Workforce, training and education
East of England

In the first and second years of dual training (ST4 and ST5) the trainee will be offered psychoanalytic consultation on some of the psychiatric cases they see in their training placement psychiatric settings or on call within Educational and Clinical Supervision with a Consultant Psychiatrist in Medical Psychotherapy.

In their first and second years (ST4 and ST5), the dual trainee is a member of a Consultant Psychiatrist in Psychotherapy facilitated (planned) Balint group for Advanced Psychiatry training peers in psychiatry.

From their third year onwards (ST6) the trainee will begin to participate in Medical Psychotherapy Consultation accompanying a Consultant Psychiatrist in Psychotherapy offering consultation on complex patients to other specialist colleagues working in psychiatry and to GPs and other professionals in primary care. In the fourth and fifth years (ST7 and ST8) the dual trainee will undertake their own supervised consultations.

Since clinical consultation is one of the most challenging aspects of the interface between the Medical Psychotherapist and their psychiatric colleagues, careful consideration will be given to the selection of cases and the supervision of this work.

The Medical Psychotherapy clinical consultation interface with other specialists represents the ‘coalface’ for the development of the trainee’s emergent psychotherapeutic and psychiatric identity. 

Medical Psychotherapy Consultation is therefore a crucial and central component of the dual training to become a Consultant Psychiatrist in Psychotherapy.

Work place based assessment (WPBA) of consultation will include cased based discussion (CBD) Structured Assessment of Psychotherapy Expertise (SAPE) and Assessment of Clinical Expertise (ACE).

The Work place based assessment (WPBA) Direct Observation of Non-Clinical Skills (DONCS) can be used for chairing professionals meetings or participating in a Care Programme Approach meeting as part of the ‘consultation sandwich’ approach developed in by colleagues in Leeds. The consultation sandwich includes seeing the professionals, then sometimes seeing the patient, then seeing the professionals again to formulate and offer recommendations on on-going patient care and management.

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