UK Training Pathway for a Psychiatrist
Training in the NHS offers an extensive training scheme and career development for psychiatrists, with the quality and depth of this programme being recognised as a gold standard throughout the international medical community.
In line with developments and progression in psychiatry across the field and around the world, training provided to UK psychiatry trainees is regularly reviewed and updated. This should make the training programme attractive to UK graduates, as well as IMG psychiatrists seeking the best training programmes for their field and career development.
In this article, we will explore the training pathway for psychiatrists in the UK, with a broad look at the following topics:
The NHS Training Pathway
The NHS training pathway refers to the complete programme for UK trainees, from foundation training to the completion of specialist or higher training, where candidates may be eligible for a CCT within their chosen specialism, such as General psychiatry or any of its sub-specialties.
It is important for IMGs to understand this process, as it clarifies what stage they can most likely enter the system if they are interested in training in the UK.
Entering the NHS Training Pathway
After graduating from medical school, doctors will receive provisional registration from the GMC which allows them to enter the Foundation programme (a two-year work-based training programme).
Upon completion of the first year (FY1), doctors will gain full registration with the GMC and will be able to apply for further study and training in a specialised area, such as psychiatry – for psychiatry, this first stage is known as Core Psychiatry Training (CT).
Specialty Training in Psychiatry
The UK Specialty Training programme in Psychiatry is 6 years long, and whilst doctors may pass through training quicker depending on how quickly they achieve their competencies, this is rarely the case and psychiatrists will usually take the indicated time, or slightly longer to complete the Specialty Training programme.
Successful applicants entering year one of core psychiatry training (CT1), will follow the Royal College of Psychiatrists’ 2017 Specialist Training in Psychiatry Curriculum.
The Psychiatry training programme
The psychiatry specialty training scheme operates both as a run-through and uncoupled programme, though it is more often un-coupled.
Depending on where your application is successful, you may complete your period of core training, as well as the Royal College exams before making a further application for the next stage of training (requiring two applications). Alternatively, you may be able to apply for run-through training, which guarantees you complete both Core and Higher training in one region, as you are recruited for the full duration of Specialty Training.
Foundation Training (FY1 – FY2)
The foundation programme usually involves six different rotations or placements in medical or surgical specialties. These rotations enable trainees to practise and gain competence in basic clinical skills.
Here, trainees will either choose whether to enter GP (General Practitioner) training, internal medicine training (IMT) or core training in psychiatry (CT).
Core Psychiatry Training (CT1 – CT3)
This part of training takes place from year 1 to 3, where trainees will work and train in several different sub-specialties within psychiatry. They will gain a broad understanding of psychiatry by rotating between 6-month posts in the following sub-specialties:
- General and Community Psychiatry - including Assertive Outreach, Crisis Home Treatment, Outreach for Homeless People, Early Intervention for Psychosis, Rehabilitation and Liaison Psychiatry.
- Old Age Psychiatry - including Memory Clinics, Community Teams, Domiciliary Clinics, Young Onset Dementia, Day Hospital and Liaison Psychiatry.
- Child and Adolescent Psychiatry - including Specialist Adolescent and Academic Psychiatry.
- Substance Misuse
- Learning Disability Psychiatry - including Specialist Asperger Services.
- Forensic Psychiatry - including all levels of security.
By the end of CT3, trainees will need to have completed the MRCPsych exams.
Please note, trainees must pass the MRCPsych Paper A, Paper B and CASC exams in order to progress to higher psychiatry training.
For more information of the Royal College of Psychiatrists examination suite, take a look at our IMG Resources library here.
There are two opportunities per year to apply to core psychiatry training. Information about how to apply, including the person specifications, is available via the North West Deanery, who manage the recruitment process.
Here, trainees who are not currently training in a run-through programme will make applications to a deanery for higher psychiatry training in their chosen specialty. Selection is open by national competition.
Higher Psychiatry Training (ST4 – ST6)
This training takes place from years 4 – 6, where trainees will complete 3 years of yearly rotations in their chosen speciality, building on their core training and develop increasing levels of competence in clinical psychiatry.
There will also be opportunities to work in other sub-specialties including: addictions, eating disorders, neuro-psychiatry, perinatal and social & rehabilitation psychiatry.
Trainees will usually be allocated a certain number of PAs (programmed activities) weekly for special interest or research purposes. As well as sub-specialty opportunities, these can also be used towards educational opportunities such as local training days/conferences in relevant domains, from clinical leadership to humanities.
Completion of the Psychiatry Specialty Training Programme
Upon completion of the training programme, the choice is made as to whether the trainee will be awarded a Certificate of Completion of Training (CCT) in General Adult Psychiatry of one of its sub-specialisms. This will be based on criteria set out in the curriculum by the Royal College. You can find the 2021 curriculum here.
At this point, the psychiatrists are entered onto the specialist register and can now take permanent consultant posts in the NHS.
Specialist Registration for overseas doctors
Doctors who completed part or all of their psychiatry training outside of the UK are eligible for specialist registration through the CESR or CESR-CP pathways. To learn more about specialist registration for overseas doctors, read our blog here.
Joining the Psychiatry Specialty Training Programme as an IMG
It is possible for overseas doctors to join the Specialty Training programme in Psychiatry in the UK, however it is very competitive.
IMGs interested in UK specialty training must have:
- Full GMC registration
- Completion of a minimum 12-month (FY1 equivalent) internship
- English language test
- 12 months post-internship experience by the time you start begin ST1
Although UK trainees are not given priority for specialty training places, it can be very difficult to join the Psychiatry Specialty Training programme without NHS experience.
So here you have it, a broad overview of the NHS Psychiatry Specialty Training pathway for UK trainees. This training scheme is the core of psychiatry training in the UK, and for IMGs looking to join the training programme, understanding of the pathway allows you to better align your overseas training with the relevant stage you wound enter into Specialty Training in the UK.
If you have any further questions about the UK training pathway or your route to the UK as an overseas psychiatrist, or would like guidance in finding NHS posts which offer CESR support, please get in touch with us here.
For access to a community of like-minded MRCPsych aspirants and dedicated psychiatry recruiters, join the IMG Psychiatrists Facebook group.
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