Friday, 18 March 2011

Psychiatry? Orthopaedics? Same difference

As one wag put it, psychiatry is a recruiting, not a selecting medical speciality. This year there were something like 550 applicants for 480 jobs in core psychiatry training and this was only after extending the recruitment window - locally we had exactly one applicant per job and before extending the window around one applicant for every two jobs. Although it sounds like enough people many of these applicants will be unappointable and many will have applied for psychiatry as a back-up and will get their first choice job (usually general practice, paediatrics, or core medical training) and not take up their psychiatry place. This means that lots of jobs will be filled in 'round 2' where the people who couldn't get in anywhere else and applicants from outside the EU apply (this explains why in one recent year only 6% of people taking the exam for membership of the Royal College of Psychiatrists had trained in the UK for their medical degree).

But I'm pretty sure stuff like this isn't going to help - the College published the questions to be used at interview in advance this year (although I'm informed that they didn't actually explicitly tell the candidates this) and I'm reproducing the beginning of the 'simulated patient scenario':
You are an F2 doctor on an orthopaedic ward. Jan Smith has been admitted to hospital this morning as a day case for a knee arthroscopy to be done under general anaesthetic... 
Presumably recruitment for core medical training included the scenario:
Imagine you are a consultant neurosurgeon...
Maybe this is some misguided attempt to be 'fair' to those with no clinical experience of psychiatry but I'm reliably informed that locally there are more F2 jobs in psychiatry than there are in orthopaedics. Maybe the College is afraid to even mention psychiatry in their application - perhaps they think no one applying actually has any interest in psychiatry so there would be no point starting a scenario with:
You are a CT1 doctor in psychiatry...

This is not encouraging - I'm also told the psychiatrists on the interview panels had some problems following the ensuing discussions about the management of anaesthetic risks. Do these people have any idea what they are doing?


Steve said...

Maybe it's worth looking at what is putting people off psychiatry. In the Uk if you are 18 and want to help people with mental illness you do a degree in psychology, then a PhD in psychology and apply for one of the few places on a clinical psychology course.

I strongly considered psychiatry as a career but then decided against it after an FY job in it. The reasons were mainly

1. New Ways of working - I felt that it was being taken over by power hungry nurses.

2. The patients all wanted things I couldn't offer like psychological treatments.

pj said...

'New Ways of Working' has definitely done a lot to deprofessionalise psychiatry but I'm not sure most trainees ever get close enough to considering a career in psychiatry to get put off by that.

Steve said...

Yup, that's true, I'm in the minority because I dropped pscyh after working in it, rather than before.