Applying to Psychiatry Training

Do you have an interest in human behaviour? Did you go into medicine to speak to patients? Are you looking for variety in your work? Do you want to make a difference in people’s lives?

Then Psychiatry could be for you!

Why Psychiatry?

Psychiatry is a wonderful speciality for anyone who has an interest in people. Being a Psychiatrist is a privileged position where you are permitted into someone’s inner world, combine this with a supportive multidisciplinary team and the result is a truly fulfilling career.

Training in Psychiatry allows you to see beyond the scenario presented and understand deeper, more complex, dynamics. Psychiatry training develops the tools needed to become a holistic doctor, giving you the ability to create tangible change for patients, colleagues and services. In recent years, this has been combined with the support of government initiatives, resulting in Psychiatry expanding as a speciality.

Why did I choose Psychiatry?
My reason for choosing Psychiatry is that I get bored easily! Each person has a unique story and I find Psychiatry offers new challenges every day. As a trainee, my week is varied with protected time for professional development; I may be presenting at a tribunal one day and administering ECT the next. The support I receive within Psychiatry surpasses anything I have experienced elsewhere. I meet with my clinical supervisor for protected time every week in addition to regular balint groups. 

Choosing Psychiatry is only the first step in opening a world of opportunities. Psychiatry is a career that can be shaped around your interests with a range of sub-specialities spanning the whole of the biopsychosocial model. This flexibility means Psychiatry suits a range of personalities. If you are looking for a career to spark your interest then Psychiatry is for you!

Training pathway

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After starting Core Psychiatry training, you will rotate through sub-specialties of Psychiatry. All programmes must provide 12 months experience in General Adult Psychiatry, 6 months experience of Older Adult Psychiatry, a 6 month Developmental Psychiatry placement (this is usually Psychiatry of Intellectual Disability or Children & Adolescent Psychiatry) and two 6 month rotations in ‘specialities’. This is the opportunity for you to choose an area of Psychiatry you are interested in. Examples include: Eating Disorders, Psychotherapy, Liaison Psychiatry, Forensic Psychiatry and Neuropsychiatry. There are additional requirements during core training, this includes administering ECT and completing psychotherapy cases. Many trainees also choose to complete their college exams during core training to ensure they are eligible for a higher training programme.

After completing core training, you are eligible to apply to a higher training programme. During higher training, you can choose to CCT in one sub-specialty of Psychiatry or dual train. Trainees rotate through a minimum of three 12 month rotations in their chosen specialty. There are additional accreditations and all higher trainees have protected time each week to pursue a special interest. Further information can be found on the college website.

How to build your portfolio

The first step to building your portfolio is to read the Core Psychiatry person specification. Try to focus on increasing your exposure to Psychiatry with rotations, taster weeks, courses and conferences. The Royal College of Psychiatrists offers bursaries for Medical Students and Foundation Doctors in addition to essay prizes. If you are able to be involved with teaching, this is also a great opportunity to increase your portfolio score.

The Royal College of Psychiatrists is not looking for individuals who are already experts in mental health. They are looking for people who have an appreciation of the career to which they are applying, and the traits needed to be a successful Psychiatrist. If you are able to demonstrate these through your portfolio, you are sure to score highly at the interview.

The application

Please be aware that the information below is based on applications to Core Psychiatry Training in 2020 and may vary in following years. Always check the application process on the HEE website.

Applications to Core Psychiatry Training are completed using the Oriel system and all applicants sit the MSRA exam. If an applicant scores within the top 10% of the country, they are able to ‘bypass’ the interview process and are successful in being appointed to their preferred training post. If not, the applicant is required to attend an interview.

The interview

There are two main interview centres (Glasgow and Manchester). The interview consists of two stations, a portfolio station and a clinical station. The portfolio station consists of questions expected at an interview and is your chance to explain why you want to do Psychiatry. It also allows an opportunity to show how you meet the person specification using a combination of your portfolio and answers to questions. The main aim of the clinical station is to demonstrate your patient communication skills. There are commonly used scenarios that involve taking a history from or explaining something to a patient actor. The interview panel are not expecting a level of knowledge beyond the requirements of a Foundation Doctor but are assessing your ability to communicate and connect with the patient. After speaking with the patient actor, you will be prompted to share your reflections on the interaction.

The scores from the MSRA are combined with the interview score. After this, all applicants are ranked and allocated to posts. There are multiple question banks that can be used to help prepare for the MSRA and I highly recommend the book ‘Medical Interviews: A comprehensive guide to CT, ST & Registrar Interview Skills’ by Olivier Picard to practice for the interview. Although Psychiatry has had lower competition ratios historically, this has increased over the years to 2.99 in 2021.

Best of luck!

Useful Resources 

Written by Dr Chloe Crofts (CT2 Psychiatry)

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