Higher training in psychiatry
Following completion of core training, trainees can progress to higher training in psychiatry.
After considering and experiencing in core training what you’d like to specialise in as a consultant, you can choose general adult psychiatry, old age psychiatry, child and adolescent psychiatry, psychiatry of intellectual disabilities and forensic psychiatry as single specialty higher training programmes. (Please note: there are no single specialty medical psychotherapy programmes available in Yorkshire and the Humber).
There are also dual higher training opportunities in Yorkshire and the Humber in:
- General adult psychiatry and old age psychiatry
- General adult psychiatry and medical psychotherapy
- Forensic psychiatry and medical psychotherapy
- Forensic psychiatry and child and adolescent psychiatry
- Forensic psychiatry and psychiatry of intellectual disabilities
- Child and adolescent psychiatry and medical psychotherapy
- Child and adolescent psychiatry and psychiatry of intellectual disabilities
Higher training is usually 3 years for a single speciality and 4 for dual specialities, but there may be exceptions to this depending on the speciality. For currently available programmes, it is worth contacting the training programme director (TPD) for your region for up-to-date information (see link below – “who we are”).
During higher training, will also have a clinical supervisor (CS) for each post (as in core training) and an educational supervisor (ES) who oversees the whole of your higher training journey. At the end of higher training, you will achieve a CCT (Certificate of Completion in Training). You can then apply for posts as a consultant.
North East West Yorkshire (NEWY) CAMHs Specialty rotation
The North East West Yorkshire CAMHS Psychiatry Specialty Training rotation covers a large geographical area within the counties of North Yorkshire, East Yorkshire, and West Yorkshire. All are locations of outstanding natural beauty with good transport links.
The six trust locations providing placements are: Tees ESK and Wear Valleys (TEWV), Leeds and York Partnership, Leeds Community Healthcare trust, Bradford and District Care trust, Humber, and South West Yorkshire Foundation Trusts.
The rotation aims to provide every higher trainee with high quality training in a range of placements that both suits the interests of the individual, covers the CAMHS curriculum for higher training and equips them for the demands of a consultant post in the future NHS.
The rotation has 14 full time equivalent trainees in three-year rotations covering essential inpatient and community capabilities.
There are 3 Dual Training 5-year programmes in CAMHS/Forensic, CAMHS/LD and CAMHS /Psychotherapy
Trainees are appointed to the whole rotation and can apply to work Less Than Full Time. They are encouraged to take ownership of their own training needs, supported by their Clinical and Educational supervisors and their Training Programme Director TPD. New starters will have a group induction and an individual meeting with their TPD and are allocated a trainee buddy to support them.
Allocations to posts are done in the twice-yearly Speciality Education Committee meeting attended by ES representatives from each trust. Trainees are requested to fill in a placement preference form to inform this process. A full-time trainee is required to do at least 6 months in an inpatient setting (generally 1 year). We encourage trainees to train across three different Trusts over their 3 years as this provides the broadest experience.
The new CAMHS curriculum will focus on PDP development, Higher Learning Outcomes, and capability development. There is a trainee led academic program specifically for CAMHS trainees that runs over a 3-year (30 day) cycle. Topics cover the CAMHS curriculum. The rotation emphasises adult learning and the creation and continuous review of personal development plans and continuous reference to the College curriculum and use of the online portfolio.
There are extensive opportunities for the development of clinical and non-clinical capabilities in preparation for Consultant practice. The CAMHS curriculum is particularly dense so it is advised that trainees develop a good PDP plan to meet all curriculum requirements in their 3 years of training before embarking on special interest days. Most trainees do achieve this and there are lots of opportunities for following special interests. Bursaries may be agreed for special academic interests supported by the PDP. The Northern School of Child and Adolescent psychotherapy (Tavistock trust) is located in Leeds. The rotation actively promotes research, quality improvement, leadership, management, psychotherapy, teaching and training activities.
Alongside educational progression, there is pastoral care and support from Clinical and Educational supervisors and TPD. There is also the HEE Yorkshire and Humber SuppoRTT programme for trainees returning from long term planned or unplanned absence.
Most Higher Trainees do take up substantive Consultant Posts in the Yorkshire and Humber region and become much-valued Consultant colleagues.
For more information please contact:
Dr Jonathan Barrett
Training Programme Director
CAMHS, Leeds Community Health Care Trust
The Yorkshire Forensic Psychiatry Scheme provides a wide range of training opportunities across the region. The scheme is based around 7 centres, which compliment each other. There are 3 medium secure units, namely Newton Lodge, The Humber Centre and Wathwood. 4 low secure/community forensic centres based at the Newsam centre (Leeds) Bretton Centre (Wakefield), the Humber Centre (Hull) and Lynfield Mount (Bradford).
There are additionally 2 community Forensic teams based out of Newton Lodge in Wakefield. The FOLS (Forensic Outreach Liaison service) and the SCFT (Specialist Community Forensic Team) There are up to 11 ST numbers in forensic psychiatry which are distributed around the region and are dependent on both Trainers being available as well as appropriate funding. At present there are no trainees being placed at the Newsam centre but this may change.
Additionally there are 2 Dual CCT numbers, one with CAMHS and the other with Psychotherapy.
The Yorkshire Deanery also supports higher training for a large number of specialist registrars in general psychiatry, older age psychiatry, medical psychotherapy, child and adolescent psychiatry and learning disability psychiatry.
STs are encouraged to take ownership of their training and monitor their own progress by setting agreed training objectives, which are delivered through the scheme’s system of supervision, appraisal and annual assessment. The Training Scheme is fully approved by the Royal College of Psychiatrists.
The Programme is the responsibility of the training programme director and will take account of individual preferences in deciding placements. The training will lead to the award of a CCT after 3 years in forensic psychiatry and 5 years specialist training in forensic psychotherapy/ forensic CAMHS.
The scheme comprises upto 2 years training based within either medium secure hospitals and one year based at one of the sites offering low security/community forensic psychiatry. An attachment to a high secure hospital is part of the training and is usually taken within the last year of training for a minimum of 6 weeks. The Postgraduate Dean normally grants an extension to the Training Scheme of a further 6 months.
The Yorkshire Training Scheme aims to provide each trainee with core training and experience as a foundation in Forensic Psychiatry on which to build and develop professional interests, specific skills and to pursue personal ambitions. It is hoped that the placements will meet the interests of the specialist trainee and equip each doctor for the demands of a consultant post in the future within the NHS.
Dr Purvesh Madhani
Training Programe Director
North East West Yorkshire (NEWY) General Adult Psychiatry Specialty rotation
The North East West Yorkshire General Adult Psychiatry Specialty rotation covers a large geographical area within the counties of North Yorkshire, East Yorkshire and West Yorkshire. The five trust locations providing placements are: Tees Esk and Wear Valleys (TEWV), Leeds and York Partnership, Bradford and District Care, Humber, and South West Yorkshire Foundation Trusts. It is a highly popular and competitive rotation.
The rotation aims to provide every higher trainee with exceptional quality training in a range of placements that both suits the interests of the individual and equips them for the demands of a consultant post in the future NHS. The rotation can accommodate 35 full time equivalent trainees in three-year rotations with a choice of over 60 approved trainers covering essential inpatient and community competencies, as well as a range of options, based on trainee preference and identified needs, including Crisis Teams, Early Intervention and Assertive Outreach Teams, Psychiatric Intensive Care, Forensic services, Rehabilitation placements, Liaison services, Addictions Teams, Perinatal and Eating Disorder Services.
There are Dual Training programmes in General Adult and Old Age Psychiatry (4 years), and General Adult and Medical Psychotherapy (5 years), as well as opportunities for Academic Posts, including Academic Clinical Fellows, Leadership Fellows and Clinical Lecturer Posts.
The trainees are appointed to the whole rotation and can apply to work Less Than Full Time. They are encouraged to take ownership of their own training needs, supported by their clinical and educational supervisors, their Training Programme Director (TPD), senior trainee mentors, the local Trainee Forum, and a monthly Higher Training Committee chaired by one of the specialty trainees.
The trainees on the rotation are expected to work across at least two different Trusts but can contribute to placement allocation after their first year. During their training they do middle tier on-call and gain competencies in managing risks and complex mental health problems. The rotation has access to established regional psychotherapy tutors to support psychotherapy competencies.
The rotation places particular emphasis on adult learning, personal development plans, Outline Training Reviews, and use of the College curriculum and portfolio, as well as extensive opportunities for clinical and non-clinical competencies in preparation for Consultant practice, based around 4 clinical days and 1 Special Interest day. Bursaries may be agreed for special academic interests supported by the PDP.
Alongside educational progression, there is pastoral care and support as needed through the HEE Yorkshire and Humber SuppoRTT programme for trainees returning from long term planned or unplanned absence.
The overwhelming majority of our Higher Trainees take up substantive Consultant Posts in the training region and become much-valued Consultant colleagues.
For more information please contact:
Dr Lackson Mzizi
Training Programme Director
South Yorkshire General Adult Psychiatry Speciality Rotation
Welcome to the South Yorkshire higher training rotation in General Adult Psychiatry (GAP). The rotation is well established and has 17 National Training Numbers. The Training Programme Director (TPD) is Dr Abhi Shetty. Dr Shetty works closely with other specialty TPDs to actively monitor interest in the rotation from core trainees and SAS doctors wishing to apply to higher training. Depending on vacancies and trainee interest there is flexibility in the number of single and dual training posts which are declared for recruitment every 6 months. Currently, dual training in GAP is available with Old Age Psychiatry (4 years WTE training) and Medical Psychotherapy (5 years WTE training). Application for less than full time training is well supported.
The rotation actively promotes research, quality improvement, leadership, management, psychotherapy, teaching and training activities. There is a lively educational programme on these topics for all trainees. Additional local and national level opportunities are encouraged, and trainees supported to apply. Special interest/research time is protected and used by trainees to enhance clinical and non-clinical skills. A generous study leave budget is available to supplement local educational activities.
The rotation benefits from enthusiastic and supportive clinical and educational supervisors. The rotation is spread across 3 major mental health trusts in the region.
- Sheffield Health and Social Care NHS FT (SHSC) is the lead employer for all trainees in the rotation. SHSC has 9 GAP posts. Clinical placements are spread across the city of Sheffield and include inpatient, community, home treatment and early intervention services. All three endorsement placements (liaison, rehabilitation, and substance misuse) are based within SHSC.
- Rotherham Doncaster and South Humber NHS FT (RDASH) has 6 GAP posts spread equally across Rotherham and Doncaster and includes inpatient, community, and home treatment placements.
- South West Yorkshire Partnership NHS FT (SWYFT) has 2 GAP post based in Barnsley and includes an inpatient and a community placement
Dr Shetty is very happy to be contacted by email for any enquiries on Abhijeeth.Shetty@shsc.nhs.uk
North East West Yorkshire (NEWY) Old Age Psychiatry Specialty rotation
The North East West Yorkshire Old Age Psychiatry Specialty rotation covers a large geographical area within the counties of North Yorkshire, East Yorkshire and West Yorkshire. The five trust locations providing placements are: Tees Esk and Wear Valleys (TEWV), Leeds and York Partnership, Bradford and District Care, Humber, and South West Yorkshire Foundation Trusts.
The rotation delivers high quality training in a range of services, equipping trainees to become tomorrow’s clinicians, medical leaders, academics, and educators in the ever-changing NHS.
This is a large specialty rotation with up to 20 full time equivalent trainees and a choice of over 30 approved trainers. The training experience will cover competencies in inpatient and community old age psychiatry, and liaison, crisis intervention and care home liaison. Trainees are expected to work across at least two different Trusts, during the three years (four years in dual training) of training. Trainees will be able to influence their choice of placement after the first year of training.
There are excellent opportunities in understanding and gaining competencies in legal frame works such as MCA and MHA, and managing cognitive impairment, and behavioural and psychological symptoms of dementia.
The School of Psychiatry also provides dual training rotations in General Adult and Old Age Psychiatry (4 years) in the same location and the two specialty rotations are closely aligned. Trainees have the option to apply for Academic Clinical Fellows, Leadership Fellows and Clinical Lecturer rotations or placements.
The rotation emphasises self-directed and reflective learning by developing annual Personal Development Plans and having clear strategies to achieve the PDP goals. These are reviewed regularly through the portfolio in line with the curriculum by clinical and educational supervisors, and the training programme director (TPD).
Trainees also have opportunities for clinical and non-clinical competencies in preparation for Consultant practice. Trainees are supported by experienced clinical and educational supervisors and a TPD. Mentoring by more senior trainee colleagues are available. The trainees are represented within a local Trainee Forum and a monthly Higher Training Committee.
Trainees are expected to do middle tier on-call and attain competencies in managing risks and complex mental health problems. There is support to ensure core psychiatry psychotherapy competencies are developed in line with curriculum expectations, and there are opportunities for research, Quality Improvement, teaching and leadership development.
There are two sessions per week for special interest sessions, which may be clinical and/or research focussed. There are bursaries available to assist with specific study interests identified by the PDP. In the final year of training there are often Acting Up consultant roles advertised. Return to work following lengthy planned or unplanned absence is supported by the HEE Yorkshire and Humber SuppoRTT (Supported Return to Training) programme.
The overwhelming majority of our Higher Trainees take up substantive Consultant Posts in the training region and become much-valued Consultant colleagues.
For more information please contact:
Dr Liz Cashman
Training Programme Director
Welcome to the HEE Yorkshire and Humber Higher Training Scheme in Medical Psychotherapy. There are two rotations within the scheme, one covering South Yorkshire and the other covering the West, North and East of the HEEYH area. All Medical Psychotherapy Training in HEEYH is offered as a dual training programme leading to a dual CCT, with no single CCT posts available in Medical Psychotherapy. The dual training programmes are supported by joint working and collaboration between the Training Programme Directors for the respective specialties. The information below should be read in conjunction with the relevant webpage for the paired training specialty in that geographical area.
As outlined in the Medical Psychotherapy curriculum, each training post allows a trainee to major in one model of psychotherapy while acquiring additional competencies in two minor models. The three models available are CBT, psychodynamic psychotherapy and systemic family therapy. Trainees are expected to acquire mastery-level skills in their major model, supported by an academic training course. There is also built-in flexibility to allow the acquisition of skills and experience in a variety of related models which have been developed for working with people with complex emotional needs, including mentalisation based therapy, dialectical behaviour therapy and cognitive analytic therapy.
The six dual training NTNs available are as follows.
South Yorkshire (lead employer Sheffield Health and Social Care NHS Foundation Trust)
- Medical Psychotherapy and General Adult Psychiatry – CBT major
- Medical Psychotherapy and General Adult Psychiatry – psychodynamic psychotherapy major
West, North and East (no lead employer)
- Medical Psychotherapy and General Adult Psychiatry – CBT major
- Medical Psychotherapy and General Adult Psychiatry – psychodynamic psychotherapy major
- Medical Psychotherapy and Child and Adolescent Psychiatry – flexible major
- Medical Psychotherapy and Forensic Psychiatry - psychodynamic psychotherapy major
Training is supported by enthusiastic clinical and educational supervisors with a range of clinical interests and specialisms within Medical Psychotherapy, as well as by trainers in the paired specialty who are supportive of dual trainees and keen to help them to integrate both aspects of their work.
The rotations follow the RCPsych and GMC requirements, as detailed on the Dual Training page of the Royal College of Psychiatrists website (Dual Training (rcpsych.ac.uk). This is a sequential model, with two years in each subspecialty, followed by a fifth and final year which is integrated and aims to allow the trainee to further develop clinical interests which they may wish to pursue as a consultant. For most trainees, the first two years will be spent in their dual specialty and they will then move into Medical Psychotherapy, followed by the integrated final year. Applications from less than full time trainees are welcomed and there is no difficulty in adapting the structure of dual training for LTFT working.
Personal psychotherapy appropriate to the trainee’s major model is a requirement of the curriculum during the Medical Psychotherapy training years. Funding to cover one session per week of personal psychotherapy is available for the all five years of dual training.
Up until now, clinical placements in Medical Psychotherapy have been available in two NHS Foundation Trusts, Leeds and York Partnership and Sheffield Health and Social Care. We are working to develop placements in South West Yorkshire, Humber and Bradford District Care Trusts and hope that opportunities will continue to expand. We expect that the rotation is likely to remain within the current pattern, where trainees are based in one clinical team for the duration of their Medical Psychotherapy years but have access to training opportunities in other services.
The contribution of non-medical psychotherapists is key to supporting training. Family therapy experience with well-established adult family therapy teams is currently available in Leeds and Wakefield for all trainees. There are opportunities to be part of a DBT programme in Leeds or Sheffield and to co-lead an analytic group in Bradford. Supervision in CBT, psychodynamic therapy and other available models is provided by Consultant Medical Psychotherapists and may also be available from adult/child psychotherapists and clinical psychologists.
In conjunction with trainers in the paired specialties, the rotation is keen to promote research, quality improvement, leadership and management, and teaching and training activities. Trainees are encouraged to be adult learners and to take ownership of their own clinical and non-clinical training needs. They are allocated an Educational Supervisor in Medical Psychotherapy from the start of the rotation, who will support them to develop a five year training plan and to adjust this as they develop their interests and career plans. Additional local and national level opportunities are encouraged, including Out of Programme Experience, and trainees are supported to apply. Special interest/research time is protected and used by trainees to enhance clinical and non-clinical skills. If they wish, dual trainees in Medical Psychotherapy and General Adult Psychiatry are encouraged where possible to gain an endorsement in one of the sub-specialties of General Adult Psychiatry.
Pastoral support is provided by the Educational Supervisor and via the employing Trust, and through the HEE SuppoRTT programme, according to trainee needs. Coaching is also available via HEEYH.
Trainees are encouraged to join the national Medical Psychotherapy trainee forum, and for trainees in Forensic Medical Psychotherapy there is a dedicated national forum to support their needs as a small specialty group. Trainees also become members of the local Higher Training Committee and Trainee Forum.
After gaining their CCT, recent dual trainees have taken up posts in a variety of specialties across Yorkshire and Humber to become valued consultant colleagues and trainers.
Anne Cooper & Vikram Luthra
Training Programme Director
HEE Yorkshire and Humber have offered a dual CCT training programmes in Medical Psychotherapy/General Adult Psychiatry and Medical Psychotherapy/Forensic Psychiatry for several years. The CAP-MP pairing was recently approved by the GMC following work carried out by the Medical Psychotherapy and Child and Adolescent Psychiatrist Faculties of the Royal College of Psychiatrists. In 2020 this was the first time that the programme was being offered in Yorkshire and Humber.
Both the Medical Psychotherapy and Child and Adolescent Psychiatry CCT training programmes are 36 month programmes, both with demanding academic training components. The Medical Psychotherapy curriculum was written for training programmes involving work with adults, and the postholder will be expected to become competent in offering psychotherapy to both adults and young people in equal measure, with the competencies relating to therapy with adults being acquired in adult psychotherapy settings, and those relating to children and young people in CAMHS settings.
The GMC-approved combined training programme is five years (60 months) in duration, as there is a sufficient degree of overlap between the curricula to shorten the overall training time from six years to five. If a postholder decides in the course of training that they wish to exit training sooner, with a single CCT in either Medical Psychotherapy or Child and Adolescent Psychiatry, they will need to ensure that they have completed 36 months in that specialty and that they have achieved all the relevant competencies.
Medical psychotherapy training and choice of major model
Within the Medical Psychotherapy CCT, trainees have a major model of psychotherapy in which they develop mastery. This is usually either psychodynamic psychotherapy or CBT, although the curriculum also allows for systemic family therapy and interpersonal therapy (IPT). The trainee also gains experience in two other models of psychotherapy. The CAP curriculum also lays a strong emphasis on the development of psychotherapy competencies. For this dual training programme, we give trainees the choice of either psychodynamic psychotherapy or CBT as a major model.
Personal psychotherapy
As part of the Medical Psychotherapy curriculum, trainees are required to undertake either personal psychotherapy, or for trainees in CBT or systemic therapy, an equivalent experience of personal reflection. For a single CCT programme this personal therapy will take place over a duration of three years, at once weekly frequency, although trainees can choose to be in personal therapy at greater frequency if this fits with other training and personal commitments. One session per week is funded through study leave funding. For the CAP – MP training programme, the requirement will be for the trainee to be in personal therapy (or undertaking equivalent experiences for CBT/systemic trainees) for the last three years of the dual training programme, and not (unless the trainee chooses otherwise) for the initial two years spent in a CAP setting.
Overall training plan
Years one and two in designated Child and Adolescent psychiatric posts supervised by a trainer with a CCT in Child and Adolescent Psychiatry:
- This will include 1 year in Community Specialist CAMHS (Child and Adolescent Mental Health Services) 0-18 years
- 6 months in inpatient TIER 4 CAMHS
- 6 months in another CAMHS post such as Paediatric-Liaison/ CAMHS-ID or similar
- The trainee will be expected to also meet the mandatory research competency as per the current CAP Curriculum, as well as the psychotherapy competencies as per the curriculum (with further time to achieve these in year five)
Years three and four in designated Medical Psychotherapy posts supervised by a trainer with a CCT in Medical Psychotherapy
- This may be one post or two one year placements
- During this time the trainee will need to meet all of the Medical Psychotherapy Curriculum competencies specific to work with adults, including those which are shared with the General Adult Psychiatry curriculum (including experience of emergency work on call). The trainee will focus on their chosen major model and acquire competencies in at least one of the two required minor models.
Year five in which there is an integration between posts to achieve the curriculum competencies.
This year is most likely to be largely in a CAMHS setting but with a clear focus on psychotherapy competencies, allowing the postholder to acquire the psychotherapy competencies required by the CAP curriculum and if time allows, to develop particular special interests relevant to future career plans. The post will be chosen to provide opportunities for the trainee to further develop their competency in their chosen major and overall to provide opportunities to deliver individual, group and systemic therapies. The trainee will have a primary clinical supervisor with a CCT appropriate to the setting and will have some involvement from a clinical supervisor in the other specialty.
Harriet Fletcher
Medical Psychotherapy TPD
Juliette Kennedy
Child and Adolescent Psychiatry TPD
January 2020