freedman

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About freedman

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  1. I can guarantee that you will regret it if you go. It is poorly organised, expensive to bring guests, and more importantly extremely boring. Unfortunately I went last year, kicking myself ever since.
  2. I don't think that a comparison to the old Part 2 is appropriate. The pass rate for the old part 2 written was usually in the region of 65%, the pass rate for the old Part 1 written was in the order of 70%. These are probably better historical comparitors. Personally think that a pass rate of less than 50% is indefsible.
  3. I'm going to the liasion psych conference as well. There is a trainnee's/new consultant group last thing on the first day, and there is the conference dinner on the second day. See you there.
  4. If you could be more specifice about what you need to study, then perhaps people could give you some sensible focused advice. All of the above books compliment each other, and have different focuses. YS
  5. It sounds like the SpR is a bit of a cock. However, if I were playing devil's advocate then I could argue that: -Part of SpR training is to gain management and leadership experience (although in this case it sounds like the SpR has failed to demonstrate proficiency in these skills). -If the SpR is in year 3/4 of their training then they are just about to gain CCT and would expect to adopt the role of consultant in the consultants absence. -The MHA Code of Conduct states (para 20.3) that 'Only the RMO can grant leave of absence to a patient formally detained under the Act. In the absence of the rmo (e.g. if he/she is on annual leave or otherwise unavailable) permission can only be granted by the doctor who is for the time being in charge of the patient's treatment. Where practicable this should be another consultant psychiatrist, locum consultant, or Specialist Registrar approved under section 12(2) of the Act.' There is no mention made of staff grades. i.e. to some extent the establishment (through documents such as the code of conduct) legitimises the leadership role of SpRs in the absence of the consultant. -and finally I have had personal experience of a fair few staff grades who swan around as if they are consultants, refuse to do ward work like re-writing drug charts or taking bloods, and some of these do not have MRCPsych despite repeated (failed) attempts. So it can work both ways. Good luck with calming your friend down. YS Freedman
  6. As an SHO on-call, your job is to provide a modicum of common-sense, and attempt to alleviate some of the GP/A+E staff/ward nurses anxiety. When you start You don't need to know about the management of rare, or even common, mental illness, as this will all be done under supervision from senior doctors. Your grounding in liaison will be really useful as you should have lots of experience in managing delirium, and sedation techniques. Read the NICE guideline on rapid tranquilisation. What you really need to do is get a grounding in the basics: 1) buy your own copy of a psychopathology textbook. Sims symptoms in the mind is ok. Fish's clinical psychopathology is in my opinion much easier to read, and the better textbook. 2) Find a really cynical review of diagnostic categories in psychiatry (plenty on the internet) and absorb the arguments. Then find a brief history of psychiatric classification - the chaper on this in the Oxford Shorter Textbook of Psychiatry is ok. 3) Despite all the limitations of classification, buy YOUR OWN copy of ICD-10 Classification of metnal and behavioural disorders. Read it. Learn it. It provides good clinical descriptions of most recognised psychiatric conditions. Bucket-loads of MRCPsych questions are taken almost verbatim from the text - a great revision tool. You need to also do step 1) otherwise you will be wasting your time, but the categories and descriptions in ICD-10 will give you a guide as to what symptoms to enquire about, and the important positive and negative findings for given presentations. 4) Get hold of a copy of the Present State Examination. This is a structures mental state examination. It gives a reasonable starting off point for examining the mental state, and give you some standard questions to fall back on when you are tired, losing concentration, or can't think of what else to ask the patient in front of you. If you do this then you are well on the way to being able to gain a good history and mental state examination. YS Freedman
  7. eeyore, I hadn't seen that. I think it is hilarious. Exactly how are most educational supervisors trained in this. My consultant seems to struggle to even log onto the HCAT system, and has very little idea what any of the different assessments consist of.
  8. I think it is entirely sensible to continue to write questions. The evidence base is continually changing. Important guidelines - including NICE - are reguarly updated. There are also DSM V and ICD 11 on the horizon. Have you also considered that the recruitment process is for people to write questions for a question bank, but that these questions may not be used until exams in the autumn of 2008 or even until 2009. In addition the college probably has a large question bank which SpRs will be well suited to comment whether the question is ambiguous, or the answer wrong or controversial. Good luck with the exam. YS Freedman
  9. The college are quite clear that yes you have to pass the MRCPsych before progressing to ST4. (See latest regulations). In fact this is a position supported by the Trainees committee of the college. HOWEVER PMETB say no such thing. It is PMETB who approve posts and supervise the progress through Speciality Training. The government and PMETB got a bloody nose because of the MTOS disaster and are not standing up to the colleges in the same way they did 1 yr ago. EVEN SO- it is PMETB who control these things, and the college are being presumptuous in dictating things in this fashion. It may turn out that the college retain power, but at the moment I would advise you to write to PMETB and ask for their opinion on the matter.
  10. Adjust the time on the clock in your therapy room by 5 mins. Also think about sneaking into the waiting room and doing the same there. Check your results. See the patient, and pretend that everything is normal. I would find it really difficult to concentrate on the session if I didn't know the result. On the other hand I would find it difficult to concentrate if I did. If I were to fail i would be morose and ruminating about the exam. If I passed I would be euphoric and in a hurry to tell everyone. I think on balance I would definitely want to know before the session.
  11. You are right. The nurses are wrong. I have worked on a ward where the nurses were convinced they could not enforce treatment under section 2. The ward manager supported them in this. The situation was really very difficult, as they were convinced they were correct. Your consultant should be involved in this situation. If they are shit (as I am afraid many are), and unable to resolve the situation, then you should raise an incident form, and also write to the medical director.
  12. Even though behaviour may not be improved at the 3 yr point, during the first 23-36 months of being on medication, these children may have managed to get something of an education, and also managed to establish some deep freindships with other children. If their behaviour does deteriorate later then the effects will be mitigated by these factors.
  13. It is dodgy to get money directly from a patient for a capcity assessment. There is a natural CoI. If you find they lack capacity to manage their financial affairs, then surely they would lack capacity to negotiatie with a doctor over the fee for such an assessment. It is howevere perfectly reasonable to negotiate and receive money from a solicitor acting for the patient.
  14. It's a bit late to be negotiating a fee if you've already done the assessment. In future negotiate your fee in advance. You can ask for any amount you like, it is up to the solicitor to decide whether or not they accept that fee. You are on very dodgy ground tyring to extract money for a capacity assessment directly from a patient.
  15. The Dean's september 2007 letter on the RCPsych website states that we will soon be able to access computerised versions of the WBAs through www.hcat.nhs.uk This website has been approved (and paid) by the college to provide this service. Geoff Searle, who is the college lead on WBAs, has said this facility should be available by the end of September. You all need a portfolio for each year. This should include the usual stuff - GMC/MPS/MDU certificate; lCV; papers; audits; log book of patients seen (anonymnised, with perhaps a few words about each presentation); certificates for BLA/Breakway; record of attendance at lectures, courses, journal clubs; reflective learning; AND a printout of each WBA you do. You can put all sorts of crap in here. You can add new sections as they crop up - thank you letters, teaching done, presentations given, Buy a black A4 lever arch folder. Start filling it now, and do so as you go along. So long as you do 3 ACE, 4 mini-ACE, a couple of Cbd, a JC, and a CP in the next year this will be more than enough. Completing your trusts mandatory training looks good. A PSQ, or a multi-feedback assessment would be a bonus. Log your out-of-hours work, and add crappy patient reflections to some of the cases, and annotate the out-of-hours cases that you have discussed in supervision. Keep a record of what takes place in each of your educational supervision sessions. The world has changed. The SpRs should have been doing this for several years. We now ALL need to be doing it. It is not difficult, just a pain in the arse. You need to adopt a JFDI attitude to it. If you are an ST1 or an ST2 then it would be a good idea to log your ECT work, and get the supervising cosultant to give you a DOPS or equivelant.