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!
Contents
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Why Psychiatry?
Psychiatry is a wonderful, multifaceted, and highly rewarding speciality for anyone who has an interest in people. To be a Psychiatrist is a great privilege as you are trusted by somebody with their innermost thoughts and emotions. Communication becomes a powerful tool for building trust as well as establishing biopsychosocial formulations and delivering treatment. Combining your assessments with a supportive multidisciplinary team leads to a holistic approach to care and a truly fulfilling career.
Training in Psychiatry allows you to think outside the box and to zoom out of algorithms. It entails developing a deeper understanding of the nuanced nature of both mental health and mental ill health. The three-year core curriculum aims to equip you with the knowledge and skills to become a safe, confident, and holistic doctor, giving you the ability to create tangible change for patients, families, colleagues, and other services. The government continues to address mental health in its long-term plan, resulting in the expansion of the speciality.
Choosing Psychiatry is only the first step in opening a world of opportunities. Psychiatry can be shaped around your interests with its strong links to other medical specialities, clinical settings, and a wide range of specialist areas for higher training. This flexibility is encouraged early by most educational supervisors and training programme directors. Psychiatry is incredibly interesting and is very likely to match with variable learning styles.
Training pathway
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During your core psychiatry training, you will have the opportunity to rotate in the different specialist areas of Psychiatry across inpatient and community settings. The training deanery must provide two 6-months placements in General Adult Psychiatry, 6 months placement in Older Adult Psychiatry, 6 months placement in Developmental Psychiatry i.e., selecting a preference for either Child & Adolescent Psychiatry (CAMHS) or Learning Disability (LD), and two 6-months placements rotations in other subspecialties. The latter is usually completed in the last year of core training (CT3) and is an opportunity for the trainee to help them decide on their higher specialty if they wish to become a Consultant Psychiatrist. Examples of such rotations include Eating Disorders, Medical Psychotherapy, Liaison Psychiatry, Forensic Psychiatry, Perinatal Psychiatry, Addictions, and Neuropsychiatry.
The additional requirements in core training are administering Electroconvulsive Therapy and completing short and long cases in Psychotherapy. Gaining these competencies is well-supervised by a senior Psychiatrist and Psychologist, respectively. It is important to note that passing the two written exams (Paper A, Paper B) and the practical exam (CASC) are essential to obtaining qualification into the Royal College of Psychiatrists (MRCPsych). It is ideal to complete Royal College exams during core training to ensure eligibility for applying for higher training in psychiatry.
Higher training is pursued either as a 3-year single subspecialty programme or a 4-year dual training 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. Higher trainees, usually referred to as Specialty Registrars (SpR), rotate across placements for a minimum of 12 months of experience per placement, compared to core trainees with a minimum of 6. There are numerous opportunities to gain further credentials through clinical and non-clinical special interests, which are covered by protected time. Non-clinical special interests can range from doing research to pursuing higher qualifications such as a Postgraduate Certificate or a part-time Master’s Degree. Further information can be found on the college website.
The application
Please be aware that the information below has been updated for applications to Core Psychiatry Training in 2024. 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 invitation to sit a computer-based test, i.e., Multi-Specialty Recruitment Assessment (MSRA). 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. Although there is no computer-based test beyond the Royal College exams, the application process requires a different set of evidence.
Psychiatry is a fantastic medical field worth considering. Its competition ratios have been lower historically but are observed to be increasing. The competition ratios in 2021, 2022, and 2023 are 2.99:1, 3.88:1, and 4.98:1, respectively.
All the best!
Useful Resources
- HEE overview
- HEE guidance documents
- Psychiatry person specification
- 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)
