This webpage aims to provide you with an overview of specialty training in Child and Adolescent Psychiatry in the Southwest, 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 still rich and varied. We have a friendly and approachable team of consultant trainers in Devon and Cornwall, and as we have a far greater number of placements than trainees, there is scope for flexibility where you train. Furthermore, and maybe more importantly, the Southwest has some of the loveliest landscapes in the country ranging from beautiful sand and surf beaches to temperature rainforests in Dartmoor, Bodmin Moor and beyond.
The Child & Adolescent Psychiatry role descriptions can be found below.
Introduction
Dr Ben Parker is the Training Programme Director. Our clinical supervisors are Dr Fernanda Garcia Costas (Plymouth), Dr Sarah Huline-Dickens (Plymouth), Dr Oana Mitrofan (Exeter), Dr Rory Conn (Exeter), Dr Sam Gothard (South Devon), Dr Femi Akerele (South Devon), Dr Susan Howson (Devon), Dr Hermione Roy (West Cornwall) and Dr Seb Rotheray (East Cornwall).
The Peninsula Postgraduate Medical Education has full GMC approval for three National Training Numbers, but this number is increasing. 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 (DPT). Usually a trainee will be in one placement per year for 3 years but longer for those working less than full time. As we currently have far more trainers and GMC approved sites than we have CAMHS higher trainees, we can endeavour to be responsive to your needs in terms of both education, but also in terms of reducing travel time (particularly if you have medical needs or childcare responsibilities) and doing our bit for the environment.
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 this training scheme in the Peninsula Deanery join up with the Severn Deanery CAMHS higher trainees (Bristol, Bath, Swindon and Gloucestershire) to attend the academic programme, This used to take place in Bristol but now occurs virtually. The teaching is in a three-year rolling programme with oversight at consultant level. The course is on alternate Fridays in three 10-week terms per year and usually represents 15 days per year in total. It includes seminars, journal reviews, clinical case presentations, research meetings, outside speakers and a Balint group. It is also an important group for peer learning.
ARCPs
This is the Annual Review of Competence Progression, and is organised via Peninsula Postgraduate Medical Education, information is available on our ARCP Pages.
Audit
Trainees are expected to participate in audit and quality improvement projects in each of their placements.
The Curriculum
The Child and Adolescent ST4-6 curriculum is available on the GMC website.
The Deanery
The Deanery 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. It is also served by a Professional Support and Wellbeing unit (PSW) to which you can refer yourself confidentially if you have any difficulties that 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.
Portfolio Online
This is an important way of keeping a record of your training. It is recommended that you regularly update your portfolio 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.
Management Experience
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.
On Call
The arrangements for being on-call, at the time of writing, are that you are on-call to Livewell (in Plymouth) wherever you are based. The main reason for this is because the Devon CYP POS is based in Plymouth and this will give you greater access to emergency assessments. Plymouth has a dedicated CAMHS on-call rota and not one that is combined with an adult on-call rota, and also has an adolescent in-patient unit. You will join the on-call rota on a 1 in 7 (for a whole-time equivalent post) basis. There will always be a substantive CAMHS consultant on-call with you. In turn you may be supervising an on-call core or vocational training scheme (VTS) trainee when there are issues with child and adolescent patients, particularly in the adolescent in-patient in Plymouth.
Placements
- Exeter: Outpatients: this post is based at Evergreen House with Dr Oana Mitrofan as the 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. There are plenty of opportunities for gaining experience in working with young people (and their families) with neurodevelopmental conditions and eating disorders (including ARFID). There is also a multidisciplinary complex assessment clinic that runs weekly.
- 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: Plym Bridge House – General Adolescent In-Patient Unit: Plym Bridge House is a purpose built General Adolescent Unit (GAU) for young people between the ages of 13 and 18. Dr Fernanda Garcia-Costas is the supervisor. The unit has 12 beds. Patients have complex psychiatric disorders including eating disorders and emerging personality disorders / Complex PTSD / significant attachment difficulties. On placement you will be responsible for the care of some patients under supervision and will participate in the weekly MDT meeting and other meetings including CPAs and Tribunals. Therapy experience includes community groups, family therapy and individual psychological therapies.
- South Devon:(Dartington): Outpatients: This post, with either Dr Sam Gothard or Dr Femi Akerele, is based in Dartington and provides opportunities for exposure to a wide variety of adolescent psychopathology & multi-disciplinary working. There’ll be opportunities develop particular experience in Eating Disorders, Learning Disabilities, Neurodevelopmental disorders and the crisis & home treatment team. Trainees will also have access to Psychological training & supervision, including CBT, DBT, Family therapy & Trauma focused CBT. This placement will provide opportunities for leadership & management experience.
- Bodmin: Sowenna, General Adolescent In-Patient Unit: Sowenna, is a purpose built, state of the art inpatient facility and the service has recently been accredited by the Royal College of Psychiatrists. Working under the supervision of Dr Seb Rotheray, higher trainees would have the opportunity to lead on the care of some patients and gain skills in inpatient management, with a focus on developmental, trauma-informed care. There is a well devised curriculum of competencies to be learnt and then taught and there is plenty of opportunity for cross MDT working, including but not limited to, working in reflective teams, developing the education programme and gaining individual therapy competencies.
- Devon-Wide: Adolescent Outreach Team (AOT): this post is with Dr Susan Howson. A trainee can be accepted with a preference to have the majority of clinical work across North Devon, Exeter or South Devon as preferred. Trainee’s will need to have access to independent transport. Clinical work is either online, home visits or visiting paediatric wards or tier 4 units, including on occasion out-of-county.
- Plymouth: : Revive - Outpatients (Mount Gould Hospital). Dr Ben Parker is the supervisor and there are a wide variety of opportunities besides Core CAMHS. These include the neurodevelopmental pathway, Severe Learning Disabilities team, DBT, CBT, Family Therapy, Art Therapy, Child Psychotherapy, Children in Care Team, CAMHS Eating Disorder Pathway, Infant Mental Health Team, CAMHS Liaison Team, CAMHS Crisis Team, CAMHS Home Treatment Team, CAMHS Early Intervention in Psychosis Team and I-TASC (specialist team working with families with developmental trauma).
- Penwith: Community CAMHS: This post is based in Penzance at Bolitho House with Dr Hermione Roy as supervisor. It is a friendly team who enjoy MDT working. The caseload can be adjusted to the needs of the trainee and there are opportunities in gaining experience in family therapy as well as other therapeutic approaches. Neurodevelopmental assessment occurs within the team and extra experience of complex neurodevelopmental assessment and intellectual disability can be gained, if desired, by short term mini placements with local specialist teams. The service is currently making steps to improve participation and nature based interventions.
Research
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 Royal College Of Psychiatrists
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, the Forensic CAMHS team, in Substance Misuse, Learning Disabilities, Infant Mental Health 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.
Supervision
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.
Study Leave
There is a study leave allowance of 30 days per year (per whole time equivalent). 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. The Peninsula Deanery have published a fairly wide list of mandatory trainings (that are funded) and non-mandatory trainings (that trainees have to self-fund). 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.
Applications for study leave should be discussed with your psychiatric supervisor in the first instance, and there are Trust specific forms for applying for leave. The Portfolio Online has a section to document the courses you have attended during your training.
Teaching
The department in Plymouth has an active teaching programme. Medical students from the Peninsula Medical School, 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.
Therapy Training
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.
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.