Pub Date : 2013-12-01DOI: 10.1192/PB.BP.112.042457
C. Oakley, Emma West, I. Jones
Aims and method The structure of academic training in psychiatry has changed in recent years and little is known about the trainees currently pursuing this career path. Two surveys were conducted of academic trainees in psychiatry and the heads of departments of psychiatry. These surveys aimed to identify the number of trainees currently in academic training, the nature of their positions and opinions about the current system of training in academic psychiatry. Results There were 165 academic trainees identified, of whom 101 were not currently in academic clinical fellow (ACF) or academic clinical lecturer (ACL) posts. Academic trainees are located in a relatively small number of universities, with a quarter being based at one institution. In total, 60% of the trainees were in general adult psychiatry. Only 4.6% of respondents rated their academic training as excellent and just over half were certain that they wished to pursue an academic career in the future. Various challenges to academic training in psychiatry were identified by both the heads of departments and trainees. Clinical implications Current difficulties in academic training in psychiatry, such as lack of flexibility of the training pathway, need addressing to ensure the provision of high-quality research and teaching in psychiatry in the future.
{"title":"Academic training in psychiatry","authors":"C. Oakley, Emma West, I. Jones","doi":"10.1192/PB.BP.112.042457","DOIUrl":"https://doi.org/10.1192/PB.BP.112.042457","url":null,"abstract":"Aims and method The structure of academic training in psychiatry has changed in recent years and little is known about the trainees currently pursuing this career path. Two surveys were conducted of academic trainees in psychiatry and the heads of departments of psychiatry. These surveys aimed to identify the number of trainees currently in academic training, the nature of their positions and opinions about the current system of training in academic psychiatry.\u0000\u0000Results There were 165 academic trainees identified, of whom 101 were not currently in academic clinical fellow (ACF) or academic clinical lecturer (ACL) posts. Academic trainees are located in a relatively small number of universities, with a quarter being based at one institution. In total, 60% of the trainees were in general adult psychiatry. Only 4.6% of respondents rated their academic training as excellent and just over half were certain that they wished to pursue an academic career in the future. Various challenges to academic training in psychiatry were identified by both the heads of departments and trainees.\u0000\u0000Clinical implications Current difficulties in academic training in psychiatry, such as lack of flexibility of the training pathway, need addressing to ensure the provision of high-quality research and teaching in psychiatry in the future.","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"375 1","pages":"398-402"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76625144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1192/PB.BP.113.045807
J. Gunn
![Figure][1] Sheila Mann was a leading figure in the Royal College of Psychiatrists, holding positions of major responsibility within the College from the 1970s for over 35 years. She joined the Research Committee in 1973, becoming its Honorary Secretary in 1977 and chairman of its first in-
{"title":"Dr Sheila Mann FRCPsych","authors":"J. Gunn","doi":"10.1192/PB.BP.113.045807","DOIUrl":"https://doi.org/10.1192/PB.BP.113.045807","url":null,"abstract":"![Figure][1] \u0000\u0000Sheila Mann was a leading figure in the Royal College of Psychiatrists, holding positions of major responsibility within the College from the 1970s for over 35 years. She joined the Research Committee in 1973, becoming its Honorary Secretary in 1977 and chairman of its first in-","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"25 1","pages":"405-405"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88156931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1192/PB.BP.112.041608
I. McKinnon, S. Srivastava, G. Kaler, D. Grubin
Aims and method To ascertain the efficacy of custody health screening for mental disorders. We assessed a sample of detainees for the presence of mental disorders and the need for an appropriate adult. The assessments were carried out using pragmatic interviews and examinations supported by structured tools. Where possible, we attributed a probable clinical diagnosis based on the information available to us. The need for an appropriate adult was judged based on this information and capacity assessments. Results Existing screening procedures missed a quarter of cases of severe mental illness and moderate depression; they also failed to detect about a half of those at risk of alcohol withdrawal and 70% of those at risk of withdrawal from crack cocaine. The need for an appropriate adult was not recognised in more than half of cases. Clinical implications Consideration should be given to modifying police screening procedures for mental and associated disorders so that detainees receive the appropriate attention.
{"title":"Screening for psychiatric morbidity in police custody: results from the HELP-PC project","authors":"I. McKinnon, S. Srivastava, G. Kaler, D. Grubin","doi":"10.1192/PB.BP.112.041608","DOIUrl":"https://doi.org/10.1192/PB.BP.112.041608","url":null,"abstract":"Aims and method To ascertain the efficacy of custody health screening for mental disorders. We assessed a sample of detainees for the presence of mental disorders and the need for an appropriate adult. The assessments were carried out using pragmatic interviews and examinations supported by structured tools. Where possible, we attributed a probable clinical diagnosis based on the information available to us. The need for an appropriate adult was judged based on this information and capacity assessments.\u0000\u0000Results Existing screening procedures missed a quarter of cases of severe mental illness and moderate depression; they also failed to detect about a half of those at risk of alcohol withdrawal and 70% of those at risk of withdrawal from crack cocaine. The need for an appropriate adult was not recognised in more than half of cases.\u0000\u0000Clinical implications Consideration should be given to modifying police screening procedures for mental and associated disorders so that detainees receive the appropriate attention.","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"41 1","pages":"389-394"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78547810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1192/PB.BP.111.035907
V. Delaffon, S. Naik, Rajandeep Mann, Arshya Vahabzadeh, Timothy Millward, AD Majeed, A. Taylor, Anshuman Pant
Aims and method A baseline audit of trainees’ ability to recognise Wernicke’s encephalopathy and initiate appropriate thiamine regimes in an in-patient alcohol detoxification unit was carried out. Based on the findings, gaps were addressed using targeted education and training, and their impact on improving standards of managing Wernicke’s encephalopathy was re-audited. Results The initial audit revealed that trainees’ ability to recognise Wernicke’s encephalopathy and initiate thiamine was inadequate. Significant improvement in appropriate use of treatment regime ( P <0.05) of thiamine and the monitoring of clinical response was observed after addressing the initial gaps through education. Clinical implications Treatment of Wernicke’s encephalopathy can be inadequate, given a lack of awareness of clinical presentation and appropriate management. This can be addressed through education and training.
{"title":"Diagnosis and treatment of Wernicke’s encephalopathy in an in-patient alcohol detoxification unit: a completed audit cycle","authors":"V. Delaffon, S. Naik, Rajandeep Mann, Arshya Vahabzadeh, Timothy Millward, AD Majeed, A. Taylor, Anshuman Pant","doi":"10.1192/PB.BP.111.035907","DOIUrl":"https://doi.org/10.1192/PB.BP.111.035907","url":null,"abstract":"Aims and method A baseline audit of trainees’ ability to recognise Wernicke’s encephalopathy and initiate appropriate thiamine regimes in an in-patient alcohol detoxification unit was carried out. Based on the findings, gaps were addressed using targeted education and training, and their impact on improving standards of managing Wernicke’s encephalopathy was re-audited.\u0000\u0000Results The initial audit revealed that trainees’ ability to recognise Wernicke’s encephalopathy and initiate thiamine was inadequate. Significant improvement in appropriate use of treatment regime ( P <0.05) of thiamine and the monitoring of clinical response was observed after addressing the initial gaps through education.\u0000\u0000Clinical implications Treatment of Wernicke’s encephalopathy can be inadequate, given a lack of awareness of clinical presentation and appropriate management. This can be addressed through education and training.","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"15 1","pages":"384-388"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82545902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1192/PB.BP.113.045799
W. Burn, A. Brittlebank
In their editorial, Michael et al focus on what they see as shortcomings in one important area of clinical assessment of psychiatrists in training and they suggest that methods of workplace-based assessment have failed. However, current thinking in assessment of doctors is to consider assessment systems as a whole and we contend that both forms of assessment - clinical examinations and workplace-based assessments - are needed because they fulfil different needs. This is not to argue that more should not be done to ensure that all who are involved in the assessment of doctors are better prepared for the task or that the current portfolio of assessment methods is complete.
{"title":"The long case: the case against its revival Commentary on . . . The long case {","authors":"W. Burn, A. Brittlebank","doi":"10.1192/PB.BP.113.045799","DOIUrl":"https://doi.org/10.1192/PB.BP.113.045799","url":null,"abstract":"In their editorial, Michael et al focus on what they see as shortcomings in one important area of clinical assessment of psychiatrists in training and they suggest that methods of workplace-based assessment have failed. However, current thinking in assessment of doctors is to consider assessment systems as a whole and we contend that both forms of assessment - clinical examinations and workplace-based assessments - are needed because they fulfil different needs. This is not to argue that more should not be done to ensure that all who are involved in the assessment of doctors are better prepared for the task or that the current portfolio of assessment methods is complete.","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"4 1","pages":"382-383"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87969424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1192/PB.BP.112.039149
E. Breen
Aims and method To document the number and type of adverse medication events in a psychiatric sector service. Significant new adverse events were collated by the author and team over 30 months. Intervention to prevent any adverse event was enacted as soon as any were noticed or anticipated. Results Thirty-six significant events occurred including three deaths and nine near misses. Corrective action was taken immediately any adverse event occurred. Inadequate communication between various hospital clinics, general practitioner practices, psychiatric clinics and pharmacies was the biggest avoidable cause of adverse events. Clinical implications Awareness of adverse drug events is essential in psychiatry. Clear, transparent pathways of prescribing are a key requirement to reduce avoidable adverse medication events. Psychopharmacology is a core module for psychiatric training.
{"title":"Adverse medication events in a psychiatric practice: a naturalistic study","authors":"E. Breen","doi":"10.1192/PB.BP.112.039149","DOIUrl":"https://doi.org/10.1192/PB.BP.112.039149","url":null,"abstract":"Aims and method To document the number and type of adverse medication events in a psychiatric sector service. Significant new adverse events were collated by the author and team over 30 months. Intervention to prevent any adverse event was enacted as soon as any were noticed or anticipated. Results Thirty-six significant events occurred including three deaths and nine near misses. Corrective action was taken immediately any adverse event occurred. Inadequate communication between various hospital clinics, general practitioner practices, psychiatric clinics and pharmacies was the biggest avoidable cause of adverse events. Clinical implications Awareness of adverse drug events is essential in psychiatry. Clear, transparent pathways of prescribing are a key requirement to reduce avoidable adverse medication events. Psychopharmacology is a core module for psychiatric training.","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"14 1","pages":"395-397"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76867279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1192/pb.bp.113.045815
J. Trauer
![Figure][1] Tom Trauer, who has died aged 68, was a leading researcher in psychiatric outcome measurement and advocate for mental health service development. His 2010 book, Outcome Measurement in Mental Health: Theory and Practice , and his many peer-reviewed articles on this subject
{"title":"Professor Thomas Trauer BA (Hons), PhD","authors":"J. Trauer","doi":"10.1192/pb.bp.113.045815","DOIUrl":"https://doi.org/10.1192/pb.bp.113.045815","url":null,"abstract":"![Figure][1] \u0000\u0000Tom Trauer, who has died aged 68, was a leading researcher in psychiatric outcome measurement and advocate for mental health service development. His 2010 book, Outcome Measurement in Mental Health: Theory and Practice , and his many peer-reviewed articles on this subject","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"18 1","pages":"406-406"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73974270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Martin & Elworthy report that the biggest reason for prescribing electroconvulsive therapy (ECT) less frequently than before is the perception among psychiatrists that ‘more effective medication’ now exists.[1][1] Unfortunately, the authors collude with this exaggerated view, claiming that ‘
{"title":"Psychiatric medications are no more effective","authors":"R. Braithwaite","doi":"10.1192/PB.37.12.403","DOIUrl":"https://doi.org/10.1192/PB.37.12.403","url":null,"abstract":"Martin & Elworthy report that the biggest reason for prescribing electroconvulsive therapy (ECT) less frequently than before is the perception among psychiatrists that ‘more effective medication’ now exists.[1][1] Unfortunately, the authors collude with this exaggerated view, claiming that ‘","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"41 1","pages":"403-403"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74046800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I could not disagree more strongly with Michael Fitzgerald’s letter[1][1] asserting that all future psychiatrists should be neuropsychiatrists. Having worked as a medical psychotherapist for over 20 years, my job changed and I had a choice between resigning and becoming a community psychiatrist. I
{"title":"Psychiatry needs more psychotherapy","authors":"Teresa Black","doi":"10.1192/PB.37.12.403B","DOIUrl":"https://doi.org/10.1192/PB.37.12.403B","url":null,"abstract":"I could not disagree more strongly with Michael Fitzgerald’s letter[1][1] asserting that all future psychiatrists should be neuropsychiatrists. Having worked as a medical psychotherapist for over 20 years, my job changed and I had a choice between resigning and becoming a community psychiatrist. I","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"31 1","pages":"403-403"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76631360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2013-12-01DOI: 10.1192/PB.BP.113.043588
A. Michael, R. Rao, Vishaal Goel
Until 2003 the long case was the clinical component of the two summative examinations for the Membership of the Royal College of Psychiatrists (MRCPsych). This changed to an Objective Structured Clinical Examination (OSCE) format, initially for the Part I examination, and more recently to the Clinical Assessment of Skills and Competencies (CASC) at the end of 3 years of basic training. Although there are distinct advantages to the objective, competency-based assessment, questions remain on its validity. The expectation that formative workplace-based assessments would fill in the void left by the loss of the long case has not materialised. The options for retaining the advantages of the long case within the CASC framework while minimising the shortcomings of the CASC are suggested as a way forward.
{"title":"The long case: a case for revival?","authors":"A. Michael, R. Rao, Vishaal Goel","doi":"10.1192/PB.BP.113.043588","DOIUrl":"https://doi.org/10.1192/PB.BP.113.043588","url":null,"abstract":"Until 2003 the long case was the clinical component of the two summative examinations for the Membership of the Royal College of Psychiatrists (MRCPsych). This changed to an Objective Structured Clinical Examination (OSCE) format, initially for the Part I examination, and more recently to the Clinical Assessment of Skills and Competencies (CASC) at the end of 3 years of basic training. Although there are distinct advantages to the objective, competency-based assessment, questions remain on its validity. The expectation that formative workplace-based assessments would fill in the void left by the loss of the long case has not materialised. The options for retaining the advantages of the long case within the CASC framework while minimising the shortcomings of the CASC are suggested as a way forward.","PeriodicalId":89639,"journal":{"name":"The psychiatrist","volume":"19 1","pages":"377-381"},"PeriodicalIF":0.0,"publicationDate":"2013-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86042109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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