NW Thames Foundation School
Individual Placement Description
Placement
F1 General Psychiatry (Liaison)
The department
The Psychological Medicine Department (Liaison
Psychiatry) at St Mary’s Hospital
Imperial College Healthcare NHS Trust, CNWL
Foundation trust. St Mary’s Hospital
Trust & Site
The type of work to expect and
learning opportunities
This exciting and innovative F1 post in psychiatry
provides an introduction to psychiatry for junior doctors.
It provides a foundation in the core competencies for
psychiatric training such as psychiatric assessment and
management, In addition, it also provides skills that are
highly relevant to the interface between physical and
mental health in primary care and hospital practice.
These include how to integrate treatment for patients
who have both mental and physical health problems,
and how to work with complex patients where poor
outcomes or complaints may be a particular risk.
The post holder will join the liaison psychiatry and
perinatal psychiatry teams at St Mary’s Hospital as well
as a general psychiatry team (the Community Recovery
Team).
The departments
The Liaison Psychiatry Service receives referrals aged
16-65 from anywhere in the hospital. Presentations are
often prompted by:
- severe behavioral disturbance and mental illness
- concerns about risk of suicide
- medically unexplained symptoms
- mental illness co-morbid with physical illness
- advice regarding complex mental capacity
assessments
The Perinatal Psychiatry Team specializes in referrals
of pre-and post-natal women. St Mary’s Maternity Unit
oversees 5000 deliveries a year.
-Childbirth is the highest risk event for mental illness in
a woman’s life.
-Mental illness is the leading cause of death in mothers.
The team sees the full breadth of mental health
presentations (most notably puerperal psychosis and
affective disorders), collaborates closely with other
services and carries out particularly eloquent risk
management to ensure the safety of mother and child.
Both services also run outpatient clinics.
The Crisis Resolution Team provides psychiatric
support to people with acute, severe mental illness in
the community, as an alternative to inpatient admission,
or during the period of high risk immediately following
hospital discharge. Referrals include:
- Severe affective disorder e.g. bipolar affective
disorder.
- Schizophrenia
- Schizoaffective disorder
This multidisciplinary team carries out home visits daily
has expertise in risk assessment and the management
of severe psychiatric presentations. Supervised by a
very senior forensic psychiatrist.
The learning opportunities and objectives
The post holder will be supported in learning psychiatric
principles as well as ‘integration’ skills specific to the
mental-physical interface. These include- Psychiatric assessment, cognitive assessment,
mental state examination, assessing risk of self-harm,
diagnosis of a broad range of psychiatric disorders.
- Management of psychiatric disorders including care
planning, pharmacology and psychotherapy. To include
common disorders often managed in primary care
alone, e.g. adjustment disorder and anxiety disorders.
Also to include managing co-morbidity of psychiatric
and physical disorder.
- Effective communication and documentation about
psychiatric disorders and risk, including referral to other
services.
-Presenting a psychiatric case.
- Collaborative working in multi-agency settings.
- Communication skills - talking with families, talking
with patients who are in conflict about their treatment or
diagnosis.
The trainee will at first observe and discuss cases, then
be able to carry assessments and reviews under senior
supervision.
Clinical Supervisor(s)
placement
for
the Dr Steve Reid (Consultant in Liaison Psychiatry)
Dr Wojtek Wojcik (Locum Consultant in Liaison
Psychiatry)
Dr Maddalena Miele (Consultant in Perinatal
Psychiatry)
Dr Philip Joseph (Consultant in Forensic Psychiatry)
Main duties of the placement
The post holder will be expected to:
Participate in daily team handover meetings and case
discussion
Carry out assessment and review of referred patients
(with close support from consultant and senior trainee)
Create management plans for common psychiatric
presentations.
Communicate with other services and document clearly.
Assist in teaching of medical students.
Attend weekly supervision with a consultant psychiatrist
Attend regular teaching and grand round.
Contribute to audit or consider a small project
depending on their interest.
Typical working pattern in this Monday
placement
Tuesday
Wednesday
Liaison/Perinatal
assessments
(inpatients
and
ED)
Team
Meeting, case
discussion
Presentations
Crisis Resolution CRT
Team (CRT)
(Lunch-St
Charles’
Grand Round
)
Liaison/Perinatal
F1 Teaching
assessments
Thursday
Liaison/Perinatal
Psychiatry
(Supervision)
Liaison
Psychiatry
Outpatient
Clinic
Friday
Perinatal
Psychiatry clinic
Liaison
Psychiatry
Assessments
(Lunch – St
Mary’s Grand
Round)
Liaison Psychiatry assessments include seeing new
referrals from inpatient wards and in the Emergency
Department, followed by senior review. This post is
currently un-banded there is no on call.
Employer information
Imperial College Healthcare NHS Trust, with honorary
contract to Central North West London (CNWL) NHS
Trust
It is important to note that this description is a typical example of your placement and may be
subject to change.