Severn Postgraduate Medical Education (PGME) covers a large geographic area in the South West of England, incorporating five unitary authorities and three shire counties. There are currently no CAMHS placements in Taunton and Yeovil. Below is a diagram to show the areas within Severn PGME which host CAMHS trainees.
The Severn Postgraduate School of Psychiatry is part of Severn PGME which is the educational arm of South West Strategic Health Authority.
Severn PGME "Magnificent Seven" Values
- Striving for Excellence - in everything we do to ensure superior patient care and the best medical education
- Working Together - building relationships and trust for the long term
- Integrity and Honesty - we can be relied on to be plain speaking and truthful
- Empowering - respecting individuality, promoting learning and developing people to achieve their full potential
- Leadership – inspiring, enabling and supporting
- Being Courageous and Judicious - making the difficult decisions well and taking positive risks
- Creativity and Innovation - actively encouraging new ways of doing things and being at the forefront of medical education
Aims and Objectives of Training and Education
The Scheme aims to provide and promote training, education and professional development in Child & Adolescent Psychiatry to a standard expected by the Royal College of Psychiatrists. This is based on the Royal college CAMHS Curriculum, trainees’ Annual Review of Competencies Progression, and the GMC Guidelines for Good Medical Practice. At the end of training specialist trainees will be expected: to have gained a thorough knowledge of normal child development; be able to assess children and families in order to make a diagnosis of psychiatric disorder if present and to be able to formulate the presenting problems and to develop treatment plans; work as a co-therapist with other members of the multidisciplinary team; have experienced a wide range of treatment modalities such as behaviour therapy, family therapy, cognitive therapy, solution focused therapy, brief focused individual therapy, long-term individual psychotherapy, group therapy and psychopharmacological treatments; worked within multidisciplinary teams; worked with other agencies (for example, attended Social Services case conferences, convened multi-professional planning meetings and provided assessments for Statementing procedures); provided consultation to other agencies and professionals, eg Social Workers, Educational professionals, voluntary agencies; dealt with clinical emergencies including deliberate self-harm; and provided psychiatric assessments for the courts.
Overview of the Training Scheme
The training programme director (TPD) is Dr Melanie Merricks.
The Severn Child & Adolescent Psychiatry advanced trainee rotational training scheme covers three NHS trusts:
- North Bristol Trust- which covers Bristol and South Gloucestershire and North Somerset
- 2gether Gloucester Foundation Trust- which covers Gloucestershire and Herefordshire
- Oxford Health NHS Foundation Trust- whose Children’s services extend into Wiltshire, Swindon and Bath and North East Somerset
There are 9 Full-time National Training Numbers (NTN’s) allocated to the scheme, with a range of placements across the three NHS Trusts. Full-time trainees will usually train in three posts, spending a year in each. Less-than-full-time trainees will train in more posts usually over five years. Trainees are required to complete 36 months of training to be eligible for award of a Certificate of Completion of Training (CCT). There is the option to remain for a six months “period of grace” at the end of training.
Most training placements are community based, with the majority of clinical work being out-patient based. Trainees usually spend a maximum of a year at one of the two adolescent in-patient units which are located in Swindon and Bristol. Training placements rotate annually in August with allocation of posts being by “guided choice”: trainees submit their choice of placement with options rated one to five. This process will usually begin in April with the allocations being announced by mid May.
Trainees are required to undertake out-of-hours emergency work as part of their training. Arrangements for this work vary between the three Trusts. All posts are compliant with the European Working Time Directive.
Less than Full Time Training (LTFT)
All posts within the training scheme are suitable for either full-time or less-than-full-time trainees. Many trainees in Child and Adolescent Psychiatry chose to train less-than-full-time and this is well supported by Severn PGME and the training scheme. Further details are available from http://www.psychiatry.severndeanery.nhs.uk/about-us/advanced-specialist-training/less-than-full-time-training/
Throughout training the Specialty Trainee (ST) will receive regular supervision from their Educational Supervisor (who is also the Clinical Supervisor). This will take place weekly in a meeting of approximately one hour. In addition, each placement provides a therapy supervisor for each of the three main modes of therapy: family, individual psycho-dynamic and individual cognitive-behavioural . Learning Objectives developed by the trainee in discussion with the supervisor will be set out in the online portfolio. The trainee, the supervisor and the TPD will monitor progress by reviewing the various updates to the online portfolio including Work Based Assessments, clinical log, and uploaded documents.
During term time, there is an academic programme for trainees to attend organised by academic programme director, Dr Gillian Combe. This is approximately 15 days per year and allows trainees opportunities to present to and learn from peers. It is usually held in Bristol and includes seminars, journal reviews, clinical case presentations, research meetings, outside speakers and a Balint group. It is also an opportunity for trainees to meet together as a group. Time to attend the academic programme will be protected.
Special Interest Sessions
Up to two sessions per week are allocated for clinical special interests. This can help broaden clinical experience and allow for a trainee to tailor their training experience to match their own personal interests. There is a vast range of possibilities that this time can be used for. These sessions may be taken in or out of the base clinic.
Additional Training and Education
Trainees are encouraged to gain as much experience as possible and there will be an individual study leave budget available to fund courses they may wish to attend. Trainees will be supported if they wish to undertake further training, education or qualifications by recognised bodies, eg family therapy training, cognitive behavioural therapy training, an MSc or an MD. However, there is no automatic additional funding available for these.
Non - Clinical Special interest
One day a week is allocated to non-clinical special interests. Trainees are encouraged to use this time over the three years to gain experience in research, teaching and management. For LTFT trainees the timetable will be adapted pro-rata over the extended period of training.
Trainees are encouraged to develop a research project, either one devised and set up under the trainee’s initiative, or one that is worked as a combined project with another trainee and Consultant. It is acknowledged that setting up research projects can be a timely matter and so a research initiative has been set up in order to combat this challenge, “SpR Research Involvement Course” Is a year long project which will include links to Bristol University with the aim for the trainee to be involved in research that is already up and running. There is also the opportunity to undertake an educational fellowship year, which will have links will include the Research module of the TLHP course at Bristol University. During the first year of CAMHS training, trainees are expected to complete a literature review as defined in the curriculum.
Trainees will be expected to undertake both formal and informal management training. They will have opportunities to act as representatives for many groups including the Advanced training group meetings, quality assurance meetings at Severn PGME, the BMA and for the PTC. Trainees will also have opportunities to apply to be involved in structured management projects as part of management initiatives within Severn PGME, “Business Internship Projects” are year long projects which aim to give trainees the experience of setting up a business idea.
There are many opportunities to teach different groups during training. These groups include medical students from Bristol University, CTs in Psychiatry, doctors in other specialties, other members of the multidisciplinary team and non-professionals. Different modalities of teaching are encouraged.
There are teaching courses available to trainees including Fit2Teach and “Teach the Teacher”. There are opportunities for trainees to gain more formal qualifications in teaching including a certificate of experience in undergraduate education and TLHP course. There is also the opportunity to take time out of training to become a teaching fellow.
There are multiple more specific teaching opportunities including attending schools to educate young people about mental health to attempt to combat stigma and being involved in arranging taster days for foundation doctors. Trainees have the opportunity to be involved in the design and execution of the weekly teaching course for core trainees either by facilitating sessions or by becoming an associate module coordinator.
There is the opportunity to become an associate unit tutor with a formal link to Bristol University. Trainees can also volunteer to be a mentor to a 3rd year medical student and/or a CT1 psychiatry SHO, holding a pastoral role as well as teaching.
Audit and Quality Improvement
Developing and improving services along with assessing services performance through audit are vital activities within the NHS clinical governance framework. Trainees are expected to participate in audit and quality improvement projects in each of their placements. Trainees may take a lead in such projects or join with other psychiatrists or multi-disciplinary colleagues in these activities.