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Guest dutchie

who wants to be a psychiatrist?

17 posts in this topic

I was reading a recent article by the new president of the Royal College, and her plans to increase recruitment into psychiatry etc,. it amazes me that the whole issue of psychiatric training and the 'exam' system adopted by the college does not seem to play a role in why

1. there are dropouts from training compared to other fields of medicine

2. a lot of psychiatrists work part-time

3. when we pass a written exam we have to repeat it if we do not pass the clinical..

4. the clinical is highly subjective.

5. the appeals procedure lets face it is non-existent

6 the college demoralises its potential members in the first place.

Iam stuck Id love leave psych and the college behind but Ive wasted too many years in psych now to change to anything else.. run a sandwich shop perhaps?

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and it's not even as tho' it gets any better- what a let down my first SpR job has been. 4 1/2 months on, my confidence and enthusiasm sapped...

Maybe I should start a website organising luxury tours to India......

or open a restaurant....

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hi folks,

took the part 1 this autumn. 95% of the faces were brown like me. seems the future of psychiatry in this country is brown. the fact remains that most of us are in psychiatry coz we found looking for jobs in other branches every 6 months nerve raking and opted for a 3 yr psych rotation. difficult to like psychiatry in such situation isnt it? specially when the single aim in life for the nurses seems to give us a hard time! and of course the bleak image of psychiatry in colleagues of other branches and even the general public....

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Yes the future of psychiatry is brown so long as the colour does not change from brown to beige ,the ever increasing deficit of psychiatrists worsens. For this reason the powers that be have got to improve the status of psychiatry in medical schools in the UK.

Surveys have shown that at 'A' levels the pupils are very receptive to the discipline but something happens in the intervening years . Maybe its about how the subject is taught , maybe its about the adverse press . Generally there are less people applying for medical school anyway these days .

Food for thought .

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Dear painplumber

I disagree with you. Your experiences and perception of psychiatry and those who join psychiatry are exactly that- your views and perceptions. To generalize that as 'facts' is not correct.

right through my 3 years in psychiatry, i have worked in a team which consisted of nurses, among other disciplines. I have found that if i communicate well with the nurses, and other members of the team, i never had 'hard times'.Respect, is a two way thing.

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I agree with ciims. I chose to train in psychiatry cos this i what ive always wanted to do...and i wouldnt give it up for the world. I have thoroughly enjoyed my training in psychiatry both in India and here and cant dream of doing anything else. I love the field i am in and it troubles me to see people generalising their experiences. A lot of us have come into psychiatry because this is what we always wanted to do and are passionate about psychiatry.

Apologies if this offends anyone.

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i dont think every surgical trainee is committed to surgery - or for that matter every school teacher is passionate about teaching. This versatility is the colour of British psychiatry now..

Where I work, I can count the heads who are really in love with psychiatry as against the overwhelming lot who simply chose the easy road to cruise along..

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Why does the myth that psychiatry is easy to cruise along persists? We have one of the more expensive and difficult exams (wrt resits due to failing a bit of a part). Training posts are hard to come by and despite many who do clinical attachments, only a handful get on to a rotation. Many of our colleagues in other fields of medicine look down on us as not proper doctors and yet, many panic and we become the 1st port of call when someone hints at having thoughts of self harm.

Even in a developed and modern thinking country like the UK has stigmatised to a degree people with mental health problems which the public dislike us for as we could 'play god' and hold people against their will. On the other hand, we are also to blamed for all these 'psychotic' people running around killing, wounding and robbing others. I loved the news headline in March when someone announced that up to 80 homicides a year are done by people with mental illness and something should be done about it... so lets forget the 1800+ which is done by people without mental illness eh. Hmmm, wonder how many of these have diabetes or even coughs & colds? Imagine the headline... 800+ homicides annually are done by people with a cold! It is the GPs / Respiratory Medics' responsibility to look after these people! Now, that would be a story!

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And if people are wondering after that rant why I am doing psychiatry... that is because I love it. I feel honoured to be in a position where people tell me things they would not tell others, inc other doctors. I enjoy the challenge of gaining patients trust and helping them on the way to recovery.

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I enjoy the challenge of gaining patients trust and helping them on the way to recovery.

I wish I could see more of this in my daily practice.

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I agree with SH. It has taken me years to find a corner of medicine which I absolutely love- I can honestly say I have enjoyed all the jobs I have done so far on the rotation, and I love this specialty- it is a difficult one to do well, and we should be proud of ourselves if we can do it well- most of the people in more glamourous specialties wouldn't be able to. It does upset me when I hear people saying 'oh I wanted to do medicine, but I didn't think I'd get on a rotation, so I applied for psychiatry because the chances were much better.' And because of the recruitment problems, people with this attitude get on. Then thank God there are some like my mate who only wanted to do psychiatry, and came to England because he wouldn't have been able to be sure of being allocated to psychiatry training in India.

I don't think the exam is particularly unfair, apart from the fact that because it's peer comparison, everyone now needs to have done loads of past questions to pass, rather than knowing about the subject in general. Still, I actually found my revision fascinating. Shame my poor old alcohol and progesterone damaged brain can't recall better!

Sorry if this upsets anyone.....

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Ive opened a few cans of worms here I can see,..

Those who find revising for the mrcpsych enjoyable good for you!.

I enjoy the psychiatry revision not the critical appraisal which seems to be losing direction with each exam. The mcq element is really ones ability to recall the question bank correctly. hardly a test of skill more a test of memory.

The exam I feel is grossly unfair. it is insulting to doctors to make them repeat written tests they have already shown competence in, it is absolutely disgraceful the conduct of some examiners in the clinical exam, the appeals process stinks, the exam fee is extortionate, and i still cant see why it takes 3.5 weeks to release the clinical results apart from 'fixing'.

I dont care what colour skin my colleagues have, most Ive worked with have been excellent. Ive seen loads repeat and repeat and repeat and repeat part 2,. its just ridiculous. Most of my colleagues in Surg/med are finished their exams. psych seems to linger, I think the college like the idea of being tough in order to somehow account for their own inadequacies, this gives them some kind of sad credibility.

Its really time to stop making candidates repeat the written, those of us who passed the written in the past 3 years should now be exempt and have 18 months to complete the clinical exam, there has to be some way around this, I am sure Ec law is being contravened somehow wouldnt it be great get the better of belgrave square?

::)

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I entirely agree with dutchie,about having to write theory agian after passing it and showing ur competence again. There are several people who go through this circus every 6 months. Theory exams prove nothing, it is no test of knowledge. Neither is the clinical. If u can't convince two people that u are good enough in psychiatry, u will have to repeat in 6 months and dish out another £ 600 to the college. And part 2 exam is a long process, it takes 3 months from the date of theory exam till u get the final results, and if u don't get through, it is back to preparing for ur next exam. So u spend all ur time, just preparing and writing exams. Nobody knows why it takes the college 1 month after the clinical exam to announce the results. Even my tutor, who is also an examiner has no clue about it. Other royal colleges like Surgery, Anaesthesia etc announce the results on the same day And the feedback that they give, when u fail is always vague, and u get no insight about how to prepare next time. It is always the same thing. Either u appeared anxious or u didn't put the patient at ease, u needed lots of prompts[even though, it is the examiners who keep interrupting u] etc etc.The royal college has to come out with reasons as to how they score the marks and why it takes such a long time to announce the results. Till they become more transparent, I cannot believe that the royal college conducts the exams in a fair manner.

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hi folks,

its great to learn that some of us do like psychiatry afterall! and better still to learn that some do have great relations with the nurses ( bidirectional respect and all). carry on psychiatrists....

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wrong or right have cleared the part 1 theory so have to practise to smile beautifully for the osce. and of course learn artificial empathy. somebody said 'world is a stage.....etc etc'.

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dear all

been folowing the above discussion for a few days now.... found it fascinating..... the richness and the variety of views expressed in these posts is truly amazing...

having spent the last 2 and 1/2 years in psychiatry myself i will say i am still undecided as to which side of the river i stand on.....

i can assure you that my time in psychiatry has been nothing short of a roller coaster ride... there have been days when i have felt absolutely ecstatic at having done something wonderful, helping someone calm down just by active listening and polite talking when half of the 'medical world' tried and failed..... when i have been complimented by patients and staff (and that includes nurses)..... but then there have been other days when i have felt nothing less than a high risk of suicide myself coz of the feeling of social exclusion and derogation and insults from my peers and patients alike....

i guess my take on this is that very early in ur career u gotta actively get what u love or else u are left with little choice but to love what you get......

nothing can be all good or all bad... though it does seem like that at times....

just smile and wait for the next day.....

meanwhile SOD THE COLLEGE BAST**DS!!!  

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