUs)
      • Children's Social Services and Safeguarding
      • Valproate in women and girls who could get pregnant
      • What are Perinatal Mental Health Services?
      • Mental health in pregnancy
      • Medication for mental health and COVID-19
      • Remote consultations and COVID-19
      • Attending hospital and COVID-19
      • Monitoring health at home and COVID-19
      • Alcohol and COVID-19
      • Eating disorders and COVID-19
      • Perinatal care and COVID-19
      • COVID-19: Self-harm in young people 
      • COVID-19: Self-harm and suicide 
      • COVID-19: Looking after your mental health – for young people and their parents and carers 
      • COVID-19: Using drugs
      • COVID-19: ASD
    • Young people's mental health
    • Translations
      • Arabic عربى
      • Bengali বাঙালি
      • Bulgarian български
      • Chinese 中文
      • French Français
      • German Auf Deutsch
      • Greek Ελληνική γλώσσα
      • Gujurati ગુજરાતી
      • Hindi हिंदीहिंदी
      • Italian italiano
      • Japanese 日本語
      • Lithuanian Lietuvių kalba
      • Pashto پښتو
      • Persian (Farsi) فارسی
      • Polish Polski
      • Punjabi ਪੰਜਾਬੀ
      • Romanian Română
      • Russian Pусский
      • Somali
      • Spanish Español
      • Turkish
      • Tamil தமிழ்
      • Urdu اردو
      • Welsh Cymraeg
    • Mental health FAQs
    • Order mental health leaflets
    • About our mental health information
    • Disclaimer about our mental health information
    • Choosing Wisely - a national campaign
    • BSL translations
    • MindEd: web tools for those working with young people
    • Order mental health packs for schools
    • Audio resources
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Bloods, sweat and…lots of tea: a day in the life of an on-call psychiatric trainee

Choose psychiatry

21 October, 2020

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Wonder what it’s like to be on call for a large psychiatric hospital? Trainee psychiatrist Dr Kay Sunderland takes us minute-by-minute through a fast-paced day supporting acutely unwell patients. 

Trainee psychiatrist - Dr Kay Sunderland

Dr Kay Sunderland

8am: I wake up to begin a weekend of 12-hour on-call shifts at my base hospital in Scotland. I make a cup of coffee and hop in the shower. Getting ready takes much less time in the middle of a pandemic as there’s only one outfit to choose from: scrubs! 

9am: In the doctor’s mess, I meet up with the other junior doctor I’ll be working with over the next three days and we commiserate with our departing nightshift colleague, who has been awake for most of the night. We put the kettle on – an essential part of any long shift.

9.15am: Two cases are handed over “to be aware of”.

A male in his 30s (Mr X) – admitted in recent days with a suspected drug induced psychosis – has been displaying significant behavioural disturbance overnight. He has utilized the maximum dose of all additional short-acting medications available to manage his agitation and may need further discussion with seniors for consideration of transfer to IPCU.

A female in her 60s (Ms Y) – also nearing max doses of additional medicines – hasn’t slept overnight. She needs daily bloods, due to poor renal function and previous lithium toxicity.

9.30am: Our jobs book (which we use to record tasks handed over to the on-call team by other colleagues) shows a variety of bloods to be taken so we set off on a phlebotomy round.

10am: We arrive on one of the older adult wards to take a lithium level and are delighted to find that one of the nurses has already done it.  As we go round, we’ve acquired some other routine jobs – more bloods, a couple of ECGs and some prescriptions as well as some swollen legs to be reviewed. 

11am: Nurse from ward calls to remind us that bloods need to be taken for the female patient we were handed over. He mentions that she has been struggling to swallow, and asks if we can listen to her chest while we’re there to rule out aspiration pneumonia. We head over to the ward.

11.10am: Our patient appears delirious and is requiring a 2:1 observation. It’s quite challenging to get her bloods as she is agitated and moving around a lot – but happily her chest sounds clear. We agree to await blood results to see if we can identify a cause for her behaviours and encourage oral fluids. Should she deteriorate, we would need to transfer to the general hospital as we can’t facilitate IVs on site.

11.30am: While I label up the blood bottles, it’s a nice opportunity to catch up with some of the nursing staff and discuss the latest hospital gossip. Working in the community clinic for the most part, I don’t get to see them all as much as I used to. Communication is vital, not only in my role as a doctor, but also in being part of the hospital community as a whole. The job can be so hectic and stressful that it is all the more important to take a moment to check in with colleagues if a chance presents itself. 

1pm: Lunch. Time to re-group and make a plan for the afternoon. We put the kettle on… again. A call comes through from the medical receiving unit looking for advice. While I’m on the phone, a medical emergency call comes through. I tell the medics I’ll call them back and we run (yes, run!) to the ward.

1.05pm: A patient has been found with evidence that they'd tried to seriously self-harm, but thankfully by the time we arrive, they have regained consciousness and don’t require any further treatment. After a thorough review and documentation, I pinch some chocolates from the nursing station and we go back to our lunch.

2.30pm: Call from the acute adult ward to say they’ve done a set of physical observations on the man we heard about at handover, and he’s tachycardic, tachypnoeic and hypertensive…with a history of the previous neuroleptic malignant syndrome (a life-threatening reaction to antipsychotic medications where the patient displays muscle rigidity, confusion, fever etc.). I ask them to perform a repeat set of observations and head over.

2.35pm: Carry out a full physical examination on the above gentleman. Due to his illness, his speech doesn’t make much sense but he denies feeling physically unwell. I can find no signs of infection, nor any abnormal neurological signs to suggest neuroleptic malignant syndrome. We ask that his observations be repeated and will continue to monitor.

4pm: Telephone call from Community Mental Health Team asking us to carry out bloods over the weekend for an outpatient whose clozapine monitoring bloods have shown that he is at risk of developing agranulocytosis – a reduction in white blood cells, secondary to the clozapine drug therapy. We arrange for them to come to the ward daily so that we can keep an eye on these levels.

4.30pm: Junior doctor from the ward calls after a consultant has reviewed Mr X. They’ve sent off urgent bloods and have asked us to chase the results. If his bloods are normal, a plan is in place for further medications.

5pm: We grab some dinner and hear news that there’s an admission coming in soon.

5.30pm: Eating disorder patient has a nasogastric (NG) tube in place for feeding. Nursing staff page us as they have been unable to obtain a sample of the stomach contents. As this might suggest the tube has moved and is no longer in the stomach, I agree to arrange an X ray to ensure it remains in the correct place.

6pm: New admission has arrived from Liaison – we attend to clerk in, complete bloods, physical and ECG. 

6.30pm: Eating disorder patient’s blood sugar has been checked and it is below 4. She is refusing any oral treatment and has previously required IV dextrose to treat her hypoglycaemia. Radiology will not perform the X-ray overnight, so we run through our options for treatment and discuss what we can and cannot facilitate in a psychiatric hospital.

7pm: Bloods come back for Mr X. His Creatine Kinase (a blood measurement of muscle damage) is raised and therefore might support the working diagnosis of NMS. We call the psychiatry registrar for advice and plan to discuss the case with the medical team. While we are doing so, the nurses repeat his observations – his temperature as spiked and his heart rate is elevated again. We decide to arrange transfer to an acute hospital for further investigation and supportive treatment.

9pm: We hand over a review of the physical health of a patient that has required restraint from nursing staff that we haven’t had time to complete, and make sure to highlight the patients who will require monitoring overnight. We also put a list of bloods and other routine jobs in the book for tomorrow.

10pm: I get home and sit on the sofa, exhaling deeply, for the first time all day! Despite it having been a busy, and at times pretty stressful, shift, I feel exhilarated. And with that, I get up and go to bed, to prepare to do it all over again tomorrow.

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Choose Psychiatry team

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