Dual training in General Adult and Old Age Psychiatry
Dual training in General Adult and Old Age Psychiatry is offered in Peninsula Postgraduate Medical Education. The numbers of training posts available varies from year to year. The numbers of posts for a particular year would be advertised at the same time as single CCTs. Doctors in training will spend two years in General Adult Psychiatry to include at least 6 months’ inpatient and 6 months’ community and two years in Old Age Psychiatry, with the expectation that Old Age posts would include 6 months inpatient experience and managing detained patients under The Mental Health Act. In General Adult, at least one year would be spent in Core General Adult Psychiatry in the form of a CMHT post and the second post could include an endorsement subspecialty, such as rehabilitation psychiatry, substance misuse or liaison. An endorsement can also be offered in liaison psychiatry during the Old Age year.
Dual Training in General Adult and Medical Psychotherapy
Dual training in General Adult and Medical Psychotherapy is offered in Peninsula Postgraduate Medical Education. The numbers of training posts available varies from year to year. The numbers of posts for a particular year would be advertised at the same time as single CCTs. Doctors in training will spend two years in General Adult Psychiatry to include at least 6 months’ inpatient and 6 months’ community and three years in Medical Psychotherapy. In General Adult, at least one year would be spent in Core General Adult Psychiatry in the form of a CMHT post and the second post could include an endorsement subspecialty, such as rehabilitation psychiatry, substance misuse or liaison.
Dual training in Child and Adolescent Psychiatry and Intellectual Disability Psychiatry
Dual training in Child and Adolescent Psychiatry and Intellectual Disability Psychiatry is offered in Peninsula Postgraduate Medical Education. The dual training post will provide a unique opportunity for Doctors in training to develop capabilities in addressing mental health issues unique to each of these populations. There is currently only one training post and availability of the post or any future additional posts will be advertised at the same time as single CCTs. It is usually worth contacting the training programme director (TPD) for either Child and Adolescent Psychiatry or Intellectual Disability Psychiatry for up-to-date information.
Doctors in training in the dual Child and Adolescent Psychiatry and Intellectual Disability Psychiatry training programme will spend a total of five years in higher specialist training. Two years will be in Child and Adolescent Psychiatry, two years in Intellectual Disability Psychiatry and 1 year to be spent in a specialist CAMHS/ID post. At the end of higher training a dual Certificate of Completion of Training (CCT) in Child and Adolescent Psychiatry and Intellectual Disability Psychiatry will be achieved. Please visit Child and Adolescent Psychiatry and Intellectual Disability Psychiatry for further details.
Dual Training in Child and Adolescent Psychiatry and Medical Psychotherapy
The dual training is five years in length and on satisfactory completion will lead to a dual Certificate of Completion of Training (CCT) in Medical Psychotherapy and Child and Adolescent Psychiatry.
The Training Programme Directors for Child and Adolescent Psychiatry and Medical Psychotherapy are available are on the school structure page. The two Training Programme Directors take joint responsibility for the running of the dual training scheme.
The dual trainee throughout be allocated an Educational Supervisor (trainer) who is a trained Consultant Medical Psychotherapist and an Educational Supervisor (trainer) who is a Consultant Child and Adolescent Psychiatrist.
There are three strands to the training programme over the five years. One strand is a full higher training in Child and Adolescent Psychiatry; the second strand is a full higher training in Medical Psychotherapy and the third strand is in integrating these two sub-specialty trainings in the applications of psychotherapy in different psychiatric settings. The underlying principle of exposing the trainee to both Child and Adolescent Psychiatry and Medical Psychotherapy from the outset of training concurrently is to foster a ‘training dialogue’ for both trainee and trainers between the two sub-specialties and their different paradigms or ways of understanding the mind.
In the first year the trainee will be offered Child and Adolescent Psychiatry training and preparation for starting their psychotherapy training (which will include starting Personal Psychotherapy where the trainee has chosen to specialise in Psychoanalytic/Psychodynamic Psychotherapy - which is the main modality of most Medical Psychotherapy Trainers in the Peninsula). The trainee should begin to look at external training courses and discuss these with the Medical Psychotherapy TPD at the earliest opportunity. The second year will also be spent primarily in Child and Adolescent Psychiatry to complete the majority of competencies needed for Child and Adolescent Psychiatry CCT, but will have the opportunity to start to attend the Psychotherapy Training Unit in DPT for a half day a week online or another psychotherapy opportunity if there is something specific (e.g. Foundation Training in Family Therapy). Ideally in the second year the trainee will be undertaking the start of their external training for Psychotherapy. The third and fourth years will be consolidating Medical Psychotherapy Training and in the fourth year the trainee will have an opportunity to emphasise leadership development and organisational consultation, as well as undertake supervision of Core Trainees in the Psychotherapy Training Unit. In the fifth year, there will be a combination of Child and Adolescent Psychiatry and Medical Psychotherapy. For example, working in a CAMHS service, but predominantly working in a therapeutic role, rather than a psychiatric role.
The allocation of training posts is made by the Programme Directors in the light of discussions with individual Specialty Trainees, initially directly after appointment and then a few months prior to each rotation point in August of each year. Specialty Trainees are strongly encouraged to meet with the Consultant trainers for their preferred placements prior to the final allocation. Placements will be tailored to trainees’ interests where possible. However, placements may change in the course of training and not all of those currently available will continue to be so at the time the trainee is approaching that stage of training.
Throughout his/her tenure, each ST doctor is entitled to one session per week for research as part of the core training programme in psychiatry and this does not constitute study leave. Specialty Trainees are entitled to additional study leave and one half day for special interest to be planned between trainee and trainer.
Personal Therapy - Trainees undertaking psychoanalytic training undergo their own personal analytic experience. This is for their personal and emotional development and the development of an understanding of the impact of the work with severe psychiatric disturbance, and in particular the emotional challenges of working across different settings with potentially very different ways of thinking about patients.
Psychoanalytic psychotherapy is required throughout the training period with a psychoanalyst or a psychoanalytic psychotherapist registered with the British Psychoanalytic Council and agreed with the Medical Psychotherapy Training Programme Director. The trainee may begin in a once weekly therapy and increase the frequency as they develop through the training but also in keeping with the requirements of the formal psychotherapy training they undertake. This may include multiple times weekly therapy, depending on the training. Some account will be taken of the time required to attend therapy during the working week, some will be in the trainee’s own time. It is expected that personal therapy would continue throughout the duration of training.
For trainees who choose to major in other models of therapy, self-reflective personal development experience which would be considered congruent with the adopted main therapeutic modality training orientation would be required. The chosen path of self-reflective development would not preclude personal therapy.
Trainees in Cognitive Behavioural Therapy or Systemic Therapy as their major modality, who wish to undergo personal therapy, would be supported subject to approval of the Training Therapist by the Training Programme Director.
Academic Training - The aim of the dual training programme is to help the trainee to become a medical psychotherapist and a child and adolescent psychiatrist, who embraces and integrates their medical and psychiatric identity as a specialist psychotherapeutic psychiatrist. The general goals of professional attributes, risk, audit, teaching and supervision, clinical and service management, organisational change and clinical governance will form the backbone of this training programme as they do other advanced psychiatric training programmes.
The distinct theoretical and experiential aim of dual training is to integrate the knowledge and skills of two CCT trainings in both Child and Adolescent Psychiatry and Medical Psychotherapy in such a way that the future Consultant Psychiatrist in Psychotherapy is helped to inform their professional orientation to their Medical Psychotherapy role according to these two different sub-specialities and different paradigms.
Trainees majoring in systemic psychotherapy will be expected to attend the Intermediate Course in systemic psychotherapy in Plymouth and the Masters course in systemic psychotherapy at Exeter University.
Trainees majoring in CBT will be expected to attend a high quality training Course in CBT such as the Oxford Course. This will need to include the application of CBT to a number of different psychological disorders as well as training in supervision.
Psychoanalytic trainees will be required to learn about the theoretical foundations of Psychoanalytic Psychotherapy as well as undertaking a clinical training which will lead to a qualification as a registered Psychotherapist. Courses available in the South West include the two year MSc Course at Exeter University, the subsequent two year BPC qualifying course. There are also opportunities to develop this training into a Clinical Doctorate or a PhD through Exeter University. Alternatively the Trainee may choose to train with the Severn side Institute in Bristol or with Group Analysis South West.
The Training Programme Director in Medical Psychotherapy recommends that all psychoanalytic trainees consider and discuss the possibility of an external psychodynamic training with a training recognised by the British Psychoanalytic Council during their training in developmental discussion with their Medical Psychotherapy Educational Supervisor. The Dual Medical Psychotherapy and Child and Adolescent Psychiatry Training Programme will aim to help the trainee to integrate any external psychoanalytic training with their development as an NHS Consultant.