This webpage aims to provide you with an overview of specialty training in Child and Adolescent Psychiatry, how the local rotation fits into the wider world of medical education, and to help you with some local practicalities. Although this is a small scheme the opportunities are surprisingly rich, there is scope for flexibility and the South West has some of the loveliest landscapes in the country.
The Child & Adolescent Psychiatry role descriptions can be found below.
Details of the scheme can be found in the job description you received from your employing Trust. Dr Sarah Huline-Dickens is the Training Programme Director, and is also educational supervisor, and other clinical supervisors are Dr Fernanda Garcia Costas (Plymouth), Dr Oana Mitrofan (Exeter), Dr Rory Conn (Exeter), Dr Sam Gothard (South Devon), Dr Femi Akerele (South Devon) and Dr Seb Rotheray (East Cornwall).
Medical education in the UK went through a period of enormous change at the end of the last decade, and continues to change quite rapidly. The Royal Colleges and the GMC have defined their areas of influence and there is much more clarity about processes and who is driving them.
The Peninsula Postgraduate Medical Education has full GMC approval for three National Training Numbers. Rotating between placements will give you a sense of different sub-specialties but also some insight into working for different organisations. The scheme covers one foundation trust (Cornwall), one social enterprise (Livewell SW) and another NHS provider. Usually a trainee will be in one placement per year for 3 years but less than full time (LTFT) trainees may train for 60% of the time and take longer to complete their training.
Our scheme comes under Peninsula Postgraduate Medical Education where it is overseen by the School of Psychiatry. The School Manager is based at the Peninsula Postgraduate Medical Education, Plumer House, Tailyour Road, Crownhill, Devon, PL6 5DH
The Academic Programme
Trainees from the Devon CAP HST training programme, the Bristol, Bath, Swindon and Gloucestershire programme attend the academic programme which traditionally has been organized in Bristol but recently has been occurring virtually. A consultant child and adolescent psychiatrist oversees the teaching in a three year rolling programme. The course is on alternate Fridays in three 10 week terms per year and usually represents 15 days per year. It is usually held in Bristol and includes seminars, journal reviews, clinical case presentations, research meetings, outside speakers and a Balint group. It is also an important group for peer learning.
Appraisal & Revalidation
Please visit our revalidation pages and the GMC website for information. As far as appraisal is concerned, it is the duty of every doctor to ensure they have an annual appraisal and this is currently, in this particular area, one of the requirements for the ARCP. The processes for appraisal are Trust based. Usually your Clinical or Educational Supervisor will undertake your appraisal.
This is the Annual Review of Competence Progression, and is organised via Peninsula Postgraduate Medical Education, information is available on our ARCP Pages.
Trainees are expected to participate in audit and quality improvement projects in each of their placements.
The final version of the Child and Adolescent ST4-6 curriculum has been approved and is now available on the College website. An overview of this document can be found on pages 154-155. . It is being adapted and will be operational in 2021 to take account of the GMC Generic Professional Capabilities Framework.
The Deanery is now known as HEESW and covers Peninsula and Severn regions. It is geographically very large. There are separate Schools of Psychiatry in each of the two ends (the Peninsula end and the Severn end). Each is led by a Head of School: the current head of School for Peninsula is Dr Simon Bonell. The Deanery coordinates the ARCPs and the quality panels and is an important source of information on training matters. Note that it is also served by a Professional Support and Well being unit (PSW) to which you can refer yourself confidentially if you have any problems you need help with. The PSW has a site on the Deanery webpage which lists the resources available to trainees and what kind of support can be offered.
This is an important way of keeping a record of your training. It is recommended that you regularly update this, and include time for doing so in your regular timetable (up to an hour per week) so that the information is collected and added to as part of an ongoing process, rather than being done in haste before the ARCP.
Especially in the final year of training, support will be given to trainees to develop their management knowledge and experience.
Throughout the different regional placements, a broad range of management experience can be arranged. In most placements, it should be possible to chair meetings, participate in interview panels, write business plans and handle complaints. Attendance at LNC meetings is also possible.
You will also be encouraged to take the lead on quality improvement initiatives.
The arrangements for being on call at the time of writing are that your on call to Livewell (in Plymouth) wherever you are based. You will join the on call rota on a 1 in 7 (for a whole time equivalent post) basis. There will always be a CAMHS consultant on call with you. In turn you may be supervising a core or vocational training scheme (VTS) trainee.
- Exeter: Outpatients. This post is based at Evergreen House with Dr Oana Mitrofan as supervisor. The post has a focus on adolescent disorders and particularly mood disorders. However the caseload can be adapted to suit the training needs of the trainee. There is an ethos of multi-disciplinary working and opportunities for audit.
- Exeter: paediatric liaison. This post with Dr Rory Conn has 3 principle areas of focus. Firstly, working as part of the Risk Assessment Service, conducting assessments of children and young people admitted to the paediatric estate with self harm and overdoses. Secondly, providing psychiatric support for young people at risk of admission for Eating Disorders, and those undertaking 3 week “refeeding” programme under paediatrics. Thirdly, caring for young people with perplexing presentations – medically unexplained symptoms, and those at the interface of physical and mental health.
- Plymouth: PymBridge Adolescent Unit. Based at Plym Bridge House, the regional adolescent unit is for young people between the ages of 13 and 18. Dr Garcia-Costas is the supervisor. The unit has 12 beds. Patients have complex psychiatric disorders including eating disorders and emerging personality disorders. On placement you will be responsible for the care of some patients under supervision and will participate in the main ward round and other multi-disciplinary team meetings. Therapy experience includes community groups, family therapy and individual psychological therapies
- South Devon: South Devon: Outpatient team. This post with either Dr Sam Gothard or Dr Femi Akerele is based in Dartington and provides special experience in the community assessment and treatment of eating disorders with regular eating disorder pathway meetings. Other pathway meetings occur throughout the week including those for primary mental health, therapeutic work and urgent care. The latter is the forum for discussing high risk cases and possible Tier 4 admissions. There is also the possibility of being part of the family therapy clinic.
- Bodmin: Day patient team. Based at a new unit called Sowenna at BodminHospital with Dr Seb Rotheray as supervisor. This placement offers the opportunity to work with complex adolescents who may have been admitted to the in patient unit on the same site. However the caseload can be adapted to suit the training needs of the trainee.
Dr Tamsin Newlove-Delgado based at the University of Exeter Medical School (UEMS), has a research interest. She welcomes contact from trainees to help develop their research interests. She is involved in a number of national studies which trainees can join. She can also help trainees develop their own projects, and advise on where to turn for appropriate research supervision.
During the first year of CAMHS training, trainees are expected to complete a literature review as defined in the curriculum.
The College website is a useful source of information.
The new curriculum is also available on the site. This sets out the competencies and standards for training. CAPSAC, the Child and Adolescent Psychiatry Specialty Advisory Committee, has overseen the development of the specialty curriculum.
The South West Division of the College (SWDT) is useful to know about and runs a number of relevant training courses throughout the year such as Section 12 courses, CV and interview skills, risk assessment, transition to being a consultant, writing court reports and workshops on clinical topics. It is based at Coombe Lodge, Blagdon, Bristol BS40 7RE and the telephone number is 01761 463979.
Section 12(2) Approval under the Mental Health Act
This is administered regionally, by Mrs Hilary Eagles, Section 12(2) Manager South West Region. In addition to being section 12 approved you now also need to be an approved clinician to practice as a consultant child and adolescent psychiatrist.
Special Interest Sessions
These can be arranged for a session per week after the completion of the research competence. Sessions will vary with the placement and may include time with the Youth Offending Team, in substance misuse, in an early onset psychosis service, or undertaking an additional training in family therapy, for example.
Specialty Training Committee
There is a Specialty Training Committee for all trainers and trainees which meets on Fridays every 3 months, of which you are a member. This meeting provides a forum for discussing changes to the scheme, providing opportunities for presenting cases or research and also for keeping up to date with educational developments, courses and conferences and the group of trainees and trainers.
It is a condition of placement approval that you should receive an hour of supervision every week from your supervisor. Obviously there may be times, e.g. during leave periods, when there might have to be arrangements for you to receive supervision from another consultant. If you do not think you are receiving sufficient supervision this should be raised with the TPD.
There is a study leave allowance of 30 days per year (per whole time equivalent). Courses need to be approved by the ES/TPD. This is inclusive of the days for the academic programme (usually 13-15 days are needed for this). A training budget is available and study leave budgets are now held by the Deanery, although you should apply for study leave from your employing Trust. In addition there are a number of locally available courses with reduced fees for trainees.
There are various local training courses, including a Foundation Course in Family Therapy, run jointly by Plymouth Psychotherapy Services, Plymouth University Clinical Psychology Teaching Unit and CAMHS.
In addition the Professional Skills Course, currently highly regarded by trainees and free of charge, runs over 5 days and includes modules on leadership, innovation and quality improvement. This is funded by HEESW (formally known as the Deanery).
Applications for study leave should be discussed with your educational supervisor in the first instance, and there are Trust specific forms for applying for leave. The E Portfolio has a section to document the courses you have attended during your training.
The department in Plymouth has an active teaching programme. Medical students from the PeninsulaMedicalSchool, University of Plymouth are taught at various stages of their training. This includes year 3 placements during the Worrying Child Week, Special Study Units (SSUs), year 5 placement blocks, and electives. You will be encouraged to deliver and to organise some teaching and you could also get involved in other aspects of medical school teaching such as clinical skills assessments.
There are opportunities in all posts to teach on the regional MRCPsych course, and to trainees of different disciplines, particularly paediatricians, GPs and emergency medicine trainees. You may have the opportunity of supervising a core trainee (in post 2) or foundation doctor (in posts 2 & 3) and contributing to induction teaching for the core trainees and vocational training scheme (VTS) doctors. You may also like to get involved with the many opportunities for multi-professional teaching especially at the Terraces CDP placement (post 2).
You can help coordinate the journal club/grand round on a Wednesday morning for the wider postgraduate community of psychiatrists attached to Livewell SW, arrange taster days for foundation doctors, and participate in careers events at either medical school.
The curriculum spells out the expected competencies in various therapeutic modalities.
It is worth looking on the Peninsula Medical School website, particularly the Postgraduate Studies at the Peninsula College of Medicine & Dentistry, the Plymouth University website, and the Exeter University website for courses on CBT, individual and family therapy.
A tripartite meeting is a three-way meeting between the TPD, educational supervisor and trainee to ensure that there is a triangulated review at the beginning, middle and end of each placement. These meetings are minuted by the trainee.
Work Place Based Assessments (WPBAs)
The College-based on line system has worked well, and will continue in use. You are responsible for ensuring that your portfolio contains an appropriate spread of WPBAs aligned with competencies. Please discuss this in supervision with your consultant to ensure that these are undertaken at appropriate points in your training and remind your supervisor if there are assessments which need approval.
All educational supervisors who take on new trainees will have been trained in the use of workplace based assessments.
Please see the School Structure page for Head of School, Training Programme Director, College Tutor and School Management contact details.