Higher training

General Adult Psychiatry is a fascinating, challenging, and highly rewarding speciality involving working with some of the most diverse, vulnerable, and stigmatied people in society.

General Adult Psychiatry encompasses a range of specialties involved with the provision of psychiatric care to working aged adults. 

Being alongside adults experiencing mental ill health is an immense privilege. Adults not only carry complex responsibilities including work and family, but also have significant capacity to change. It is about realising potential and recovery. 

You will encounter a wide range of disorders, including manifestations of "organic" brain disorders, psychoses, neurosis, mood disorders, and personality disorders. You will work closely with other agencies within mental health. The psychiatrist works as an integral part of the team.

Work in General Adult Psychiatry allows you to maintain a varied practice, but there are also many opportunities to subspecialise. As such, you could work in a variety of settings and with a huge range of coleagues. 

Knowledge of psychiatric disorders is developing, as are treatments. General Psychiatry is, therefore, a rapidly changing area of psychiatry and one that will allow significant personal development for those within it.

Here at Nottinghamshire Healthcare NHS Foundation Trust we will help you to achieve your full potential.

We are part of the East Midlands Training Scheme and you could join us as part of the three-year higher training programme in General Adult Psychiatry for doctors who have already demonstrated the essential competencies and completed core training from CT1 to CT3. Alternatively, to enter at the ST4 level, candidates should possess MRCPsych or equivalent qualification, in addition to at least 3 years' of experience after Foundation Year 1 training, out of which at least 30 months should be in the speciality of Psychiatry. 

The postgraduate training programme is based on the Competency Based Curriculum for Specialist Training in General Adult Psychiatry developed by the Royal College of Psychiatrist. It is designed to support training for obtaining a CCT in General Adult Psychiatry by working towards an Annual Review of Competency Progression each year. Entry to the programme is through the National Recruitment System administered by Health Education England Northwest. 

We are able to offer endorsements in:

Substance Misuse - "Specialist in Substance Misuse Psychiatry work with others to assess, manage, and treat people of all ages with mental health problems arising from, or complicated by, the misuse of substances such as alcohol, nicotine, and other drugs. They also treat people who have gambling addiction. In addition to working with patients and their families. Substance Misuse Psychiatrist also contribute to the development and delivery of effective substance misuse services."

Liaison Psychiatry - "Specialist in Liaison Psychiatry work with others to assess, manage, and treat people with mental health problems in conjunction with physical (medical or surgical) illness. They have particular expertise in the relationship between physical illness and psychological distress and contribute to the development and delivery of effective services."

Rehabilitation Psychiatry - "Specialist in Rehabilitation Psychiatry work with others to assess, manage, and treat people with severe and enduring mental health problems, and contribute to the development and delivery of effective services for these people and their relatives and carers. The culture of services reflects the prime importance of personal and social outcomes over conventional cure of symptoms."

Experienced Consultant Trainers will provide supervision on a weekly basis throughout the training. Study leave will form part of the educational programme and is arranged in conjunction with the trainees' Educational Supervisor and Training Programme Director. Trainees will take part in an on-call rota during evening and weekends and the nature of these vary depending upon your location. These on-calls are also non-resident. North Nottingham HST on-call rota covers Nottingham and Mansfield and there are 3 STs on call (North, South, Mansfield). You will be supervised by the consultant on-call as the 'first on-call' for queries from junior trainees and other issues requiring senior input out of hours; there are also opportunities to complete out of hours mental health assessments / Section 12(2) work. 

We provide a range of inpatient, outpatient, community, and emergency work in urban and rural settings. 

This is a multidisciplinary profession, and we receive a range of referrals and you will be involved in making decisions regarding the direction and outcomes for these referrals. During working hours, you will be involved in seeing new and follow up patients in a variety of settings. Trainees will take part in an on-call rota during evenings and weekends, the nature of these vary depending upon your location but invariably will involve participating in Section 12(2) work. There is also experience in preparing evidence for tribunals, attending tribunals, and potentially other court reports. 

Trainees have the opportunity to access a wide range of placements relevant to their training, including but not limited to: early intervention in psychosis, assertive outreach, crisis and home treatment, eating disorders, perinatal psychiatry, community forensic services, adult ADHD and specialist autistic spectrum disorder assessment (now known as the Neurodevelopmental disorders services), specialist depression and bipolar services, gender identity services, and psychological services. 

Throughout the three years, trainees are encouraged to complete psychotherapy cases in a range of modalities and will have dedicated supervision either individually or as a group to discuss from a psychological perspective. If psycotherapy interests you then you may also choose to involve yourself in the running of local Balint groups for junior trainees and medical students. 

As a higher trainee you will be encourged to develop competencies in a wide variety of areas including, but not limited to, management and leadership, medical education, clinical governance, clinical audit, quality and improvement, and research. Many of the trusts will run schemes which can even enable you to achieve postgraduate qualifications in the aforementioned. Uniquely we have a close working relationship with local universities and medical schools and many opportunities are available to you both in medical education and clinical research.

There will also be two dedicated sessions a week for special interests tailored to your training needs for example ECT, Nottingham Specialist Depression Service, or Research. 

Nottinghamshire Healthcare NHS Foundation Trust operates across a range of sites in the Nottinghamshire area. More detailed locations of inpatient and community settings can be found by exploring our specialities. 

East Midlands North TPD
Mahendra Kumar
Email: mahendra.kumar@nhs.net

Nottingham and Mansfield DME
Kehinde Junaid
Email: kehinde.junaid@nottshc.nhs.uk

There are 26 GA NTNS in North HEEM of which 13 are in Nottingham and 4 in Mansfield. There are endorsements available in substance misuse, liaison and rehabilitation psychiatry.

You will rotate between three posts during your training to spend 12 months developing skills in each placement. A typical General Adult Higher Trainees' progression may be as follows:

• ST4 CORE (12 months) 50% community experience, 50% inpatient experience 
• ST5 12 months in subspeciality / endorsement year substance misuse 
• ST6 12 months in subspeciality - competencies focus, working towards a 3-month acting up period

Trainees receive great benefits from the monthly speciality teaching programme, owned and run by the trainees, with consultant support. These sessions provide an opportunity for trainees to learn together, continuing professional development, facilitate peer group discussion and support. The schedule usually incorporates a represenative meeting where trainees are offered a safe space to confidentially comment on any training issues which can be shared and subsequently resolved with support from the wider speciality training committee. Trainees also attend the weekly academic programme / journal / case club within the appropriate department. Trainees also have the opportunity to teach on the MRCPsych Teaching Programme. Trainees will often supervise medical students during their clinical placements and facilitate aspects of their programme such as clinical task groups. There is protected supervision incorporated in the timetable for one hour each week. Trainees are involved in wider medical student education and can also become mentors as part of the PsychStart programme.

We offer an immensely supportive environment to train in General Adult Psychiatry as part of Academic Clinical Fellow posts. There is a strong research focus, and trainees supported by the Trust and the National Institute of Health Research. Not only enjoyable, but this experience has helped trainees develop further as both a clinician and researcher. There are also links with the Institute of Mental Health at the University of Nottingham. There are chances to undertake postgraudate qualifications, for example Diploma, PG certificate, Masters, or MD. These opportunities are not limited to academic fellows and are open to all higher trainees.

Trainees are encouraged to use one of their special interest sessions each week for research, with opportunity for recruitment to multi-centre studies. There is a culture within the organisation where trainees are positively encourged to take opportunities to develop in other areas in addition to clinical practice, such as quality improvement projects both through collaboration and in developing their own projects. Trainees can undertake additional training in quality improvement to help fine tune their skills and support their individual projects. 

We have a long history of strongly promoting leadership and management at a local and national level and trainees in the scheme are actively encouraged and supported to develop their skills in this area. Trainees will gain excellent experience in leadership and management, including having the opportunity to work with or alongside clinicians / senior managers who undertake these leadership roles, as well as having support and time to lead on quality improvement initiatives, audit, and other practical management projects.

There are also many opportunites to take active leadership and management roles in the organisation of local events that promote the speciality. Furthermore we also provide opportunities to gain postgraduate qualifications in leadership and management. Leadership and management topics are included in the local monthly academic programme for trainees and trainees are supported to attend the Health Education East Midlands leadership training days.

• Trainees are provided with furnished office space including a computer with internet access as well as IT facilities for remote working where needed
• There is flexibility within training (LTFT, external posts, academic posts) 
• Car parking is available on site, free of charge
• Each team is supported by one or more medical secretaries who are based on-site
• Trainees are expected to drive his/her own vehicle. Home visits should be arranged in close liaison with the members of the multidisciplinary team. Higher specialist trainees are expected to travel during their on-call should the need arise. 

• Royal College of Psychiatry
• Faculty of General Adult Psychiatry
• Institute of Mental Health