The CAMHS run-through pilot has been ongoing since 2018, and we now have five cohorts going through the pilot. The pilot is run in England jointly by HEE and RCPsych and has GMC approval.
In August 2021, our first cohort of trainees moved into ST4, enabling us to begin our programme evaluation.
What does the programme involve?
Trainees in the run-through programme will be registered with an NTN as an ST1 trainee.
Trainees on the run-through programme undertake core training alongside trainees in CT1-CT3. Programme outlines for ST1-ST3 are as follows:
- Six posts of six months’ duration (as for CT1-CT3).
- In ST1, there will be two six-month WTE placements in General Adult Psychiatry / Old Age Psychiatry etc – like CT1
- In ST2, there will be one six-month placement WTE in child & adolescent psychiatry, and one six-month WTE placement in a paediatric linked post (e.g. paediatric liaison or ambulatory paediatrics).
- In ST3, trainees will undertake the same placements outlined for those in CT3.
- In the ST2 year, even in the paediatrics-linked placement, the ST2 trainee in the run-through pilot will undertake psychiatry on-call, will continue to have psychiatric supervision, and will attend all the educational and academic programmes (e.g. the MRC Psych course, psychotherapy courses and experience) as all the other Core Trainees.
- The trainees on the run-through pilot will have a psychiatry ARCP every year ST1-ST3 along with the other psychiatry trainees.
- Trainees on the run-through pilot must attend their local MRCPsych course and all the other psychiatry educational programmes, and psychotherapy training. They must provide the same evidence of academic activities and psychotherapy competencies as required in the Core Psychiatry training and outlined in the Core Psychiatry Curriculum.
- All components of the MRCPsych examination (Papers A and B, and CASC) must be completed and passed to progress to ST4.
- Any extensions to training time for the Core Psychiatry programme will also be available to run-through pilot trainees. This is as per the provisions in the Gold Guide. If the trainee is unable to pass the MRCPsych examination despite the maximum allowable extension to training, they will be released from training as per the Gold Guide.
- Trainees in the run-through programme will directly progress to ST4 in CAP if they pass the MRCPsych examination. They will not need to participate in the national competitive interviews for entry to ST4-6 training. The CAP TPD, the Core TPD, and the School of Psychiatry in the area will ensure that the run-through trainee will have a post for ST4-6 training on the local CAP rotation.
- If the run-through pilot trainee does not wish to progress to cap training ST4-6, they must undertake national ST4-6 interviews to apply for the psychiatry specialty of their choice.
- Qualitative feedback about the pilot (through questionnaires sent to trainees and educators) and quantitative outcomes including ARCP outcomes, progression data and exam results will be collected by Dr Suyog Dhakras – Chair CAPSAC - RCPsych (the Clinical Lead for the pilot), Ms Pauline Whitelaw (Quality and Curricula Assurance Manager – RCPsych) and Ms Molly Baker (RCPsych – Quality and Curricula Assurance Coordinator). They will submit annual reports to the GMC & HEE.
Trainees in the run-through programme will be allocated a run-through mentor alongside their educational, clinical, and psychiatric supervisors.
RCPsych holds periodic induction meetings for trainees, and all the senior educators involved in the pilot.
- Ability to take detailed developmental history and assessment (including relevant physical examination) understanding normative development and pathological changes
- Identifying the mental health disorders/ comorbidities in CYPs presenting with physical illnesses/ disorders
- Developing an understanding of possible organic differential diagnoses to mental health presentations, gain understanding of relevant physical examination and investigations
- Risk assessments and management plans in Paeds ED & Paeds wards
- Assessing and exploring factors underlying medically unexplained symptoms
- Understanding physical health issues in cases of eating disorders
- Developing and demonstrating ability to work across disciplines and specialties
- Understand the process of providing the CAMHS consultation between Paeds and CAMHS systems
- Understand the use of CAP psychopharmacology in acute Paediatrics
- Understanding of CAMHS work – specialist CAMHS & also Tier 4 (some CT-ST2 posts likely to be in CAP inpatient units)
- Common presentations in the main age groups in CAP (0-5; 5-12, 14-18)
- Developmental disorders – understanding especially ADHD, ASC, Tics
- Common presentations re mood disorders, anxiety disorders, eating disorders, somatoform disorders, impact of social issues – bullying, school issues, social media
- Understanding the ‘systemic perspective’ – not just the ‘family system’, but also Education, Local Authority, Paediatrics etc
- Safeguarding , especially vulnerable groups – e.g. Children Looked After, CYPs in Youth Justice
- Relevant CAP Psychopharmacology and physical health issues
- Assessment of risk and management of risks in CAP age group, systemic underpinning of risk management
- Relevant medico-legal frameworks and emergency work (including CAP out-of-hours if relevant)
- Psychological therapies in CAP – especially Systemic Therapy
|CT1 – CT3||ST1 – ST3|
|6 x 6 months placements across 3 years WTE||6 x 6 months placements across 3 years WTE|
|Combination of GAP, OPMH, FP, AoT, Liaison, etc.||ST1 year – 2 x 6 month WTE placements (GAP/OPMH, etc.)|
|Will do either ID/CAP as “developmental post”|| ST2 year – will do 6 months WTE CAP and 6 months WTE Paediatric Linked post (Paeds liaison/ambulatory paeds)
ST3 year – similar to CT3
|On call – in Psychiatry||On call – in Psychiatry|
|Academic activities (MRCPsych Programme, Psychotherapy experience etc.)||Academic activities (MRCPsych Programme, Psychotherapy experience etc.)|
|ARCP – Psychiatry ARCPs||ARCP - Psychiatry ARCPs each year (including ST2)|
|MRCPsych gateway to ST4 (must complete all 3 components)||MRCPsych gateway to ST4 (must complete all 3 components)|
|National competitive ST4 interviews||No interviews to start ST4 in CAP|