It is now recognised that exposure to Psychiatry during Foundation years is one of the greatest predictors of foundation doctors subsequently planning a career in Psychiatry.
A number of new initiatives in seeking to enhance experience in Psychiatry for foundation doctors are now being formulated.
1. Increase in Foundation Doctor numbers
In 2019 the Scottish government announced an increase in the number of Foundation posts available to new medical graduates, recognising the increase intake to Scottish Medical Schools over recent years. The Scottish Government stipulated that these new posts should be prioritised for “community facing “ specialties such as General Practice and Psychiatry.
Unfortunately, due to the recruitment difficulties into General Practice over recent years, these new posts have preferentially been allocated to GP with only modest increases in the number of new Psychiatry placements coming on stream in 2021 and 2022. It is hoped however, in light of more recent recruitment difficulties into Core psychiatry, that the balance between GP and Psychiatry will be re-visited in the near future.
2. Psychiatry Foundation Fellowships.
For three years now, the Royal College of Psychiatrists in England has offered a number of specially badged Foundation Doctor Posts termed as Psychiatry Foundation Fellowships. Successful applicants to these posts were guaranteed a Psychiatry placement, generally during their FY1 year, plus guaranteed attendance at their local Core Psychiatry Balint Group, a Psychiatric Mentor who would offer regular supervision for the duration of the successful applicants’ foundation training and attendance at the Royal College of Psychiatrists Annual International Congress.
This initiative was funded by Health Education England (HEE) and for the first time in 2020 was rolled out to each of the devolved administrations. Scotland, Wales and Northern Ireland were each allocated three such posts. Although the recruitment process for foundation Fellowships did not neatly dovetail with actual Foundation recruitment, these posts were advertised and interviewed for in March 2020.
Three successful candidates were appointed and have started in their new roles in August 2020. The successful candidates were Dr Zain Hussein, Dr Kimberley Duffy and Dr Esme Beer. Both Drs Hussein and Duffy have commenced employment with NHS Tayside and Dr Beer has started working in NHS Greater Glasgow and Clyde. There is some ongoing debate as to how this model fits in NHS in Scotland however and other more innovative developments are now due to be piloted.
3. Foundation Priority Programmes
Whilst there was very real competition for the Foundation Fellowships, the long term impact on recruitment into Psychiatry remains an unknown as it was obvious that all the candidates interviewed had set their hearts on a career in Psychiatry early on in Medical School. Thus, together with the Foundation School in Scotland, the Mental Health Specialty Training Board is seeking to develop what is called a Priority Programme for Psychiatry.
Priority Programmes in Foundation already exist in other specialties, most notably Remote and Rural Medicine, but until now, no consideration had been given to developing similar programmes in Psychiatry. From August 2020, the Foundation School and the Mental Health STB are going to pilot a Psychiatry Priority Programme in the North region of NHS Education for Scotland. The north region was chosen because historical recruitment issues in this geographical location, especially in the Inverness locality.
In essence, Priority Programmes are advertised and recruited to earlier than the main Foundation recruitment process and are generally seen as popular because of this and because Foundation trainees have advance knowledge of their geographical location and their placements for the subsequent two years of training. In order to enhance the potential popularity of this programme, the successful candidates will be given similar benefits to the Foundation Fellowships.
This will include a Psychiatric mentor for two years, attendance at their local Core Psychiatry Balint group and funding for attendance at one or more Royal College of Psychiatrist in Scotland meetings such as the annual Winter and Summer meetings or at any of the meetings run by the constituent faculties within Scotland.
Once this programme has been evaluated, we will be looking to roll out further Psychiatry Priority programmes throughout Scotland with southwest Scotland being proposed as the next geographical location.
Dr Seamus McNulty, ETC Representative and Chair of the STB
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