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Are some subspecialties better with foundation doctors?

Published online by Cambridge University Press:  02 January 2018

Luke Solomons
Affiliation:
Berkshire Healthcare NHS Foundation Trust, Royal Berkshire Hospital, Reading, UK, email: luke.solomons@berkshire.nhs.uk
Gopinath Ranjith
Affiliation:
Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, London, UK
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Abstract

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Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2012

Welch at al's Reference Welch, Bridge, Firth and Forrest1 qualitative exploration and findings on the views of foundation trainees on psychiatry placements were interesting and hopefully will contribute towards creating posts that are valuable to trainees. The transition from medical school to the ward environment is a challenging one Reference Tallentire, Smith, Wylde and Cameron2 and early impressions can influence trainees a great deal in their choice of careers. Reference Maidment, Livingston, Katona, McParland and Noble3

The conclusions of Welch et al's paper are not as favourable as the outcomes described by Boyle et al. Reference Boyle, Chaloner, Millward, Rao and Messer4 There could be several reasons for this: larger numbers of respondents, trainees’ individual preferences, life choices and career plans. Perhaps another reason was the subspecialty in Boyle et al's report – old age psychiatry. The large amount of physical and mental health comorbidity in this patient group gives trainees the opportunity to contribute to the management of physical health (which they are more familiar with) as well as learn about assessment and treatment in psychiatry. If Welch et al had broken down feedback from trainees by subspecialty, this might have helped clarify whether some subspecialties lend themselves better to foundation year programmes and the unique challenges they pose in terms of trainee needs.

Welch and colleagues report on the importance of maintaining links with the acute hospital and sense of isolation trainees experience away from their peers. Liaison psychiatry services are uniquely placed to bridge this gap and working within liaison psychiatry teams based in the acute hospital gets around these problems. Trainees would not need to travel to attend mandatory teaching sessions or medical grand rounds. Liaison psychiatry is also a good training experience to those trainees who do not opt for psychiatry as a career but would still have to assess and manage patients with mental health problems in their chosen specialty. Liaison teams, too, benefit from having foundation trainees attached to them. Not only are their medical skills and knowledge of medical terminology of value to multidisciplinary team members, but their informal contacts with peers on medical wards often clarify the covert reasons underlying referrals and lead to successful consultations.

It is also our experience that news of positive training placement by foundation trainees gets around the hospital, and we often get requests for psychiatry taster days or weeks by trainees who have not been allocated a psychiatry job. We have found that acute hospital clinicians value the training provided by liaison psychiatry teams to trainee doctors. Reference Solomons, Thachil, Burgess, Glen-Day, Hopper and Ranjith5 Liaison psychiatrists are thus uniquely placed to take on foundation year trainees and be the gateway to psychiatry for an increasing number of trainees.

References

1 Welch, J, Bridge, C, Firth, D, Forrest, A. Improving psychiatry training in the Foundation Programme. Psychiatrist 2011; 35: 389–93.CrossRefGoogle Scholar
2 Tallentire, V, Smith, S, Wylde, K, Cameron, H. Are medical graduates ready to face the challenges of Foundation training? Postgrad Med J 2011; 87: 590–5.CrossRefGoogle ScholarPubMed
3 Maidment, R, Livingston, G, Katona, C, McParland, M, Noble, L. Change in attitudes to psychiatry and intention to pursue psychiatry as a career in newly qualified doctors: a follow-up of two cohorts of medical students. Med Teach 2004; 26: 565–9.Google Scholar
4 Boyle, AM, Chaloner, DA, Millward, T, Rao, V, Messer, C. Recruitment from foundation year 2 posts into specialty training: a potential success story? Psychiatr Bull 2009; 33: 306–8.CrossRefGoogle Scholar
5 Solomons, L, Thachil, A, Burgess, C, Glen-Day, V, Hopper, A, Ranjith, G, et al. Quality of psychiatric care in the general hospital: referrer perceptions of an inpatient liaison psychiatry service. Gen Hosp Psychiatry 2011; 33: 260–6.Google Scholar
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