Accessibility Page Navigation
Style sheets must be enabled to view this page as it was intended.
The Royal College of Psychiatrists Improving the lives of people with mental illness

Starting Out as Trainee Psychiatrist

To contact the Psychiatrists' Support Service please telephone: 020 7245 0412  or e-mail:

This guide is for new UK trainee psychiatrists this leaflet includes tips on how to keep yourself healthy and happy, and keep your career on track.


Day-to-day life as a CT1–3



Your induction programme is likely to include mandatory courses specific to psychiatry, such as risk assessment, use of the Mental Health Act (different in England, Wales, Scotland and N Ireland) and training in rapid tranquillisation.


It is important to note the differences in the policies and procedures at psychiatric hospitals compared with acute hospitals, particularly regarding the management of acute medical incidents.


Training Posts


During your CT1 year, you can expect to have 6–12 months in general adult psychiatry, but it is also common to work in old age psychiatry in this period.


During your CT2 and CT3 years you will typically work in more specialist posts, such as child and adolescent psychiatry, learning disability psychiatry, forensic psychiatry, liaison psychiatry, addiction psychiatry and psychotherapy, as well as gaining further general adult psychiatry experience.


The process for allocation of training posts varies between deaneries. Training posts are generally 4-6 months. If you want to work in a specific post during your training, your training programme director is usually the best contact.




You should have weekly supervision from your educational or clinical supervisor. During this session, you will have an opportunity to discuss cases, as well as your career and opportunities for audit, research and teaching. You will also join a case-based discussion group (sometimes known as Balint group) to analyse the psychodynamic aspects of clinical cases.




On-calls may range from covering in-patient psychiatric units to medical wards, and conducting psychiatric assessments in the accident and emergency (A&E) department.

For A&E department and medical ward cover, responsibilities are often divided between core trainees, liaison departments and crisis and home treatment teams; the local protocols should be explained at induction.


Providing out-of-hours cover to psychiatric wards is likely to incorporate the provision of both psychiatric and acute medical care for patients, the medical registrar on call at the relevant acute hospital should be available to provide advice on medical issues. You may be asked to carry out assessments under the Mental Health Act; training on this should be provided at induction.

Psychiatric ST4-6s and consultants are generally very approachable. It is important to discuss relevant issues with your seniors and these discussions are valuable teaching opportunities which can also be used as workplace-based assessments  (WPBAs).


Organising your workload


Prioritise, delegate and manage your tasks to stop you feeling overwhelmed by multiple demands on your time. Remember to make time for teaching, research and audit, which all form an important part of your training. Administrative staff are a crucial component of overall psychiatric care and are often an important source of information.


The Royal College of Psychiatrists


All psychiatry trainees have to join the Royal College of Psychiatrists. You can register online.

We encourage you to join The Psychiatric Trainees’ Committee (PTC). Made up of trainees elected from every College division, and has representatives on most College committees. Further details are available on the PTC webpages; you can contact the PTC by email at

Portfolios and personal development plans


With input from educational supervisors, all trainees are required to maintain a portfolio and a personal development plan. You can set up and manage your portfolio at the College’s Portfolio Online website.




The College membership examination (MRCPsych) comprises of two Written Papers: Papers A, B and the Clinical Assessment of Skills and Competencies (CASC). Each paper is 3-hours long and contains approximately 200 questions. Both question papers consist of multiple choice questions (MCQs) and extended matching items (EMIs).

You can find further guidance in the PSS Exams guide and on the exams section of the website.




Workplace-based assessments include:


  • Assessments performed as part of your normal day-to-day job,
  • Incorporate evaluation of your clinical, communication and teaching skills,
  • Journal club presentations.


Annual review of competence progression (ARCP)


Every June at least three panel members will examine your portfolio to determine if you have attained the required competencies. Further information can be found in the Gold Guide.



Tips for looking after yourself




  • Attend promptly to occupational health requirements,
  • Participate in induction courses and mandatory training,
  • Join the College as a pre-membership trainee (PMPT) and get access to Portfolio Online,
  • Look into the ARCP process and the training requirements,
  • Maintain patient confidentiality and keep good records; ensure appropriate entries are made in clinical records whenever you see, or have contact with, a patient,
  • Get professional indemnity insurance. Information can be found here.
  • Book study and annual leave well in advance to allow you to swap on-calls if necessary,
  • Find out about annual National Health Service appraisal procedures in your trust.




  • Try to maintain a healthy work/life balance,
  • Keep in touch with family and friends and make time for hobbies outside work,
  • Exercise regularly and eat healthily,
  • Register with a local general practice.


If you become unwell, seek help and allow yourself time to recover. Flexible training is possible if you meet the criteria; your deanery can offer further advice.




What to do if things are not going so well


Psychiatry is rewarding but involves dealing with complex cases and hearing about difficult and emotional issues brought in by patients. You may experience personal difficulties yourself. If things are not going well, please ask for help from family or friends, or from your educational supervisor, training programme director or local College tutor. You may also consider seeking help from your deanery.


Experiencing some difficulties at work is common and it is better to openly discuss issues with your supervisor rather than ignore or minimise them.


Further sources of help and support can be found in our Resource Booklet.





The Gold Guide 6th Edition Feb 2016



The information should be used as a guide only and is not a substitute for professional advice. If you need further advice and support, please contact the Psychiatrists’ Support Service.


© Royal College of Psychiatrists 2016



Back to PSS home page

If you require advice and support about a particular issue then please contact the Psychiatrists' Support Service at the Royal College of Psychiatrists on 0207 245 0412 or email

feedback form feedback form

Please answer the following questions and press 'submit' to send your answers OR E-mail your responses to

Your responses will be anonymised and confidential and therefore, it will not be possible to identify you from the responses that you provide.

On each line, click on the mark which most closely reflects how you feel about the statement in the left hand column.

Your answers will help us to make this leaflet more useful - please try to rate every item.

This leaflet is:

Strongly agree




Strongly Disagree

  Strongly Agree Strongly Agree Agree Neutral Disagree Strongly Disagree Strongly Disagree
Respectful, does not talk down
Well designed

Please provide us with the following information:

Are you a psychiatrist?      
Are you a member of the College?      

Was this information for you   or for   ?


Thank you for providing your feedback on this leaflet.

Login - Members Area

If you don't have an account please Click here to Register

Make a Donation