Training in Psychiatry & Commissioning: A Guide to What Needs to Be Provided in Provider Healthcare Organisations

Aims

To ensure that the new provider continues to provide current high quality medical education (both undergraduate and post-graduate).

To promote the provision & development of training within the new provider.

Policy Guidance

• GMC guidance for training: Promoting Excellence: Standards for Medical Education and Training (commences January 2016) http://www.gmc-uk.org/education/standards.asp

GMC Gold Guide 

• Relevant Royal College trainee specifications and curricula

• Health Education South West – Severn: guidance and standards for trainers and trainees

General Overview

In order to provide sustainability for the medical workforce, it is essential that all major providers of health care are able to provide high quality training, both for undergraduate medial students and for post-graduate trainees in the medical specialties. A major provider of any mental health service has a particular responsibility to ensure that it is able to provide this training, and to ensure that services are staffed in a manner that promotes high quality teaching and learning.

Psychiatry is currently experiencing difficulties nationally with recruitment (at all levels). The South West has fewer consultant psychiatrists per head of the population than any other region of England (DoH census, 2015). If we are to promote careers in psychiatry (and thereby meet the mental health needs of the population) we must contribute effectively to medical student education.

Current Provision

Medical Students from the University of Bristol undertake psychiatry placements in their fourth year. Senior trainees and consultants contribute to medical student teaching and students who are interested in child psychiatry can request clinical placements as part of their psychiatry rotation.

Training in psychiatry within Severn School of Psychiatry is of a high quality. This is reflected in the results of the annual national GMC trainee survey: in 2014 the core programme was second for overall satisfaction, and 2015 the core programme was first, as were general adult, Child and Adolescent psychiatry programmes.

All substantive Consultants who have been in post for at least one year are eligible to apply to become educational supervisors for the training programme. They are required to complete appropriate training and submit a detailed application outlining the training post. The applications are scrutinised by the School of Psychiatry Quality Assurance Group to ensure that training of a suitably high standard can be provided. In addition, the programme undertakes an annual quality panel to ensure that the training continues to be of high quality.

Requirements For Trainees

Each trainee must be placed with an approved and registered educational supervisor and must train in premises that have been approved by the GMC. In order to meet the training requirements, the bases must provide appropriate resources including access to clinical facilities to undertake assessments and treatments and access to administrative facilities to support training. These will include trainees having a desk, with a PC, telephone and a lockable cabinet. Trainees must be provided with administrative support for all aspects of their work, including their non-clinical activities. In order to meet their training requirements, trainees must undertake direct and indirect clinical activities relevant to their learning objectives as well as non-clinical activities such as teaching, research, audit, quality improvement and management and leadership activities. Trainees are required to attend an appropriate academic programme and must have access to study leave funds for further educational development.

The resource requirements for trainees are specified in the GMC guidance Promoting Excellence (see above).

Trainee must be able to complete relevant assessments (currently Work Place Based Assessments), and record their training activity on a suitable electronic portfolio. All medical and non-medical colleagues must be able to support training by assessing trainees using WPBA’s.

Requirements For Educational Supervisors

In order for trainees needs to be met, they require educational supervisors whose needs are also met. Educational supervisors (and prospective ES’s) must have sufficient time within their job plans to attend appropriate training for their educational role, as well as time to supervise trainees. All psychiatry trainees require at least one hour per week, per trainee, for educational supervision. More than one hour may be required if trainees have additional needs. In addition, ES’s must directly observe the clinical and non-clinical practice of their trainees and complete WPBA’s.

ES’s require a quite private space to deliver educational supervision without interruptions. ES’s require desk space, PC and telephone, with secure storage for paperwork related to training. ES’s must be able to access their trainees electronic portfolio.

Requirement To Support Senior Faculty Development

Provider organisations need to be fully involved in all aspects of training, including leadership & regional development roles. They need to support senior consultants to apply for & take on roles such as simulation lead, Deanery/College roles, Regional Advisor, Head of School. The provider organisation must promote a culture of senior consultant staff contributing locally, regionally and nationally to training.

Wider Educational Requirements

All consultants are required within their nationally agreed contracts to contribute to teaching and learning of others. Consultant psychiatrists who are trainers must have time within their job plans to undertake such teaching. This includes the teaching of core and advanced psychiatric trainees, foundation doctors, BBT, GP & other non-psychiatric medical trainees, medical students and non-medical health professionals.

All local education providers must have structures in place to oversee and support the delivery of medical education.

Benefits To Provider Organisations From Providing Training

• Post-graduate trainees, although supernumerary, are senior professionals often with considerable experience as doctors. Whilst they are required to prioritise their learning needs, by undertaking appropriate clinical work (under supervision) they contribute to service provision. They are funded largely through direct MADEL funding, through the Deanery & via a contract to provider organisations.

• Trainees need to be aware of the latest developments within their specialty and bring this aspect to the wider teams.

• Training promotes a culture of continuing professional development which is of benefit to all staff.

• Currently, most core & advanced trainees in psychiatry provide a vital on call service, supporting provision of medical input to wards crisis teams and other emergency settings.

• Services that provide high quality training are attractive organisations for prospective employees. By contrast, services that do not provide post-graduate training frequently experience difficulties recruiting high calibre consultants to their posts.

• Many trainees prefer to remain within the area in which they train for their future careers, thus providing high quality training delivers a pool of suitably trained and qualified future consultants.

Authors: MM & RM, last update October 2015