Core Psychiatry Training in South East Scotland
These Locum Appointment for Training posts are recognised training posts on the South East
of Scotland Core Psychiatric training scheme. As such, any person appointed as a LAT on the
scheme will have access to all the training opportunities described below for the 6 month
time limit of the post. The posts which are advertised are:
1) Learning Disability Psychiatry in the Borders with Dr Mark Hughes
2) General Adult Psychiatry at the Royal Edinburgh Hospital with Dr Donald Macintyre
3) Child and Family Psychiatry in Fife (Cupar) with Dr Claudia Grimmer
4) Learning Disability Psychiatry at Lynebank Hospital with Dr Colin Morrison
The South East of Scotland Deanery covers a wide geographical area and placements are
available within the following Health Board Regions: * Lothian (including East, Mid and
West Lothian) * Borders * Fife.
Core training takes place over 3 years in order to reach competencies to apply for Advanced
Training.
During Core Training, trainees will normally undertake six 6 month posts, although longer
(12 month) placements are arranged for General Adult Psychiatry posts. It would be expected
that trainees would work in two or more hospital bases during Core training to gain a breadth
of experience. Normally the first year will be spent in one hospital, with rotation to other
hospitals in the second and third years of training based on the educational needs of the
trainee.
Trainees will spend a minimum of 12 months each in General Adult Psychiatry, 6 months in
Old Age Psychiatry and a further 6 months in subspecialty placement (Child or Learning
Disability Psychiatry). Remaining placements may include Addictions, Forensic, Liaison,
Psychotherapy, or Rehabilitation Psychiatry, depending on the trainee's requirements.
Trainees are expected to participate in the half day Psychiatry Curriculum Course at the
Royal Edinburgh Hospital in preparation for their Royal College examinations, to undertake
audit (or research) projects and to contribute to local teaching. Teaching sessions for trainees,
including journal club presentations, take place on Wednesday mornings.
Trainees are also expected to attend the Psychotherapy Foundation Course, which takes place
on Friday mornings. There is also a Special Lecture Series, which takes place on Wednesday
afternoons during term time.
Research, audit, teaching and management opportunities
South East Scotland offers a diverse and rewarding training in Core Psychiatry, with access
to a large range of specialties during the three year scheme, and supervision by an
enthusiastic group of trainers. There is also excellent academic support for trainees, and
several trainees have recently progressed to academic career streams towards the
end of their core years. South East Scotland also has very high pass rates for
both the three MRCPsych written papers and the CASC clinical exam.
Since August 2014 we have been able to create a brand new core training post which has 4
dedicated sessions for research. This point is well supported by the local academic
department, and the aim is for this arrangement to lead to the production of a piece of
published research.
Where is the training delivered?
This programme involves placements in some or all of these Health Boards and hospitals:
Herdmanflat Hospital, Haddington, Midlothian Community Hospital, Bonnyrigg, Queen
Margaret Hospital, Dunfermline, Royal Hospital for Sick Children, Edinburgh, Royal
Edinburgh Hospital, Royal Infirmary of Edinburgh, St Johns Hospital, Livingston, Stratheden
Hospital, Whyteman’s Brae Hospital, Kirkcaldy, Huntleyburn House, Melrose.
Contacts and Useful Links
Deanery sponsoring
South-East of Scotland
programme
Postgraduate Dean
Professor William Reid
Responsible
Associate - GP
Director
Deanery based or National: Deanery
Programme Type
Specialty or Sub-specialty: Specialty
Date of GMC recent
October 2015
approval
Associated Royal
Royal College of Psychiatrists (web site)
College - Faculty
Curriculum and
Associated
Assessment System
Name: Terry Brown
Deanery
Address: NHS Education for Scotland, 1st Floor, 102 West Port,
Administrative
Edinburgh, EH3 9DN
Contacts
Tel: 0131 656 3498
Email: teresa.brown@nes.scot.nhs.uk
Name: Dr Norman Nuttall
Email: norman.nuttall@nhslothian.scot.nhs.uk
Programme Director Address: Dr Norman Nuttall c/o Secretary: Leanne Gulisano –
leanne.gulisano@nhslothian.scot.nhs.uk Royal Edinburgh Hospital
Morningside Terrace Edinburgh EH10 5HF
Quality of Training
Post No 1
Specialty:
Learning Disability
Location:
Scottish Borders
Clinical Supervisor(s):
Dr. Mark Hughes, Consultant Psychiatrist
Dr. Chammy Sirisena, Associate Specialist in Psychiatry
Educational Supervision to be provided by: Dr. Mark Hughes
Description of Service & CT Post
Scottish Borders Learning Disability (LD) Service is a fully integrated (Health & Social Work)
service, operating as part of the SEAT regional planning network, and the Managed Clinical
Network for Specialist LD services in South East Scotland. Scottish Borders (Pop. 112,000) is
largely rural with a wide geographical spread, presenting a challenge in providing specialist
services. Currently the LDS is divided into 2 Community LD Teams (CLDTs) jointly managed
by Health & Social Work.
Current Staffing (all figures WTE): 1.0 Consultant LD Psychiatrist (Hosted by NHS Lothian),
0.8 Associate Specialist in Psychiatry, 0.2 WTE Consultant Forensic Psychiatrist,
1.0 Consultant Clinical Psychology (0.5 Clinical Forensic Psychology approved: to be
appointed), 1.0 Psychology Assistant, 1.0 Psychology Trainee (8 months per year),
12.0 LD Nursing, 0.6 Forensic LD Nurse (approved: to be appointed), 10 WTE Social Work,
0.8 Music Therapist, 1.4 Occupational Therapy, 1.8 Speech and Language Therapy,
1.2 Physiotherapy, 0.4 Dietetics, 0.2 Podiatry
There are no LD inpatient beds within the Borders, with access to inpatient services from the
local General Adult Inpatient Unit (where appropriate) and from inpatient services within the
MCN, or further afield.
The LDS provides input for adults (>16) with a Learning Disability. This is defined as:



Significant impairment of intellect (e.g. IQ<70)
Onset before adulthood
Associated with impaired social and adaptive functioning
In addition to requiring a learning disability, the service requires that the individual either has
difficulty in accessing mainstream services or requires specialist interventions that cannot be
provided by such services. The LDS provides assessment & management of:




mental illness, psychological problems & challenging behaviours
communication difficulties; eating, drinking & swallowing disorders
mobility & physical function
adaptive functioning


risk & capacity; intellectual ability
finances, social & physical care needs, care packages and employment opportunities
Learning Disability Psychiatry provides psychiatric assessment, risk assessment and treatment
to clients with learning disability and complex mental health needs, including psychosis/
schizophrenia, depression, bipolar disorder, anxiety disorders, obsessive compulsive disorder,
autistic spectrum disorders, and dementia. Psychiatric court reports and assessments of
decision-making capacity (physical health treatment, welfare and financial affairs) are also
provided. Both Psychiatric Consultants and the Associate Specialist act as Approved Medical
Practitioners in terms of the Mental health (Care and Treatment) (Scotland) Act 2003. LD
psychiatry adopts a multi-disciplinary style of working with all other team members, and in
addition to the above, provides consultancy and advice to other team members, primary and
secondary healthcare, and to care providers. It is also involved in the training of staff,
professional and non-professional, from within the LDS and outside.
The core trainee should take on an appropriate caseload under the clinical supervision of the
Senior Psychiatric staff, initially assessing patients jointly with other experienced members of
the team to allow the development of skills in assessing psychiatric problems in LD. Trainees
will be expected to contribute to treatment decision-making, liaison with other team members
and professionals, and administration duties (e.g. correspondence with GPs). 1 hour/week
protected supervision will be provided by the clinical supervisor. There is also a fortnightly
CPD Educational programme provided by NHS Lothian, which the trainee will be encouraged
to attend. Opportunities for audit will be available through the Borders LDS. Involvement in
ongoing LD research projects is available through the LD clinical academic staff, based in NHS
Lothian.
In addition, opportunities to shadow other team members from different disciplines will be
provided in order to experience as wide an experience of the role and function of the LDS as
possible. This is expected to include (amongst others) psychological assessments, assessments of
autism, dementia assessment, SaLT and OT assessments and Music Therapy. Contact with
other regional speciality services can be arranged for interested trainees. These could include
NHS Borders services such as CAMHS LD, or NHS Lothian Services including inpatient
assessment/ treatment units & day hospitals, LD Epilepsy Clinics, and the SE Clinical Genetics
Service.
All first and second year trainees will be expected to attend the weekly Psychiatry Curriculum
Course teaching on Wednesday mornings, and to take on a psychotherapy case. They will also
be able to attend regular journal club and case conference meetings.
Core Objectives
Trainees will be expected to demonstrate achievement of the 18 competencies set out in the 2010
Competency Based Curriculum for Core Specialist Training in Psychiatry (see appendix for list
of Learning Outcomes). Achievement of these competencies will be demonstrated by use of
Work Place Based assessments and supervisor overview.
Range of Experience Available
1) Psychiatric assessment and management of a range of mental illness in adults with LD
2) Develop skills in interviewing and communicating with individuals with complex intellectual
and communication difficulties
3) Assessment of complex cases involving a combination of psychiatric, psychological, social,
physical and development factors
4) Subspecialty assessments (ASD and Dementia)
5) Experience of integrated multidisciplinary working (including psychology, nursing, SaLT,
OT, Music Therapy, Physiotherapy & Social Work)
6) Opportunities to experience regional services (e.g Inpatient Units, LD Epilepsy Service,
Clinical Genetics)
7) Opportunities for Audit and Research
WEEKLY TIMETABLE
Regular Weekly Educational Supervision is a Mandatory Requirement from the Royal College
a.m.
Outpatient Assessments
p.m.
Psychiatric Educational Meeting
1.30-2.30pm
Journal Club 2.30-3.30pm
Junior Doctor’s Meeting
MONDAY
Autism diagnostic pathway meeting
2-3pm (monthly)
TUESDAY
WEDNESDAY
Garvald Clinic 9-5pm (monthly)
Garvald Clinic 9-5pm (monthly)
Outpatient Assessments
Outpatient Assessments
Journal Club 9am
Psychotherapy Supervision Group
Curriculum Delivery Course 10am
Research & Audit
(first and second year trainees)
CLDT meeting 9.00-10.30am (2/52)
THURSDAY
Outpatient Assessments
Dementia Pathway meeting 10.3011.30am (monthly)
Clinical Contact
FRIDAY
9am -10.30am – Psychotherapy Case
Based Discussion Group teaching
(first year trainees)
Medical & Nursing staff meeting 23pm (monthly)
Edinburgh LD Journal Club (2/52)
Supervision with Clinical Supervisor
9.30-11.00
Outpatient Assessments
Outpatient Assessments
On Call Commitment: Borders Psychiatry Rota, currently 1 in 8
Other Rota Commitments: Cross cover for trainees on leave / study leave
Post No: 2
Specialty:
In-Patient General Adult Psychiatry
Location:
Balcarres Ward, Royal Edinburgh Hospital
Clinical Supervisor(s):
Dr. Macintyre
Educational Supervision to be provided by: Dr Macintyre
Description of Post
This is a General Adult Psychiatry post providing cover for in-patients in North West
Edinburgh. The inpatient unit consists of 40 beds which are shared between NEast and NWest
Edinburgh. Trainees will attend daily ward meetings and be jointly responsible (with an FY2
doctor) for patient care.
First and Second Year trainees will be expected to attend the weekly Psychiatry Curriculum
Course teaching on Wednesday mornings. They will also be able to attend regular journal club
and case conference meetings. Psychotherapy case based discussion groups will be held on
Friday mornings.
Core Objectives
Trainees will be expected to demonstrate achievement of the 18 competencies set out in the 2010
Competency Based Curriculum for Core Specialist Training in Psychiatry (see appendix for list
of Learning Outcomes). Achievement of these competencies will be demonstrated by use of
Work Place Based assessments and supervisor overview.
Range of Experience Available
1) Managing acute psychiatric conditions
2) Assessing and managing Risk
3) Taking part in ward meetings / multidisciplinary reviews and leading these where
appropriate.
4) Mental Health Act work including Mental Health Act Tribunals
5) Liaising with community psychiatric teams
6) Meeting with carers and relatives as appropriate.
WEEKLY TIMETABLE
Regular Weekly Educational Supervision is a Mandatory Requirement from the Royal College
a.m.
p.m.
9am Ward Meeting
Multidisciplinary Case Reviews
9am Ward Meeting
Ward Work
MONDAY
2.30pm Supervision
TUESDAY
9am – Journal Club
WEDNESDAY
Ward Work
10am – Curriculum Delivery Course
(first and second year trainees)
9am Ward Meeting
Multidisciplinary Case Reviews
9am -10.30am – Psychotherapy Case
Based Discussion Group teaching
(first year trainees)
Ward Work
THURSDAY
FRIDAY
On Call Commitment:
To General Adult on-call rota at REH or St Johns
Other Rota Commitments:
Cross cover for trainees on leave / study leave
Emergency 2222 bleep during day time
Post No: 3
Specialty:
Child and Adolescent Psychiatry
Location:
Playfield House, Stratheden Hospital, Fife
Clinical Supervisor(s):
Dr. Claudia Grimmer
Educational Supervision to be provided by: Dr. Claudia Grimmer
Description of Post
CAMHS Fife is based at Stratheden Hospital, Cupar; Fair Isle Clinic , Kirkcaldy and Carnegie
Clinic, Dunfermline. The trainee is based at Stratheden Hospital, but will experience seeing
patients in all 3 locations. Apart from the geographically organised teams there are also service
wide speciality teams for DSH, complex cases and eating Disorders (Intensive Therapy
Team)and Family Therapy.
The trainee is encouraged to attend the weekly ITT meeting, weekly case discussions and team
meetings. The trainee assesses DSH referrals on a Friday and discusses them with the DSH
nurses or consultant if appropriate. 1 hour weekly supervision.
This post provides a great experience of working in multidisciplinary teams, e.g. with
psychologists, nurses, OTs, child psychotherapists. It also gives ample opportunity to consider
child protection issues, communicate with social work, teachers and parents.
First and Second Year trainees will be expected to attend the weekly Psychiatry Curriculum
Course teaching on Wednesday mornings. They will also be able to attend regular journal club
and case conference meetings. Psychotherapy case based discussion groups will be held on
Friday mornings.
Core Objectives
Trainees will be expected to demonstrate achievement of the 18 competencies set out in the 2010
Competency Based Curriculum for Core Specialist Training in Psychiatry (see appendix for list
of Learning Outcomes). Achievement of these competencies will be demonstrated by use of
Work Place Based assessments and supervisor overview.
Range of Experience Available
1) Assessment and treatment of mental illness in young people up to age 18
2) Observation of Autism assessments
3) Anxiety group work
4) Option of taking part in Family therapy clinics
5) CBT cases and 2 weekly supervision group
6) attendance at therapy workshops
7) Attendance at training events provided through Playfield Institute
8) classroom observations and school meetings
WEEKLY TIMETABLE
Regular Weekly Educational Supervision is a Mandatory Requirement from the Royal College
a.m.
MONDAY
p.m.
Assessments at Fair Isle Clinic
ITT meeting
TUESDAY
Team meeting/case discussion
Therapy workshop 1/12
CBT supervision group 2/52
9am – Journal Club
WEDNESDAY
10am – Curriculum Delivery Course
(first and second year trainees)
THURSDAY
10.30-11.30 supervision
9am -10.30am – Psychotherapy Case
Based Discussion Group teaching
(first year trainees)
FRIDAY
DSH referrals
Any unfilled time is for clinical cases
On Call Commitment: The trainee carries the hospital bleep for Stratheden Hospital on a
specified morning or afternoon
Other Rota Commitments: Cross cover for trainees on leave / study leave
Post No: 4
Specialty: Psychiatry of Intellectual Disability
Location: Fife, Lynebank Hospital
Clinical Supervisor(s): Dr Colin Morrison
Educational Supervision - provided by Dr Morrison
Description of Post
The CT1-3 on attachment with the LD Service in Fife will work with the West Fife Community
Learning Disability Team (CLDT) under the clinical supervision of Dr Colin Morrison, Consultant
Psychiatrist and Clinical Lead. The CT will also work alongside Dr Rosalind Vallance, Staff Grade
doctor with the CLDT who, along with having a community case-load, also provides medical input to
the LD epilepsy Team within the sector.
The trainee will also have the opportunity to work with the MDT in Tayview Ward at Lynebank
Hospital, a ward for 2-3 patients with complex problems – both forensic and with behavioural
challenges. Dr Morrison is the RMO for this ward.
The trainee will be on-call on the CT/GPST/FY2 on-call rota in Fife as a member of the Unscheduled
Care Team.
The trainee will have dedicated office space, a mobile phone and access to a computer. He/she will
also have dedicated secretarial support and will be encouraged to use digital dictation.
Of note Dr Morrison works full time in Fife and so is available for advice either in person or via his
phone 5 days per week; Consultant colleagues provide cross cover when Dr Morrison is away.
(First and Second Year trainees will be expected to attend the weekly Psychiatry Curriculum
Course teaching on Wednesday mornings. They will also be able to attend regular journal club
and case conference meetings. Psychotherapy case based discussion groups will be held on
Friday mornings)
Core Objectives
Trainees will be expected to demonstrate achievement of the 19 competencies set out in the 2013
Competency Based Curriculum for Core Specialist Training in Psychiatry (see appendix for list of
Learning Outcomes). Achievement of these competencies will be demonstrated by use of Work Place
Based assessments and supervisor overview.
Range of Experience Available
1) The trainee will gain experience in the assessment, treatment and management of mental health
problems (and ‘challenging behaviour’) in adults with mild, moderate and severe degrees of
intellectual disability.
2) The trainee will gain experience working in a range of clinical settings i.e. in the community (in
clinics with Dr Morrison as well as home visits – always accompanied by either Dr Morrison or one
of the experienced members of the West Fife CLDT) as well as in Tayview Ward at Lynebank
Hospital. The trainee will also be expected to provide cross-cover for Mayfield, Levendale and
Daleview wards when other non-consultant-grade staff are away.
3) The trainee will also gain experience in working with adults with a LD who also in addition,
amongst others, have forensic problems, epilepsy, autism etc.
4) There will be the opportunity for the trainee to gain experience in working with SW colleagues as
well as GPs, families, carers and a range of care providers.
5) The trainee will have the opportunity enhance their formulation skills and to work systemically.
6) There will also be opportunities to gain more understanding of the use of the Scottish Mental
Health and Adults with Incapacity Acts in adults with a learning disability.
7) The trainee will also gain knowledge of the use of Adult Support and Protection Guidelines.
8) The trainee will be encouraged to participate in MDT meetings and also gain knowledge of the
roles of the various members of the LD Team – e.g. LD Nursing, Psychology, SaLT and OT as well
as Art Therapy.
9) The trainee will also be able to gain experience in the assessment of capacity as well as of Autism,
ADHD and personality issues.
WEEKLY TIMETABLE
Regular Weekly Clinical Supervision is a Mandatory Requirement from the Royal College
a.m.
p.m.
MONDAY
2-3pm Clinical Supervision
2-4.30pm O/P clinic – Linburn Road
Health Centre
TUESDAY
WEDNESDAY
11-12.30pm
meeting
THURSDAY
FRIDAY
West
Fife
CLDT
2-4pmTayview ward MDT
9.30-11am – alternate weeks SE 2-3.30pm O/P clinic – Linburn Road
Scotland LD CPD meeting/Journal Health Centre
Club/Case Conference
On Call Commitment:
Fife Unscheduled Care Team?
Other Rota Commitments:
Cross cover for GPST/Staff Grade/Specialty Doctors when on-call/rest periods/annual leave /
study leave
Appendix - The Intended Learning Outcomes For CORE PSYCHIATRIC TRAINING
Intended Learning Outcome 1
Be able to perform a specialist assessment of patients and document relevant history and
examination on culturally diverse patients to include: presenting or main complaint, history of
present illness, past medical or psychiatric history, systematic review, family history, sociocultural history, developmental history
Intended Learning Outcome 2
Demonstrate the ability to construct formulations of patients’ problems that include
appropriate differential diagnoses.
Intended Learning Outcome 3
Demonstrate the ability to recommend relevant investigation and treatment in the context of the
clinical management plan. This will include the ability to develop and document an investigation
plan including appropriate medical, laboratory, radiological and psychological investigations
and then to construct a comprehensive treatment plan addressing biological, psychological and
socio-cultural domains.
Intended Learning Outcome 4
Based on a comprehensive psychiatric assessment, demonstrate the ability to comprehensively
assess and document patient’s potential for self-harm or harm to others. This would include an
assessment of risk, knowledge of involuntary treatment standards and procedures, the ability to
intervene effectively to minimise risk and the ability to implement prevention methods against
self-harm and harm to others. This will be displayed whenever appropriate, including in
emergencies.
Intended Learning Outcome 5
Based on the full psychiatric assessment, demonstrate the ability to conduct therapeutic
interviews; that is to collect and use clinically relevant material. The doctor will also
demonstrate the ability to conduct a range of individual, group and family therapies using
standard accepted models and to integrate these psychotherapies into everyday treatment,
including biological and socio-cultural interventions.
Intended Learning Outcome 6
Demonstrate the ability to concisely, accurately and legibly record appropriate aspects of the
clinical assessment and management plan.
Intended Learning Outcome 7
Develop the ability to carry out specialist assessment and treatment of patients with chronic and
severe mental disorders and to demonstrate effective management of these disease states.
Intended Learning Outcome 8
Use effective communication with patients, relatives and colleagues. This includes the ability to
conduct therapeutic interviews in a manner that facilitates information gathering and the
formation of therapeutic alliances.
Intended Learning Outcome 9
Demonstrate the ability to work effectively with colleagues, including team working.
Intended Learning Outcome 10
Develop appropriate leadership skills.
Intended Learning Outcome 11
Demonstrate the knowledge, skills and behaviours to manage time and problems effectively.
Intended Learning Outcomes 12
Develop the ability to conduct and complete audit in clinical practice.
Intended Learning Outcome 13
Develop an understanding of the implementation of clinical governance.
Intended Learning Outcome 14
Ensure that you are able to inform and educate patients effectively.
Intended Learning Outcome 15
Develop and utilise the ability to teach, assess and appraise.
Intended Learning Outcome 16
Develop an understanding of research methodology and critical appraisal of the research
literature.
Intended Learning Outcome 17
Ensure that you act in a professional manner at all times.
Intended Learning Outcome 18
Develop the habits of lifelong learning.
Intended Learning Outcome 19
Reflective practice