Ask an expert:

What got you interested in Psychiatry as a specialist skill?

I’ve always been interested in psychiatry and had initially intended to become a psychiatrist when I applied for medical school. Although I eventually chose a career in a medical speciality, I have always found the psychiatric presentations and the interplay between physical and mental illness fascinating. However, I noticed that many patients fell between the specialties and were managed as either a psychiatric or physical illness, and I felt there was a growing need for doctors who have training in both areas. As increasing numbers of patients with psychiatric illnesses are admitted to medical beds, either due to limited inpatient psychiatric facilities or due to a physical health problem with a psychiatric comorbidity, having a better understanding of mental illness and the medications used in psychiatry is more important for acute medics than ever.

How did you train in Psychiatry as a specialist skill?

I completed the MSc Psychiatry over 3 years at Cardiff University which uses a distance learning approach. For my dissertation, I reviewed the admission data for four large hospitals in my region to determine the proportion of patients admitted to medical beds who had a psychiatric illness, either as their reason for admission or as a comorbidity (over 40%!). This spurred me on to gain additional experience in psychiatry to improve my knowledge further, so that I could better support patients with mental illness who are admitted to medical hospitals.

I have been working with the crisis team in the community, reviewing patients in clinic who have recently presented to acute services needing urgent support, and undertake sessions with the liaison teams within the hospitals where I am placed on my medical rotations. To get the most out of this experience I am also planning a short out of programme placement with a community liaison team.

Were there any challenges?

When I started my acute medicine training. psychiatry was not an approved specialist skill. I, therefore, submitted a proposal to SAC outlining how I would achieve the specialist skill and why I felt it was relevant to acute medicine. Once this was approved, I needed to approach psychiatry teams to arrange to work with them in order to gain experience. Although the liaison teams were happy to facilitate this, without a curriculum and being the first person to pursue this specialist interest meant it could be difficult to explain what it was that I was hoping to achieve. However, the regular exposure has meant I am more comfortable with the commonly used psychiatric medications, mental health legislation and various presentations of mental illness.

How does/will this fit into your consultant working?

I am still almost two years away from CCT but would hope to continue doing some sessions with the mental health teams, either in community or in the hospital. However, my main role will be an acute medical consultant and I expect that I will mostly use my psychiatric knowledge when managing medical patients in acute medical departments. My understanding of psychiatric medications, community service provisions within mental health departments, and the Mental Health Act will improve patient care for individuals with mental illness who are admitted to medical beds. I hope this will also help to improve patient flow and build closer relationships between the medical and psychiatric teams.

Do you have any tips for trainees who may be interested in Psychiatry as a specialist skill?

I would definitely recommend psychiatry as a specialist skill and really enjoy my psychiatry sessions. I would suggest getting in touch with mental health teams in your hospital early to set up sessional or block placements as this can take some time. There are plenty of clinics in the community which you may be able to attend and these are really useful for your training. One of the biggest challenges, at least in my area, is that the psychiatry teams use different IT systems which you will need training on, along with breakaway training, before you start. My main advice really is to approach the teams early so that you get as many sessions as possible during your SPA time before rotating somewhere new.