Prison psychiatry: is the training experience safe?

2018 ◽  
Vol 13 (4) ◽  
pp. 219-227
Author(s):  
Ruairi Page ◽  
Matthew Tovey ◽  
Fiona Hynes
Keyword(s):  
Forensic Psychiatry ◽  
General Medical Council ◽  
Training Programme ◽  
Medical Council ◽  
Training Experience ◽  
Content Type ◽  
Electronic Survey ◽  
Mental Health Settings ◽  
Review Protocol ◽  
Training Programme Director

Purpose Training in the prison settings is a mandatory part of higher training in forensic psychiatry. Violence in prisons is a recognised issue, which can impact on trainee safety and overall training experience. The Royal College of Psychiatrists have produced guidelines regarding the safety of the environment in inpatient mental health settings, but there is currently no such guidance regarding the prison setting. The purpose of this paper is to report on a survey of UK-based ST4-6 trainees in forensic psychiatry regarding their training experience in prisons, focusing on supervision and safety. Design/methodology/approach The authors constructed an electronic survey which comprised of 18 items. This was sent to each UK training programme director in forensic psychiatry, who were asked to distribute the survey to trainees in their region. Findings There were 36 unique responses, out of an approximate total of 100 trainees. The questions fell into two broad categories: trainee safety and trainee supervision. The main themes that arose were that the majority of trainees (59 per cent) reported that they had not received a formal induction at their prison and had not received training in using the Assessment, Care in Custody and Teamwork framework (58 per cent) and serious incident review protocol (83 per cent). The vast majority (76 per cent) reported not being allocated a personal safety alarm, and 27 per cent reported having received a direct threat from a patient in prison. Responses with regards to consultant supervision were varied. The majority indicated that they received weekly supervision (62 per cent). Originality/value The findings indicate that there are a number of areas where both safety and supervision within the prison environment may be improved. This is concerning given the standards outlined by Promoting Excellence (General Medical Council), which highlights the importance of a safe and supported learning environment, and suggests the need for further analysis locally of training opportunities within prisons.

Attitudes to antipsychotics: a multi-site survey of Canadian psychiatry residents

2018 ◽  
Vol 13 (6) ◽  
pp. 318-338
Author(s):  
Anees Bahji ◽  
Neeraj Bajaj
Keyword(s):  
First Generation ◽  
Treatment Options ◽  
Similar Efficacy ◽  
Psychiatry Residents ◽  
Training Experience ◽  
Content Type ◽  
Electronic Survey ◽  
Site Survey ◽  
Long Acting ◽  
The University

Purpose The purpose of this paper is to identify the training needs of the next generation of psychiatrists, and barriers in prescribing first-generation antipsychotics (FGAs), long-acting injectable (LAIs) antipsychotics and clozapine. Design/methodology/approach An electronic survey was sent to psychiatry residents (N= 75/288, 26 percent) at four Canadian residency programs in late December 2017. The survey was based on an instrument originally developed at the University of Cambridge and consisted of 31 questions in 10 content domains. Findings Nearly 80 percent of residents were aware that FGAs and second-generation antipsychotics (SGAs) have similar efficacy. However, extra-pyramidal symptoms and lack of training experience were the leading concerns associated with the prescribing of FGAs. Although over 90 percent of residents felt confident about initiating an oral SGA as a regular medication, only 40 percent did so with FGAs. Confidence with initiating LAIs and clozapine was 60 and 61 percent, respectively. Practical implications The survey highlights the need for better training in the use of FGAs, clozapine and LAIs. These medications can be effectively used in providing patients with the most appropriate evidence-based treatment options to improve treatment outcomes, while ensuring that these resources are not lost to the future generations of psychiatrists. Originality/value The survey may be the first of its kind to assess antipsychotic prescribing attitudes in Canadian psychiatry residents in multiple sites.

scholarly journals Mental health law training should be mandatory for all doctors

2011 ◽  
Vol 35 (12) ◽  
pp. 466-468 ◽  
Author(s):  
Christopher Schofield
Keyword(s):  
Mental Health ◽  
Quality Care ◽  
General Medical Council ◽  
Medical Schools ◽  
Training Programme ◽  
Medical Council ◽  
Health Law ◽  
Mental Health Law ◽  
Law Training ◽  
Good Quality Care

SummaryOver many years and with various pieces of new legislation there are significant gaps in doctors' knowledge about mental health law. It is time to ensure that doctors know the law and can apply it to the patients they see. Practising legally and not detaining or allowing people to leave hospital inappropriately should be a mandatory part of training for every doctor no matter what the specialty. Medical schools, deaneries, training programme directors and the General Medical Council should take up the challenge and ensure good-quality training for all doctors to ensure good-quality care in this area is given to all patients.

Higher specialty training in genitourinary medicine: A curriculum competencies-based approach

2018 ◽  
Vol 29 (8) ◽  
pp. 738-743 ◽  
Author(s):  
Mitesh Desai ◽  
Olubanke Davies ◽  
Anatole Menon-Johansson ◽  
Gulshan Cindy Sethi
Keyword(s):  
Service Delivery ◽  
General Medical Council ◽  
Training Programme ◽  
Clinical Activity ◽  
Medical Council ◽  
Specialty Training ◽  
Post Intervention ◽  
Modular Training ◽  
Genitourinary Medicine ◽  
Trainee Satisfaction

Specialty trainees in genitourinary medicine (GUM) are required to attain competencies described in the GUM higher specialty training curriculum by the end of their training, but learning opportunities available may conflict with service delivery needs. In response to poor feedback on trainee satisfaction surveys, a four-year modular training programme was developed to achieve a curriculum competencies-based approach to training. We evaluated the clinical opportunities of the new programme to determine: (1) Whether opportunity cost of training to service delivery is justifiable; (2) Which competencies are inadequately addressed by direct clinical opportunities alone and (3) Trainee satisfaction. Local faculty and trainees assessed the ‘usefulness’ of the new modular programme to meet each curriculum competence. The annual General Medical Council (GMC) national training survey assessed trainee satisfaction. The clinical opportunities provided by the modular training programme were sufficiently useful for attaining many competencies. Trainee satisfaction as captured by the GMC survey improved from two reds pre- to nine greens post-intervention on a background of rising clinical activity in the department. The curriculum competencies-based approach to training offers an objective way to balance training with service provision and led to an improvement in GMC survey satisfaction.

scholarly journals Modernising medical careers, the Foundation Programme and psychiatry

2005 ◽  
Vol 29 (6) ◽  
pp. 204-206 ◽  
Author(s):  
Nick Brown ◽  
Dinesh Bhugra
Keyword(s):  
Postgraduate Education ◽  
General Medical Council ◽  
Health Department ◽  
Training Programme ◽  
Medical Council ◽  
Unfinished Business ◽  
Implementation Team ◽  
Department Of Health ◽  
Medical Careers ◽  
Foundation Programme

The stated aim of the new Foundation Programme is to equip all doctors with a range of generic competencies before they embark on a specialist training programme, following the advice in Modernising Medical Careers (Department of Health, 2003, 2004), which built upon Unfinished Business, Proposals for the Reform of the Senior House Officer Grade (Department of Health, 2002). The educational aims of this 2-year programme are to develop generic skills, competencies and attitudes to ensure professional conduct that will reflect ‘good medical practice’ as defined by the General Medical Council (1998). Any education for the Foundation Programme must concentrate on these areas. A Curriculum for the Foundation Years in Postgraduate Education and Training is being produced by the Academy of Medical Royal Colleges in co-operation with the Modernising Medical Careers Implementation Team at the Department of Health (Department of Health, 2005).

Pre-hospital care

2018 ◽  
Author(s):  
Oliver Harrison
Keyword(s):  
Emergency Medicine ◽  
Hospital Care ◽  
General Medical Council ◽  
Training Programme ◽  
Hospital Environment ◽  
Medical Council ◽  
Building Site ◽  
Acute Medicine ◽  
Town Centre ◽  
Hospital Teams

Many doctors are attracted to pre-hospital emergency medicine (PHEM) because of the variety of challenges that it presents. With limited time and resources, the doctor is expected to assess and treat a range of medical and traumatic pathologies in patients of any age, without delaying transport to the most appropriate location for definitive care. This must be done in spite of what is usually a suboptimal environment, e.g. in a ditch at the roadside, on a rainy building site, or in a crowded town centre. Recognizing the limitations of what can be achieved on scene is a key skill that must be balanced against the increasing range of lifesaving interventions at the disposal of pre-hospital teams. While PHEM has been practised by a variety of doctors for many years, it has only recently gained General Medical Council (GMC) subspecialty recognition. A formal training programme may now be undertaken by trainees with base specialties of acute medicine, anaesthetics, emergency medicine, and intensive care medicine, leading to a dual certificate of completion of training. The challenging nature of the pre-hospital environment, the high-risk nature of the interventions that can be undertaken, and the lack of availability of immediate assistance on scene mean that PHEM is a service delivered by consultants and senior trainees. Medical students and foundation doctors who may be interested in PHEM training should seek to spend time in the above mentioned acute specialties, as well as looking for opportunities to observe alongside some of the services that operate nationally. The following questions represent a small selection of the range of scenarios that may be faced by a PHEM practitioner on a day-to-day basis.

scholarly journals Unsuccessful Article 14 Submissions to the Specialist Register for Trauma and Orthopaedic Surgery

2009 ◽  
Vol 91 (5) ◽  
pp. 172-174
Author(s):  
J Gray ◽  
M Arnander ◽  
D Ricketts
Keyword(s):  
Medical Education ◽  
Orthopaedic Surgery ◽  
Postgraduate Medical Education ◽  
General Medical Council ◽  
Training Programme ◽  
Medical Council ◽  
Specialty Training ◽  
Legal Requirement ◽  
Medical Education And Training ◽  
And Training

It is a legal requirement that all NHS consultants have their names entered on the General Medical Council (GMC)'s specialist register. Entry to the register can be obtained by two routes. The first is to obtain a Certificate of Completion of Training (CCT) in a recognised specialty training programme approved by the Postgraduate Medical Education and Training Board (PMETB). The second is by obtaining a Certificate of Eligibility for Specialist Registration (CESR) by the article 14 process.

scholarly journals Survive and thrive wellbeing programme: an innovative experiential wellbeing programme for trainees in Health Education England- Thames Valley (HEE-TV)

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S161-S161
Author(s):  
Haido Vlachos ◽  
Aisling Higham ◽  
Sara McDouall
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Time Lag ◽  
General Medical Council ◽  
Training Programme ◽  
Behavioural Therapy ◽  
Mental Wellbeing ◽  
Medical Council ◽  
Self Awareness ◽  
Work Related

AimsThe aim of this project was to develop an experiential programme which encouraged trainees to develop their own processes for mental resilience acting to mitigate difficult work and life environments.BackgroundDoctors are at considerable risk of work-related stress, burnout and mental health problems, particularly trainees, many of whom are experiencing symptoms earlier in their career. The Thriving at Work Review, the British Medical Association and HEE all call for cultural and organizational change that works to prioritise, promote and enhance wellbeing by providing good working conditions and an atmosphere that encourages open discussion about mental health with access to appropriate support that destigmatises mental health.MethodAcross HEE-TV we identified that there were no regular wellbeing initiatives for trainees, and specifically no psychologist-facilitated Cognitive Behavioural Therapy-style sessions to enhance resilience. Six schools identified a specific need for HETV-targeted resources focused on enhancing trainee mental wellbeing.The current course has morning sessions that cover self-awareness, and afternoons are psychologist-facilitated sessions. The initial pilot was run for the School of Anaesthetics, and later offered to specialties with a General Medical Council-survey identified need. Multiple improved iterations of the course have been driven by detailed trainee feedback, including adding the psychology sessions to give trainees tools for self-help.ResultWe triangulated feedback from attendees at the sessions, nominated trainee representatives from all specialties across Thames Valley via the Trainee Advisory Committee (TAC), and HEE-TV quality assessors. Feedback from trainees who attended was almost universally positive. The Quality Committee noted improvement of trainee morale in Anaesthetics and direct improvement in aspects of the learner environment that would not have happened without this intervention. The TAC endorsed this as one of the measures to support trainees in difficult learner environments. They also recommended it be rolled out for all as a preventative measure as there can be a time lag before items appear on the Risk Registers and are officially recognized as requiring support. The biggest measure of success is that HEE-TV have agreed to fund these sessions ongoing.ConclusionWe learned that an iterative response to trainee feedback and careful co-ordination is key to successful engagement via the training programme directors who arrange regional training programmes. This, and making the SAT course free at the point of use, makes it easier for trainees to access this programme. In addition we will be including the trainee voice is shaping bespoke aspects of the day for each specialty.

scholarly journals A model for improving postgraduate medical education using the GMC survey

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S155-S156
Author(s):  
Martin Schmidt ◽  
Timothy Leung
Keyword(s):  
Medical Education ◽  
Medical Training ◽  
Postgraduate Medical Education ◽  
General Medical Council ◽  
Medical Council ◽  
Job Descriptions ◽  
Training Experience ◽  
Annual Survey ◽  
National Training ◽  
The Impact

AimsTo investigate whether the General Medical Council (GMC) National Training Surveys (NTS) can be analysed to develop a plan of action that improves postgraduate training.BackgroundAs part of its role in quality assurance of medical training, the GMC conducts an annual survey of trainers and trainees. The Doctors in training survey, part of the NTS, consists of 70 questions which are grouped into 18 indicators of quality. At Surrey and Borders Partnership NHS Foundation Trust, we were keen to use the comprehensive data in the NTS to improve training. We analysed each question to create a plan of action to improve the quality of training.MethodWe used data from the online reporting tool to calculate the scores for each question in the 2018 NTS. Taking into account the impact of year-on-year changes in the content of the survey, we examined the score, change from 2017 to 2018, and difference between the score and indicator mean to identify poorly-performing questions. Other questions with clear potential for further improvement were also highlighted. A plan of action was produced by the Leadership and Education Fellow and Director of Medical Education.Result29 actions were identified. The most common were to ensure that information (e.g. job descriptions, professional opportunities) was accessible to trainees (8 actions); liaise with other teams (e.g. Human Resources, Safety team) (6); discuss issues with or provide information to trainers (5); discuss with trainees to contextualise survey results within their experiences (4); and ensure that information was delivered at induction (3).To implement these actions, we conducted a workshop for trainers and held feedback meetings with trainees. 76.5% of trainers (13/17) and 88.5% of trainees (23/26) surveyed following these respective events agreed or strongly agreed that the NTS can be used to improve the training experience. A presentation on making the most of the placement was added to trainee induction and was rated excellent or good by all respondents (28/28). Posters were also produced to disseminate information. In the subsequent NTS, there was an improvement in SABP's performance in 12/18 indicators in the Doctors in training survey, with one green flag denoting performance in the top quartile of trusts nationally.ConclusionThe NTS can be analysed to create a plan of action with elements that trainers and trainees feel can improve their experience. Our model demonstrates the potential for using NTS data to plan quality improvement in training.

An inevitable crisis? From first to second year in counsellor training

2020 ◽  
Vol 5 (1) ◽  
pp. 74-89
Author(s):  
Hugh Crago
Keyword(s):  
Right Hemisphere ◽  
Training Programme ◽  
First Year ◽  
Training Experience ◽  
Counsellor Training ◽  
Student Dropout ◽  
Second Year ◽  
Neurological Research ◽  
First Year Of Life ◽  
And Control

In a seminal 1973 paper, Robert Clark described the very different “cultures” of the first and second year students in a four year clinical psychology PhD programme. The author applies Clark’s template to his own experiences as trainee or trainer in five different counsellor education programmes, one in the US and four in Australia. Each of the programmes, to varying degrees, demonstrates key features of the pattern identified by Clark, where the first year is “therapeutic” and other-oriented, the second is “professional” and self-focused. The author concludes that all the surveyed programmes exhibited some level of “second year crisis”, in which a significant number of students felt abandoned, dissatisfied, or rebellious. The author extends and refines Clark’s developmental analogy (first year = childhood; second year = adolescence) to reflect recent neurological research, in particular, the shift from a right hemisphere-dominant first year of life, prioritising affiliative needs, to a left hemisphere-dominant second year, prioritising autonomy and control. This shift is paralleled later by a more gradual move from a protective, supportive childhood to necessary, but sometimes conflictual, individuation in adolescence. The first two years of a counsellor training programme broadly echo this process, a process exacerbated by the second year internship/placement, in which students must “leave home” and adjust to unfamiliar, potentially less nurturing, authority figures. Finally, the author suggests introducing more rigorous “academic holding” into the first year, and greater attention to “therapeutic holding” of dissident students in the second, hopefully decreasing student dropout, and achieving a better balanced training experience.

The Duties of Doctors In Medical Education: A Letter To The Editor (Preprint)

2019 ◽  
Author(s):  
Sneha Barai
Keyword(s):  
Medical Education ◽  
Medical Students ◽  
Role Models ◽  
Role Model ◽  
General Medical Council ◽  
Future Generations ◽  
Medical Council ◽  
Positive Role ◽  
The Uk ◽  
And Training

UNSTRUCTURED The UK General Medical Council (GMC) explicitly states doctors have a duty to ‘contribute to teaching and training…by acting as a positive role model’. However, recent studies suggest some are not fulfilling this, which is impacting medical students' experiences and attitudes during their training. As such, doctors have a duty to act as role models and teachers, as specified by the GMC, which it seems are not currently being fulfilled. This would improve the medical students’ learning experiences and demonstrate good professional values for them to emulate. Therefore, these duties should be as important as patient care, since this will influence future generations.

Sign in / Sign up

Export Citation Format

Share Document