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!
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Why Psychiatry?
Psychiatry is a dynamic, highly rewarding specialty centered on human connection. As a psychiatrist, you are privileged to build deep trust with patients, using communication as a primary tool to form biopsychosocial formulations and deliver holistic care alongside a supportive multidisciplinary team.
Training encourages holistic clinical judgment rather than rigid medical algorithms, giving you a deep understanding of mental health and illness. The 3-year core curriculum develops safe, confident doctors capable of making a tangible impact on patients and health services, with ongoing NHS expansion providing strong career growth.
The specialty offers exceptional flexibility and varied career paths. With strong links to other clinical specialties and diverse sub-specialist training options, educational supervisors actively encourage trainees to tailor their pathway to their individual interests and learning styles early on.
Training pathway
During Core Psychiatry Training (CT1–CT3), you rotate through inpatient and community settings. Mandatory rotations include 12 months in General Adult Psychiatry, 6 months in Older Adult Psychiatry, 6 months in Developmental Psychiatry (CAMHS or Learning Disability), and two 6-month posts in elective subspecialties (e.g., Liaison, Forensic, Perinatal, Addictions, Eating Disorders, or Psychotherapy) during CT3 to help guide higher training choices. Core training also requires supervised competencies in Electroconvulsive Therapy (ECT) and Psychotherapy (short and long cases). Passing the MRCPsych exams—Paper A, Paper B, and the CASC—is essential during CT1–CT3 to progress to higher training.
Higher training consists of either a 3-year single-specialty or a 4-year dual-specialty CCT programme. The latter takes longer as it allows the Psychiatrist to obtain two Certificates of Completion of Training (CCT), making them eligible to apply in both specialist registers and work in either area. Specialty Registrars (ST4–ST6) undertake 12-month placements (rather than 6-month posts) and receive dedicated protected time for clinical or non-clinical special interests, such as research, medical education, or postgraduate degrees.
The application
Please be aware that the information below has been updated for applications to Core Psychiatry Training. Always check the application process on the NHS England website.
Since early 2021, the interviews and portfolio scoring for CT1 Core Psychiatry Training, ST1 Child and Adolescent Psychiatry, and ST1 Psychiatry of Learning Disability are no longer applied. The process now involves a standardised application, longlisting, and an invitation to sit a computer-based test, i.e., the Multi-Specialty Recruitment Assessment (MSRA).
Because offers are made strictly in rank order based on the cohort’s performance, there is no fixed pass mark or set cut-off score:
- Minimum Eligibility Threshold: Candidates must achieve a raw score of at least 186 in both papers (Professional Dilemma and Clinical Problem Solving) and avoid a Band 1 result in either section.
- Competitive Scoring: Due to the steep increase in competition (over 20 applicants per post), candidates generally need a score comfortably above 530–550+ (placing in the top percentiles nationwide) to secure an initial offer, especially in competitive regions like London or the South East. Lower scores may occasionally yield offers during later recycling/upgrade rounds depending on post preferences.
According to the NHS England website, applying for the latest Round 3 February 2025 intake requires documentation evidence of a medical degree, English language skills and medical Foundation competencies, or a single scanned CREST form signed by a Consultant who has supervised the applicant. Offers will be based only on the ranking of MSRA scores. The application process is facilitated through the Oriel electronic portal.
It is well worth noting that interviews remain for applications in higher training (ST4), which have been conducted online in the last few years.
Competition for Core Psychiatry Training (CT1) has risen sharply in recent recruitment cycles:
2025 Competition Ratio: 21.83: 1
– Applications: 10,677; posts: 489
Previous Trends:
2024: 9.45: 1 (4,650 applications for 492 posts)
2023: 4.98: 1 (2,610 applications for 524 posts)
2022: 3.88: 1 (1,876 applications for 484 posts)
Psychiatry is a fantastic medical field worth considering. All the best
Useful Resources
- HEE overview
- HEE guidance documents
- Royal College of Psychiatrists information on Psychiatry training
- Royal College of Psychiatrists information on bursaries and prizes
Written by Dr Chloe Crofts (CT2 Psychiatry)
Reviewed by Dr Dominique Calilung (ST4 Forensic Psychiatry) and Izemnur Arican (CT3 Psychiatry)
