The clinical experience in the higher training programme in Psychiatry of Learning Disability consists of three full time years (or equivalent for LTFT). Typically these posts are spread between general adult Learning Disability, Secure services (medium and low secure) and CAMHS-LD.
The trainee will be working across Coventry and Warwickshire Partnership NHS Trust (COVWARKPT), Birmingham and Solihull Mental Health foundation Trust (BSMHFT), Black Country Mental Health Foundation Trust (BCPFT) and Worcestershire Health and Care NHS Trust (HACW).
The main training placements will be general adult Learning Disability (Community and Inpatient) which are 12 months long with two 6 month posts in secure services and CAMHS-LD.
After successful appointment, trainees are given the opportunity to rank in order of preference their first post. After completion of post the Training programme director usually asks trainees for their preferences. Posts are then allocated according to training needs and requirements of the service.
After completion of training a CCT (Certificate of Completion of Training) will be provided to the trainee after successful completion of 36 months of training to the required level of competence. At times the trust provides up to six months of extension of employment if the trainee is on the lookout or in the process of securing a Consultant post.
The Role of the Higher Trainee
As a registrar in Psychiatry of Learning Disability you will be an integral part of the team you join. You will have a higher level of freedom and autonomy as compared to core training. You will get opportunities to assess referrals received from Primary care services and general mental health teams. You will also review and assess patients in your clinical supervisor’s case load. You will have the opportunity to hone your skills of assessment and treatment in an independent and safe manner.
You will also have the opportunity to step in for your supervisor and gain valuable experience in leadership by undertaking some of their duties. Attending a tribunal, managers hearing or chairing MDT meeting are some of them.
Educational and Training Objectives
You are allocated to work with Clinical Supervisor (CS) who would be responsible for day to day clinical supervision and WPBA. Your clinical supervisor will complete the online mid-term and end of term supervisor reports detailing your progress. At the commencement of each new placement you will set your educational objectives with your Trainer. These should be reviewed with your Trainer at regular intervals during your placement to ensure you are on track to achieving them. You would be allocated an Educational Supervisor (ES) who would be responsible to oversee your training for the whole of 3 years. You will also have regular meetings throughout the year (1-2) with your Educational Supervisors.
Weekly Supervision will be with your clinical supervisor at a pre-set day and time for up to one hour per week. This will primarily focus on your personal development, progress made in training and any training needs identified.
Work Place Based Assessments (WPBA’s) and ePortfolio
During each year of the scheme you will be expected to build up an eportfolio (online) of your experience and assessments which will be used at your annual portfolio review and ARCP to assess your progression through the competencies.
Progression through training is detailed through the undertaking of work place based assessments. It is essential for you to complete, and prove satisfactory in, the Royal College WPBAs to be able to progress through training. These must be submitted online with the Royal College (Assessments Online). ST4 - 6 trainees complete at least one WPBA assessment per month. A minimum of 12 WPBA’s are needed for ARCP. At this level of training the majority of WPBA’s should be either Assessment of Clinical Encounter (ACE) or Case based discussions (CbD). Your Portfolio should have evidence of you gaining Psychology experience. You should endeavour to have an adequate mix and number of assessments showing good curriculum coverage.
In addition to the WPBA’s you will be required to undertake a minimum of one multi-source feed-back (Mini-PAT) per post. The School of Psychiatry requires a minimum of 06 responses with one from each discipline. Feedback should be sought from the following groups: Consultant, junior doctor on your team, secretaries, all grades of nursing staff, other professional groups such as psychology, SALT, OT etc.
On Call Responsibilities
The Learning Disability registrars share the on call Rota with their mental health counterparts while working in Coventry and Warwickshire. The rota is divided into Doctors 1 and 2. The on call hours during the week are 5pm till 9am the next weekday or 9am till 9am on the weekends. The on calls are non-resident. Registrars are expected to undertake Mental health act assessments exclusively. Doctor 1 covers assessments for a referral for a patient that is not open to the Crisis resolution home treatment team. Doctor 2 covers referrals for patients that are open to the CRHTT, they may at times be called to provide telephone support to the Crisis team regarding a patient they may have reviewed. The registrars are paid one hour of the total on call slot and can claim for the Mental health act assessments carried out. There are rest facilities available at the Caludon Centre Coventry if an on call doctor feels tired or unreasonable to drive back home during the night.
Academic Programme
The academic programme runs on a weekly basis for three terms each year. It is held on a Wednesday afternoon at Brooklands Hospital and the autumn term commenced in Sep 2020. The three-year rolling programme has been specifically designed to cover all the taught aspects of the Royal College Curriculum. The programme is currently being held virtually through Microsoft Teams. This has in effect increased attendance at the programme due to the convenience of attending online.
The programme is currently managed by Dr Hassan Majid ST5.
This is an important forum for Trainees to participate and present cases, journals and audits that they have undertaken. External speakers are also invited to speak, adding to the value of the programme. Nelly Afas is the admin lead for this academic programme. One trainee every year is allocated to lead this programme effectively.
Currently the programme is running online on MS Teams due to Covid-19 risks.
Annual Review of Competency Progression (ARCP)
ARCP is the formal mechanism for deciding whether a trainee has met the competencies required to pass on to the next stage of training. The review is conducted by a panel which will include the Training Programme Director. The review concentrates on the trainee’s portfolio and a decision is made based on the quality of the portfolio. Before the ARCP a Portfolio Review is usually held with two independent trainers. The portfolio review panel completes the Educational Supervisors report. Trainees have attended these reviews in person however they are being conducted online during the Covid-19 pandemic.