Workforce, training and education
East of England

Outline Structure for the Five Year Training Period


The principle of proposing and ratifying each year of the Advanced Medical Psychotherapy Training Plan (see appendix A) year on year between the Trainee, the Training Programme Directors and the two Educational Supervisors will apply throughout the period of dual training, depending on the developing training needs of the trainee.

The detail of where particular General Psychiatry placements take place is therefore omitted in the following outline with the principles underlying the training objectives for each year described.

As the dual trainee will rotates through different General Psychiatry placements, it is beneficial to provide the background containment and consistency of one Medical Psychotherapy placement in which their core psychotherapy clinical work, educational supervision takes place.  This takes place in the psychotherapy department Southend which has established experience of having higher general adult trainees undertaking a year placement in Psychotherapy as part of their General Adult higher specialist training.  The Trainee and Trainer will meet regularly in this secure base in Southend and include General Psychiatry Trainers in their developmental programme.

General Psychiatry placements are identified which do not necessarily include Educational supervisors with a special interest in psychotherapy but do include the Educational Supervisor actively in planning the placement and articulating the aims of the dual training before the trainee begins in their General Psychiatry placement.  The general adult placements will be in South Essex to facilitate practicalities of training and because of existing relationships with trainers of both subspecialties, but with the potential of arranging special interest sessions  elsewhere depending on the needs of the trainee. 

Year 1 and 2: Specialty Training Year ST 4 & 5

General Adult Psychiatry: three days per week

Three days per week will be spent in General Adult Psychiatry which may begin in any General Psychiatry setting, with in-patient teams often favoured over a community mental health team to begin.  The General Adult Psychiatry Educational Supervisor is the Consultant in this setting.

Medical Psychotherapy: one day per week

Trainees will be expected to use their special interest/research time, one day per week spent in Psychotherapy.  Clinical supervision of psychotherapy cases seen once weekly will begin in the first year and continue throughout the training. Trainees will be expected to attend an appropriate training course in psychoanalytic theory and currently the scheme has relationships with the Tavistock clinic in London.  The trainee’s Medical Psychotherapy Educational Supervisor will remain their trainer beyond the first two years of the training to provide continuity and containment.

Year 3 and 4: Specialty Training Year ST 6 and 7

Medical Psychotherapy: three days per week

In the third year it will be anticipated that one of the two subsidiary models of therapy will be introduced alongside the adopted major modality of psychoanalytic psychotherapy.  In year 4 the trainee will undertake more intensive/challenging clinical cases under supervision and pursue appropriate experience in all three therapy modalities, e.g. psychoanalytic/systemic/cognitive-behavioural or an agreed derivative therapy model of these three therapies.

General Adult Psychiatry: one day per week

The trainee will be expected to use their special interest/research time in General Adult Psychiatry.  This will now begin to be orientated towards developing applied skills in different psychiatric settings.  For example, the trainee could co-facilitate a reflective practice group in a community mental health team.  The trainee would also begin to join Medical Psychotherapy Consultations on behalf of other specialists seeking a medical psychotherapeutic opinion for complex psychiatric patients.

The General Adult Psychiatry component in year four will be decided on the basis of the trainee’s special interests and career aspirations

Year 5: Specialty Training Year ST8

Medical Psychotherapy in Psychiatry: five days


This final year of dual training is devoted to honing competence in psychotherapy and its applications in various settings of psychiatry. 

The aim in this final year of dual training is for the trainee to begin to consolidate the integration of their psychiatric and psychotherapeutic experience that has been developing over the previous four years and to consolidate their emerging as a psychotherapeutic psychiatrist in mental health services.

The trainee’s placements and Advanced Training Plan (see Appendix A) will, in the latter part of the training, have come to reflect particular areas of special interest and career aspiration as far as possible with placements agreed in collaboration with Educational Supervisors and the Medical Psychotherapy and General Psychiatry Training Programme Directors.

Tuesday, 27 November, 2018
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Tuesday, 27 November, 2018