UK Training Pathway for a Psychiatrist

  • February 10, 2022
 

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. 

Selection 

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. 

Selection 

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 
    • PLAB 

AND 

  • 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. 

Getting started 

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.  

To receive the latest news and updates on all things psychiatry, including the Royal College, GMC registration and the NHS, follow us on social media and join the conversation. 

            

 

Relevant Jobs

110,257 - 164,372

We are looking to recruit a Consultant Psychiatrist to a Crisis & Assessment Team role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.

The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather.

Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%.

The Department & Team

The Crisis and Assessment Team (CAT) serves as the primary gateway to adult and older people\'s mental health services, conducting assessments in the community and emergency settings, alongside medical reviews. They collaborate closely with law enforcement, responding to Adult Protection Notices and coordinating mental health law assessments. This role within the CAT focuses on streamlining referrals, providing short-term crisis interventions, and ensuring individuals receive appropriate ongoing care. You\'ll engage with both working-age adults and older adults, with responsibilities extending to police referrals and mental health law assessments during standard working hours, with on-call commitments.

Continued Professional Development

Professional development is integral to their ethos, offering CESR Portfolio Pathway support, access to specialty training, and opportunities for sub-specialist development. They prioritize ongoing learning through conferences, local CME events, and a generous study leave allowance.

Life in the area

Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.


Am I eligible for this role?

UK based candidates:

  • Experience in General Adult Psychiatry
  • Specialist Registration or locum consultant experience

EEA candidates: 

  • Experience in General Adult Psychiatry
  • European Specialist Qualification


Non-EEA candidates:

  • MRCPsych
  • Experience in General Adult Psychiatry
110,257 - 164,372

We are looking to recruit a Consultant Psychiatrist to an Old Age role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.

The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather.

Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%.

 

What is the health & community service like?

Working in this location is professionally rewarding, offering high-quality, patient-centered care. Clinicians lead in developing and managing services, supported by strong links with UK specialists. With a generous study leave budget, doctors are encouraged to pursue further education. Exciting developments include a new general hospital and a new mental health inpatient unit. The service fosters strong relationships between mental health, primary, and secondary care, promoting joint learning and teaching in a modern education center.

What is the department & team like?

The inpatient services are currently undergoing extensive refurbishment, including two wards for older adults. One ward offers 14 assessment beds for individuals over 65 experiencing functional mental health issues, with some flexibility for those under 65. The other ward provides 10 assessment beds for patients with dementia. Following the refurbishment, the latter ward will feature 8 acute assessment beds and 8 transitional/step-down beds for those with dementia or enduring mental health problems who cannot be supported in local nursing or residential homes.

The Older Adults Community Mental Health Team (OACMHT) manages a caseload of about 300 patients, including new referrals triaged by the Crisis and Assessment team, providing both short-term treatment and long-term care coordination. The role involves providing medical support to the OACMHT alongside two other consultants and a staff grade doctor.

The post holder will join an established team, comprising 2 WTE older adult consultants, 1.0 WTE Associate Specialist (Memory Assessment Service), 2.0 WTE staff grades (inpatient and community), and 1.0 WTE F1 doctor (inpatients and community). Dedicated administrative support includes a 0.5 WTE medical secretary and ward and team secretarial support.

Continued Professional Development

This position offers further training and accreditation within psychiatry, including CESR Portfolio Pathway support, access to specialty training, and the opportunity to develop sub-specialist interests. The post holder will have ample opportunities to develop knowledge, skills, and experience through attendance at relevant courses, conferences, and locally organized CME events. The organization supports Continuing Medical Education with time and financial support, offering study leave of 30 days in 3 years and an annual study leave allowance. Regular case discussions, teaching sessions, and MDT supervision ensure ongoing professional development, meeting the Royal College of Psychiatrists\' CPD requirements.

Living in the Area

Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.

Am I eligible for this role?Am I eligible for this role?

UK based candidates:

  • Experience in Old Age Psychiatry
  • Specialist Registration or locum Consultant Experience
EEA candidates: 
  • Experience in Old Age Psychiatry
  • European Specialist Qualification
Non-EEA candidates:
  • MRCPsych
  • Consultant experience in Old Age Psychiatry
110,257 - 164,372

We are looking to recruit a Consultant Psychiatrist to a General Adult role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.

The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather. 

Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%

General Adult Psychiatry Department & Team

The inpatient service features 17 adult acute beds, including an extra-care area, for individuals aged 18 to 65 with severe mental illness requiring admission. The goal is to promote recovery and well-being, helping service users achieve their potential. The service caters to a diverse population with complex needs. The multidisciplinary inpatient team includes doctors (two part-time consultants, staff grade/clinical fellow, and F2), a clinical psychologist, nurses, a social worker, occupational therapists, an art therapist, healthcare assistants, and administrative staff.

The Home Treatment Team functions as a step-up, step-down service to prevent unnecessary hospital admissions and facilitate early discharge. They attend ward reviews, support patients on leave, and assist with discharge planning, also gatekeeping inpatient beds. The team includes two part-time consultants, a 0.5 FTE team manager, two FTE senior practitioners, 5.5 FTE nurse practitioners, one FTE social worker, three FTE senior HCAs, and one FTE occupational therapist. Covering all adult ages, there is an arrangement with an Older Adult Consultant for additional support if needed.

Continued Professional Development

This position offers further training and accreditation within psychiatry, including CESR Portfolio Pathway support, access to specialty training, and the opportunity to develop sub-specialist interests. The post holder will have ample opportunities to develop knowledge, skills, and experience through attendance at relevant courses, conferences, and locally organized CME events. The organization supports Continuing Medical Education with time and financial support, offering study leave of 30 days in three years and an annual study leave allowance. Regular case discussions, teaching sessions, and MDT supervision ensure ongoing professional development, meeting the Royal College of Psychiatrists\' CPD requirements.

Living in the Area

Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.

Am I eligible for this role?

UK based candidates:

  • Experience in Adult Psychiatry
  • Specialist Registration or locum Consultant Experience

EEA candidates: 

  • Experience in Adult Psychiatry
  • European Specialist Qualification

Non-EEA candidates:

  • MRCPsych
  • Consultant experience in Adult Psychiatry
110,257 - 164,372
We are looking to recruit a Consultant Psychiatrist to a Child & Adolescent  role in the Channel Islands, a UK territory sitting off the coast of France and just a 1 hour flight from London. This job presents a great opportunity to advance your medical career in the UK.

The health service, separate from the NHS, is an integrated, taxation-funded system, free at the point of delivery, managed by the Health and Community Services Department on the island. Key benefits of working there are higher salaries than the NHS, lower taxes and sunnier weather.

Consultant Pay range - £110,257 to £164,372
Single rate of tax - 20%.

The post holder will be expected to take on the full range of duties including the routine and emergency diagnosis and management of children and young people with significant mental health problems (up to the age of 18), the support of other team members, and providing consultation and advice to other agencies. Successful applicants will be encouraged to develop a special interest and take a clinical lead in one of the following areas: Eating Disorders, Crisis Intervention, Neurodevelopmental Disorders, or Transition.

The Health Service

Working for this service is professionally rewarding, offering high-quality, patient-centered care. Their clinicians lead in developing and managing services, supported by strong links with UK specialists. With a generous study leave budget, doctors are encouraged to pursue further education. Exciting developments include a new general hospital and a new mental health inpatient unit. They foster strong relationships between mental health, primary, and secondary care, promoting joint learning and teaching in their modern education centre.

Department & Team

The Mental Health Service is staffed by a dedicated multi-disciplinary team, supported by secretarial and administrative staff. The service provides comprehensive assessment, treatment, and therapeutic interventions for a wide range of developmental, behavioral, emotional, and psychiatric issues in children and young people up to their 18th birthday.

Currently, CAMHS manages 1,627 open cases. In 2022, 926 new referrals were received, with 752 new referrals to date in 2023. The current locum postholder\'s caseload is approximately 90, with most cases having an allocated care coordinator. While most new assessments are conducted by other members of the multi-disciplinary team, some will require an initial medical assessment. On average, there are 1-2 new assessments and 15-20 follow-up appointments per week, depending on case complexity and other commitments.

Continued Professional Development

The health service offers further training & accreditation within psychiatry, including CESR Portfolio Pathway Support, access to specialty training, and the opportunity to develop sub-specialist interest. The post holder will have ample opportunities to develop knowledge, skills, and experience through attendance at relevant courses, conferences, and locally organized CME events. Health & Community Services supports Continuing Medical Education with time and financial support, offering study leave of 30 days in 3 years, and an annual study leave allowance. Regular case discussions, teaching sessions, and MDT supervision ensure ongoing professional development, meeting the Royal College of Psychiatrists\' CPD requirements.

Living in the Area

Living in this location offers significant financial benefits. The flat income tax rate of 20% is notably advantageous compared to the UK, and a generous public sector pension scheme is provided, not constrained by UK lifetime or annual contribution limits. The consultant contract closely mirrors the UK model but offers higher incremental levels starting at £110,257 and with a top basic salary of £164,372.

Am I eligible for this role?

UK based candidates:
  • Experience in Child & Adolescent  Psychiatry
  • Specialist Registration or locum Consultant Experience
EEA candidates: 
  • Experience in Child & Adolescent  Psychiatry
  • European Specialist Qualification
Non-EEA candidates:
  • MRCPsych
  • Consultant experience in Child & Adolescent Psychiatry
52,530 - 82,400

A prime opportunity awaits a dedicated Specialty Doctor in Psychiatry to join the Crisis Resolution Home Treatment Team (CRHTT) for a NHS job in the UK, with CESR support. Located at Eaglestone Health Centre on Milton Keynes Hospital Campus, you\'ll provide top-tier assessment, consultation, and treatment for individuals in mental health crises, with office space and administrative support.

As part of a medical team with a Consultant Psychiatrist and Trainee Doctor, you\'ll demonstrate motivation, energy, and a fervent commitment to exceptional patient care. Strong teamwork, organizational skills, initiative, effective communication, and empathy are key. Operated by an NHS Foundation Trust that is known for excellence locally, nationally, and internationally, this role offers professional growth opportunities for EU-trained specialists and experienced IMGs seeking CESR completion.

What is the NHS Foundation Trust like?

Established in 2002 through the merger of several trusts, this NHS Foundation Trust is among the UK\'s largest. With about 7,000 staff, they serve a third of London\'s population and extend services to areas like Milton Keynes, Kent, Surrey, and Hampshire.

Their focus is on delivering patient-centered, safe, and effective care across various settings, from hospitals to community clinics and even patients\' homes. They emphasize community-based services, aligning with the NHS\'s modernization goals. They prioritize recruiting exceptional individuals who support patients and colleagues alike, offering opportunities for career development. The role entails participating in clinical supervision sessions with the team\'s consultant psychiatrist.

What is the Department & Team like?

The Crisis Resolution and Home Treatment Team (CRHTT) comprises a multi-disciplinary group of mental health professionals delivering a 7-day service for individuals in acute psychiatric crises. They offer intensive community-based interventions as an alternative to hospitalization and support early discharge, facilitating the transition back to the community. The team triages referrals, deciding on home treatment or admission, aiming to provide less restrictive alternatives to hospitalization when feasible.

The Team is composed of:

  • 1.0 wte Consultant Psychiatrist
  • 1.0 wte Specialty Doctor
  • 1.0 wte Core Trainee / equivalent
  • 1.0 wte Team Manager
  • 3.0 wte Senior Practitioner Band 7
  • 14.5 wte Mental Health Practitioner Band 6
  • 2.6 wte Occupational Therapist Band 6
  • 2 wte Therapy Support Staff Band 4
  • 6.6 wte Support Worker Band 3
  • 3 wte Medical Secretary and Team Administrator Band 4

The post holder is expected to make an assessment, diagnosis, formulation of risks and development of a management plan for new referrals, re-referrals and patients under the care of the team. The post holder is expected to identify need for referrals to other services such as referrals for psychological interventions and review treatment plans and risk assessments of patients in the service.

Career Development & Opportunities Available

There is real opportunity to progress through CESR at pace at this trust, with a strong desire for newly-qualified consultants to develop their specialty areas of interest and undertake in various cancer trials and research projects where possible. Research is encouraged here, particularly when this is appropriate to professional development and to the service development of the department. 

If you are a new consultant you will receive mentoring and support from medical leads as well as access to a large peer group of enthusiastic and high-caliber Consultants. 

Life in South East

South East, a vibrant urban area in Buckinghamshire, offers a blend of city amenities and rural charm. Residents enjoy scenic parks & perfect for outdoor activities. The area boasts excellent schools and universities. Transportation links are convenient, with easy access to major cities like London and Birmingham via train and nearby airports like Luton and Birmingham. Housing options range from modern apartments in the city center to spacious suburban homes, catering to diverse preferences and lifestyles.

Am I eligible for this role?
UK based candidates:

  • Experience in General Adult Psychiatry - Crisis Resolution Home Treatment Team
EEA candidates: 
  • Experience in General Adult Psychiatry - Crisis Resolution Home Treatment Team
Non-EEA candidates:
  • MRCPsych
  • Experience in General Adult Psychiatry - Crisis Resolution Home Treatment Team

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