MissRachael

ST4 dilemma ... advice appreciated

8 posts in this topic

Hi folks,

I'm currently CT3 psychiatry, have completed MRCPsych and am due to start applying for ST4 posts in February ...

My major dilemma is that I have absolutely no idea what to specialise in and where. I love psychiatry, it was a no brainer for me in terms of core training, and I have been fortunate enough to love every rotation so far. I feel I could probably be happy and competent in any of the specialities and I suppose different things attract me to all of them (I've done adult, liaison, old age, forensic, CAMHS and due to start substance misuse in feb)

One idea that I am quite drawn to is the possibility of dual training in General Adult and Medical Psychotherapy. This would likely mean a relocation as I am currently in the Northern Deanery and I don't think there are upcoming posts, I wondered if anyone had any experience of this/views.

I'm probably a bit of a mix in that I love the acute side of psychiatry including risk management, the challenge of limited resources , the variety of a busy OP clinic ... but I also have a real interest and passion for different forms of psychotherapy and how they can provide alternate ways of viewing clinical problems and helping patients on an individual basis, but also at a team or service level.

I suppose I'm just looking for any advice really, as I rapidly approach ST4 applications with a sense of not having a clue what decision I should go with...

The other thing I considered was taking 12 months out to locum in psychiatry in Australia or NZ, i guess to get a bit more experience, including life experience, then go back to it with a hopefully clearer direction.

Any thoughts/comments would be so much appreciated.

Rachael

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what does ur heart say ?

after 3 years in psych as a core trainee, i assume that you have had a fair share of experience of the various subspecialities... which one was it that made you feel the most comfortable and at home ??

also assess your priorities.. does geographical take priority for you over a subspeciality of choice or vice versa ??

i admit it wont be an easy decision to make, give it some thought.. speak to trusted friends, family, colleagues, consultant and the other half.. and then make a decision.. think about time 5 years from now on and make a decision that you wont regret then..

good luck !

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In relation to the job market post CCST, I would go for CAMHS, Old Age, LD probably in that order (arguable whether greater demand in LD or Old Age - but I see bigger growth in Old Age - demographics) - I would avoid Substance Misuse, it is being taken over by a number of private/third sector organisations, and pay/workload/job security are not good, dread to think what will have happened in 3-5 years.

Adult probably gives the greatest opportunity for private work outside of work hours. Forensic would open the door to working in the private sector in a substantive post - big money - think starting salaries above the max NHS Consultant scale, plus a nice bit of Medico-Legal on the side. Happy to have a "no obligation" chat if you like, just PM me with your mobile number.

I would also do your training first, and then go to Oz/NZ, you will be snapped up, with a firm job offer before even applying for registration with the Medical Council there.

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Medical psychotherapist are a dying breed sadly. However the way forward is as you rightly pointed out Dual training.

I think psychotherapy lends a certain art to the practice of psychiatry (whichever branch you choose.)

There is also the option of Analytic training which also would open up doors for private work if that's what you want to do.

It is a tremendous investment however time wise.

There are a number of dual training numbers in most deaneries so you would be spoilt for choice as to where to go.

The competition will obviously depend on where everyone else wants to be.

How much training /work have you done in Psychotherapy? That is usually the clincher at interviews.

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You sound young and without commitments (which is excellent, because it increases your options).

Higher training is 3 years, thus, if the above is correct, you can afford to sojourn anywhere in the country prior to taking up a permanent consultant post.

If you are considering OA/LD talk to trainees in other parts of the country /services you have not worked in. I've seen people crumble/ change their mind once faced with a reality of dealing with a situation/service organisation different to what they were expecting. 'The challenge of limited resources' is a recipe for burnout me thinks...!

They say there's lots of private sector work for LD & For, but what of the financial impications re: pension et?

If someone knows the answer to that one...let me know :)

Psychotherapy is dead/no growth I know three CCT holders who are retraining in GA.If you have a strong interest, do it the other way round (train in GA and use your special interest in psychotherapy)

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In relation to the job market post CCST, I would go for CAMHS, Old Age, LD probably in that order (arguable whether greater demand in LD or Old Age - but I see bigger growth in Old Age - demographics) - I would avoid Substance Misuse, it is being taken over by a number of private/third sector organisations, and pay/workload/job security are not good, dread to think what will have happened in 3-5 years.

Adult probably gives the greatest opportunity for private work outside of work hours. Forensic would open the door to working in the private sector in a substantive post - big money - think starting salaries above the max NHS Consultant scale, plus a nice bit of Medico-Legal on the side. Happy to have a "no obligation" chat if you like, just PM me with your mobile number.

I would also do your training first, and then go to Oz/NZ, you will be snapped up, with a firm job offer before even applying for registration with the Medical Council there.

Hi Paul

 

I am in the same dilemna as well.is there any chance you could give me advise on this

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Hi MissRachael, I was curious, if you're still reading this forum, where you landed up?!

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Reading these discussions makes me feel so laid back 

I didn't think so detailed

 

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