‘Having completed all of my previous medical training within the West Midlands, I was keen to remain in the area for Higher Training. I worked as a CT3 trainee at Reaside Clinic in Birmingham with Dr Tom Clark, Consultant Forensic Psychiatrist, and found that I enjoyed being able to work with patients as part of a large and generally well-resourced multi-disciplinary team, as well as the interface with other agencies including the criminal justice system hence I decided to apply for the Forensic Psychiatry training programme. I started as an ST4 in February 2019.
Our Training Programme Director, Dr Whitworth, is very keen to maximise and personalise the training experience for each trainee, taking into account their training needs, clinical interests and personal circumstances such as family commitments, and is usually able to place each trainee in their preferred rotations. The on call rotas are also generally very flexible. Many of the current Higher Trainees work Less Than Full Time, which is fully supported.
For my ST4 year, I was placed at Reaside Clinic for a 12 month rotation. During this time I enjoyed a wealth of opportunities and experiences including leading multi-disciplinary assessments of patients with complex psychiatric presentations such as psychosis with co-morbid autism, substance use and personality disorder. These assessments were in a variety of settings; prisons, high secure hospitals and general psychiatric hospitals as well in custody suites out of hours whilst on call. The patients often had histories of significant offending, including homicide; I have enjoyed learning how to complete structured assessments of risks including violence and sexual offending. I was also able to shadow my clinical supervisor appearing in court as an expert witness and was supported to develop my own report writing skills for tribunals, the Ministry of Justice and for the court. Chairing our Clinical Team Meetings was a frequent occurrence, allowing me to develop clinical leadership and build confidence in my decision making. I have also been involved in developing new policies and guidelines within Secure Services, particularly in substance misuse.
My weekly prison clinic was in a local remand prison, HMP Hewell, where I participated in the inpatient ward round on the Healthcare wing and contributed to MDT meetings. There was a huge amount of psychopathology to manage here, and I referred several patients for admission to medium and high secure hopsitals. Being diagnostically discerning is very important in the often demanding settings of prisons and learning to manage severe and enduring mental illness without all of the input typically available in a hospital setting has been hugely interesting and challenging.
Aside from clinical activities, there was also ample time for pursuing non-clinical interests and this was strongly encouraged by supervisors and my Training Programme Director. I was able to complete my PGCert in Medical Education, was Honorary Tutor for the CT1 trainees as part of the local MRCPsych programme, SpR co-lead for the Forensic Academic Programme and completed a year as an RCPsych Leadership and Management Fellow. I have particularly appreciated the support I have received to be able to pursue these interests flexibly around my other training requirements.
Although placed with a single consultant trainer for each rotation, there is vast knowledge, experience and an array of special interests across the multi-disciplinary teams and across the Deanery. I have always found senior colleagues from all sites to be willing to help and support trainees with their development in areas of interest, both clinical and non-clinical. This, coupled with the flexibility of training and the variety of training opportunities available for Higher Trainees within Forensic Psychiatry, including specialist services such as FCAMHS, women’s secure services and Elliot House approved premises, makes the West Midlands very attractive for those looking to work within this speciality. We really are very lucky as trainees.’
Dr Shay-Anne Pantall, ST5 Forensic Psychiatry