The Scheme offers posts in all Trusts providing psychiatric care in Devon and Cornwall, with experience ranging from cities to suburban and dispersed rural areas. There is a range of models of service provision on inpatient, outpatient and community based care. The rotational scheme affords placement in several branches of psychiatry; liaison psychiatry; substance misuse, general psychiatry, psychiatry of old age; Forensic Psychiatry, Home Treatment, Early Intervention in Psychosis, Eating Disorders and Psychotherapy. Training occurs in a number of different settings; psychiatry hospitals, community units and academic departments. As there are more approved training opportunities than funded posts Specialty Trainees have considerable choice and flexibility in planning an individually tailored training programme.
The training in each of the training posts have been planned to give each Specialty Trainee a broad experience as well as providing scope to develop research and pursue a special clinical interest. Please see post descriptions below for more information:
The basic plan of each one year training post is:
- Eight clinical sessions with the principal Consultant Trainer
- One special interest session, which may be with the Consultant Trainer or with another Consultant. The special interest sessions will be arranged after discussion with the Programme Director.
- One research session supervised by a member of the Academic Department or a supervisor approved by the Programme Director.
The training scheme is based around main centres in Bodmin, Redruth, Exeter, Plymouth, Barnstaple and Torbay. Each centre has its own on-call arrangements. Specialty trainees on the scheme are employed by one of three NHS Trusts: Cornwall Partnership NHS Trust, Devon Partnership Trust and Plymouth Primary Care Trust. The Peninsula Postgraduate Dean is Geoff Smith, Plumer House, Tailyour Road, Crownhill, Plymouth, Devon. PL6 5DH
The training will be split into 3 years of training, the first year would usually be a core post with years 2 and 3 more specialised depending on the trainee career plans. The order of these posts and the individual placements will be dependent on the training needs of the trainee and availability of posts. Each 12 month placement will be allocated after discussions between the trainee and Training Programme Director. Specialty Trainees are strongly encouraged to meet with the Consultant trainers for their preferred placements prior to the final allocation.
Dual Training in Adult and Old Age consists of 4 years training, 2 in each specialty. The order of these posts will be dependent on the trainee plans and availability of posts allocated after discussion with the TPD.
There are 15 posts on the rotation. Four NTN’s exist in Old Age Psychiatry and eleven in Adult Psychiatry. It is possible to apply to dual accreditation in Old Age and General Adult Psychiatry. Of the fifteen posts, four are allocated to Cornwall Partnership Trust, four to Livewell Southwest and seven to Devon Partnership Trust.
Throughout his/her tenure, each Specialty Registrar 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 an additional study leave and this is not used for the day per week for research as part of core training. The Specialty Trainees are also encouraged to meet monthly for informal support and specific educational activities.
The Programme Director runs a regular training surgery in each locality and trainees are encouraged to make use of this facility. The scheme has a well established ARCP (Annual Review Competency Progression) process which is highly regarded by trainees.
Specialty Trainees are encouraged to conduct research. Each Trust has modern library facilities and access to internet facilities.
Opportunities exist within both University of Exeter Medical School and Plymouth University Peninsula Schools of Medicine and Dentistry for undertaking MSc degrees in clinical research and education and trainees are actively encouraged to undertake a higher degree. In addition, opportunities exist within the academic department of mental health, in both universities for working collaboratively on research projects in the field of mental health.
SPECIAL INTEREST SESSIONS
Specialty Trainees are encouraged to make full use of their special interest sessions which may be used to pursue a higher qualification that is relevant to their training.
Cornwall has a population of approximately 486,000. It represents the second largest county in the area but has the lowest population density.
The county has the longest coastline of any English county, some 570 km; the river Tamar forms a physical and cultural divide with the rest of Great Britain for all but 18km of its length. The Isles of Scilly lie 45km off Lands End. The distance between the north and south coast varies from 72km in the east of the county to as little as 8km at the western end.
Much of the county’s identity has been maintained in traditions and culture and it possesses distinctive physical features in its peninsular form with stunning coastlines, moorlands and a temperate climate. A past history of mining has been subsumed by the growth as a holiday area together with some recent manufacturing industry. The area remains however largely rural in character and farming and fishing in the west is still the mainstay of economy.
There is a wide scatter of small towns and villages. Only 31% of the population live in towns of over 10,000 inhabitants (Penzance, Camborne, Redruth, Falmouth, Truro, Newquay, St Austell, Bodmin and Saltash).
Cornwall’s renowned temperate climate allows for such activities as sailing, wind surfing, swimming, and walking. There are also several Golf Courses in the county. Leisure Centres are provided throughout the county. The attractive cathedral city of Truro is the sub-regional centre and offers extensive shopping and leisure facilities. Performing arts are catered for at the Hall for Cornwall, Truro and a range of other venues including the spectacular Minack theatre in Carrick. There is a thriving artistic community and the centre for modern and contemporary art is at the St Ives Tate Gallery in the west of the County. There are also a number of impressive restaurants throughout the county providing a wide choice of cuisine. The County offers excellent primary and secondary education through state and public schools, coupled with a comprehensive choice of adult education classes.
Major national and international tourist attractions such as Heligan Gardens and the Eden Project attract visitors throughout the year.
A choice of properties including waterfront, smallholdings, traditional and new build are all available within county.
Plymouth is a major centre of population with large industrial, residential and leisure sectors and as such its population has a wide range of health care needs. Livewell South West is responsible for providing secondary mental health, rehabilitation medicine and geriatric services plus a range of primary community services including community nursing, reablement teams, dental services and remedial therapies. In addition the Trust manages two community hospitals, located at Tavistock and Kingsbridge. Livewell South West provides services to acute general adult psychiatry, rehabilitation and old age psychiatry for the catchment area. There is a specialist Community Drugs Service and a developing Community Alcohol Service. Child and Adolescent Psychiatry care is now also provided by the Trust. Glenbourne also houses an ECT suite, administrative offices and meeting and conference rooms.
Almost 60% of the population served live in the city itself and services must therefore cater for a large inner city population. Unlike some other areas of the SW Region, Plymouth does not have an unusually high number of elderly people in its population. The age structure is similar to the national pattern with 19% under 15 years and 17% over 64 years. Projections show that although the population will grow by only 3% during the next 10 years, there will be a 36% increase in those over 75 years of age. There are good road and rail links to central southern England. To the north-east is the rugged and virtually unpopulated Dartmoor national park. The South Hams area to the east of Plymouth boasts many charming villages and fishing ports. The area has a full range of educational and leisure facilities.
A large part of Wednesday mornings is devoted to the academic programme for the training of junior doctors. Under the supervision of the Clinical Tutor, the Specialty Trainees are involved in organising and participating in this training. There is a weekly case presentation and Journal Club, where Specialty Trainees are expected to be active participants in organising, delivering and teaching. In addition, Dr Montgomery runs a regular research clinic to support trainees undertaking research projects. From September 2009, the Peninsula MRCPsych course will be coordinated and delivered from Plymouth run by Drs Cooper, Rana and Bickerton. Higher trainees are actively encouraged and supported to involve themselves in delivering the teaching.
- Devon Partnership Trust
The Devon Partnership NHS Trust was created on 1 April 2001. From July 2002 the Trust provided Mental Health, Learning Disability and Social Services to the majority of the Devon population apart from those living in Plymouth, who continue to receive those services from Plymouth Community Healthcare and Plymouth Social Services.
The Devon Partnership Trust offers a comprehensive range of mental health and social care provision with services to adults, older people, people with learning disability, children and adolescents, adults with physical/sensory disability and people with drug and alcohol problems. Across the Trust there are specialist services for Forensic Psychiatry and Psychotherapy. There are strong academic links with our main research partner, the University of Exeter Medical School, through the Mental Health Research Group based in Exeter.
Exeter is a Cathedral city and is the regional centre and county town of Devon. The Devon Partnership Trust headquarters are at Wonford House Hospital, Dryden Road, Exeter. Wonford House Hospital is adjacent to the Royal Devon and Exeter Hospital on the same site. The Wonford site is within its own grounds, a mile from the city centre. Devon Partnership Trust provides services to Exeter and the surrounding area through the Exeter and East Devon locality. The Exeter and East Devon locality serves a population of 243,000 in total; 21% of that population are aged 65 plus; 57% lie between 20 and 64; and 22% between 0 and 19.
Wonford House Hospital houses the Specialist Eating Disorders Unit, Older Persons Psychology facilities for Exeter City, and district Psychiatric Rehabilitation Services. The Cedars, a purpose-built unit, adjacent to Wonford House, provides acute admission facilities for Exeter, East Devon and Exmouth localities, Delderfield Ward; and the Tiverton/Okehampton localities, Coombehaven Ward. The Liaison Psychiatry service to the Royal Devon & Exeter Hospital, and the Mental Health Group of the Institute of Health and Social Care Research, University of Exeter Medical School located in Wonford House Hospital. The Department of Clinical Psychology is also on the Wonford site, adjacent to other medical academic departments of the Peninsula Medical School.
The library situated in Wonford House is specialist and stocks a wide range of books covering all aspects of mental health. It is part of the University of Exeter library service and the catalogue can be accessed on http://www.exeter.ac.uk/library/. There is a range of periodicals and journals for reference. The library is staffed during weekdays except Wednesdays. The librarian can arrange inter-library loans. There is access to online databases and literature searches. Additional specialist journals are held in the department of clinical psychology.
Within Wonford House there are regular, well organised, activities supporting training and continuing professional development:
- Case conferences are held over Tuesday lunchtime from 12.30 in the Bucknill Conference Room. Journal club runs on Wednesday lunchtime in the junior doctor’s common room from 12.30.
- Audit meetings are held monthly on Mondays from 12–1pm. There is support from the audit department for trainee projects.
- Wonford House Hospital hosts the Exeter Part 1 and Part 2 MRC Psych course on Thursdays and Fridays, attended by trainees from across the Peninsula.
Torbay incorporates the areas of Torquay, Paignton and Brixham and extends from Dartmouth in the south to Dawlish and Moretonhampstead in the north.
The district is mainly rural in nature, with small towns and a major urban conurbation on the bay. It provides extensive holiday facilities which produce a large increase in population in the summer months and holiday periods of the year. The main industries are tourism, leisure and residential care. The area has an extensive range of leisure facilities from water sports to moorland walking. There are good schools in the area including both boys and girls grammar schools. Torbay is an attractive centre with a favourably mild climate and easy access to Dartmoor National Park and the coast. The county’s two major cities, Exeter and Plymouth, are both less than an hour away by road. There are good rail links with Bristol and London (less than four hours away).
The teaching programme is organised by the Clinical Tutor (psychiatry). There is a weekly session for postgraduate education with a tutorial held by the Clinical Tutor and a weekly tutorial held by the Specialty Trainee and/or Consultants in the Department of Psychiatry. The postholder would be expected to contribute to the educational session, tutorials and examination practice sessions.
Clinical audit is co-ordinated by the Consultant responsible for audit, who is supported by a secretary. The postholder will be expected to present at audit at least once in the academic year. The postholder will be expected to contribute to audit and training sessions with the non-medical clinical staff.
- University of Exeter Medical School and Plymouth University Peninsula Schools of Medicine and Dentistry
These two medical schools were formed from The Peninsula Medical School. Within the University of Exeter Institute of Health and Social Care, the Mental Health Research Group conducts health services research and has a strong track record of publication and grant income generation. Details of research activity is available at http://medicine.exeter.ac.uk/research/healthresearch/. Specialty Trainees are encouraged to become involved. Many recent Specialty Trainees have been involved in research through the department and have published successfully in the peer-reviewed literature. There are opportunities for training in research methodology and statistics through both schools. There are a number of research-based courses available from workshops through taught masters degrees to MD or PhD. Plymouth is rapidly increasing its research activity along with expanding its research networks.
The Peninsula MRCPsych course is hosted in Plymouth. Specialty Trainees are actively encouraged to become involved in postgraduate teaching on the course.