I was appointed to be a Consultant in Old Age Psychiatry in a community mental health team in November 2014. I have since become part of the undergraduate education team as I have some allocated sessions for teaching medical students as well as doing clinical work. Here is my story from medical student to consultant psychiatrist.
I took a gap year after sixth form and had 5 months in Southern India with Projects Abroad. http://www.projects-abroad.co.uk This led me to live in an isolated rural village in Tamil Nadu with a host family, where I had a placement in a small village hospital. I really enjoyed working and living in challenging circumstances; there was no running water where I stayed. It was really character building and I learnt so much from the hospital - assisting in caesarean sections, giving injections and seeing the care of very poor rural patients for a range of conditions. I also developed a love of travel and experiencing different cultures.
On my return from India I went to Liverpool University. I was attracted to the course which included problem-based learning and had clinical experience weekly from year 2. I am from Southampton and decided to apply for universities ‘up north’, ideally the further the way the better, so Liverpool fitted the bill in terms of course and location, and they said they would have me!
During medical school I quickly ruled out what I didn’t want to do…. Anything with an 8am start (surgery, obs & gynae etc, anaesthetics), paediatrics (I don’t like sick kids), GP (each placement made me temporarily miserable) and ophthalmology (I’m squeamish with eyes). I developed a career short list including mainly hospital medicine and psychiatry. I chose special study modules to help me get more experience of things I liked and have more exposure to them, this included one in a drug and alcohol service and one in community adult psychiatry. I loved them both and this started to push psychiatry up my short list. At the end of 4th year we did our finals (and I passed) and I then took a year out to do a Masters in Science at Liverpool School of Tropical Medicine. I had really wanted to intercalate in something and this masters looked the most interesting of all that was on offer in Liverpool. It also allowed the dissertation project to be overseas - that sold it for me. I soon realised that I had no patience for microscope work, which was a large part of tropical medicine. I also realised that it would be a very difficult career to balance with my other half, who was also a medical student at the time. I did complete a really interesting project in Ghana looking at the sensitivity and specificity of rapid diagnostic tests for malaria. The Masters helped me see that tropical medicine or infectious diseases were not for me but the year gave me a really good grounding in research skills and the opportunity to travel to Ghana for 6 weeks.
After final year, I did my F1 and F2 in a big teaching hospital in Liverpool. There was not the option to do psychiatry posts so I went to do a taster week in adult psychiatry and spent the rest of the two years mainly doing medicine and surgery with 4 months research as an academic F2 in respiratory medicine. http://www.foundationprogramme.nhs.uk/pages/academic-programmes . I decided by F2 that although I enjoyed hospital medicine I preferred psychiatry despite many comments from physicians, e.g. “You seem too good to become a psychiatrist, you should become a …”.
I applied for an ACF (academic clinical fellow post) in Psychiatry for CT1-3. I was offered a post in Manchester and Bristol and decided to move to Bristol as I wanted to work with Prof David Nutt, who I had gone to meet and was very inspired by (see his blog http://drugscience.org.uk/ and http://en.wikipedia.org/wiki/David_Nutt). I really enjoyed working in Severn Deanery and the training in Psychiatry was excellent. It took six months to really know anything about psychiatry having not done it since medical school, but I picked it up quickly and really enjoyed the training. I had posts in community general adult, inpatients, child and adolescent, old age and research. I found role models in Old Age Psychiatry and could see that the consultants seemed happy, enjoyed their job and were keen to teach. I also really enjoyed working with older people and their families and preferred that there were fewer patients in crisis than in general adult psychiatry. I also completed research projects at the university in generalised anxiety and panic disorder and treatment-resistant depression.
I subsequently applied to Wessex for Higher Training in Psychiatry. http://www.wessexdeanery.nhs.uk/specialty_schools/school_of_psychiatry/old_age_psychiatry.aspx I had decided that I wanted to move closer to where I was from and that I would want a consultant job in the area. I also had decided not to pursue a research career, which was an option after the academic clinical fellowships. I enjoyed higher training in Wessex and also became a representative for the Royal College of Psychiatrists Trainees Committee. This was really fun and I learnt a great deal about getting things done at a National level. They also have a medical student and foundation representative so well worth looking into. http://www.rcpsych.ac.uk/traininpsychiatry/trainees/ptc.aspx. There is also a free e-journal/newsletter for those that join as student associates (for free). http://www.rcpsych.ac.uk/training/studentassociates.aspx
During my higher training I also completed a Wessex quality improvement fellowship and some postgraduate qualifications in teaching and management. I have now become a consultant in a community mental health team for older people. It’s challenging at times but really enjoyable and worth all the years of studying. If you are thinking about psychiatry, you can read more at: http://www.rcpsych.ac.uk/discoverpsychiatry/acareerinpsychiatry.aspx.