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The expansion of the Foundation Programme in psychiatry

  • Jennifer Perry (a1), Ann Boyle (a2) and Simon Wessely (a3)
  • Please note a correction has been issued for this article.
Summary

The Broadening the Foundation Programme report has led to an expansion in the number of psychiatry foundation placements. This change will have far-reaching benefits for foundation doctors doing psychiatry, no matter what their future career intentions. Doctors will develop a better understanding of mental illness, they will improve their communication skills and they will gain experience of working within multidisciplinary teams. Recruitment into psychiatry is also likely to improve. The Royal College of Psychiatrists is putting in place a number of measures to ensure that placements are of a high quality so that foundation doctors have a good experience of psychiatry.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Jennifer Perry (jenperry@doctors.org.uk)
Footnotes
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The title of this paper has been amended post-publication, in deviation from print and in accordance with a correction to be published in the October issue.

Declaration of interest

None.

Footnotes
References
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1 HM Government. No Health without Mental Health: A Cross-Government Mental Health Outcome Strategy for People of All Ages. Department of Health, 2011.
2 NHS England. Five Year Forward View. NHS England, 2014.
3 Health Education England. Broadening the Foundation Programme: Recommendations and Implementation Guidance. HEE, 2014.
4 Crisp, A, Gelder, M, Goddard, E, Meltzer, H. Stigmatization of people with mental illnesses: a follow-up study within the Changing Minds Campaign of the Royal College of Psychiatrists. World Psychiatry 2005; 4: 106–13.
5 Health Education England. Investing in People for Health and Healthcare. Workforce Plan for England: Proposed Education and Training Commissions for 2015/16. HEE, 2015.
6 Centre for Workforce Intelligence. In-Depth Review of the Psychiatrist Workforce: Main Report. CFWI, 2014. Available at http://www.cfwi.org.uk/publications/in-depth-review-of-the-psychiatrist-workforce/@@publication-detail (accessed July 2015).
7 Goldacre, MJ, Fazel, S, Smith, F, Lambert, T. Choice and rejection of psychiatry as a career: surveys of UK medical graduates from 1974 to 2009. Br J Psychiatry 2013; 202: 228–34.
8 Kelley, T, Brown, J, Carney, S. Foundation Programme psychiatry placement and doctors' decision to pursue a career in psychiatry. Psychiatr Bull 2013; 37: 30–2.
9 Brockington, I, Mumford, DB. Recruitment into psychiatry. Br J Psychiatry 2002; 180: 307–12.
10 Scher, ME, Carline, JD, Murray, JA. Specialisation in psychiatry: what determines the medical student's choice pro or con? Compr Psychiatry 1983; 24: 459–68.
11 Dein, K, Livingston, G, Bench, C. ‘Why did I become a psychiatrist?’: survey of consultant psychiatrists. Psychiatr Bull 2007; 31: 227–30.
12 Boyle, A, Perry, J. A Guide to Psychiatry in the Foundation Programme for Supervisors. Royal College of Psychiatrists, 2015.
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
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The expansion of the Foundation Programme in psychiatry

  • Jennifer Perry (a1), Ann Boyle (a2) and Simon Wessely (a3)
  • Please note a correction has been issued for this article.
Submit a response

eLetters

The bigger issue with recruitment - a student's perspective

Munzir Z Quraishy, Medical Student, Cardiff University
26 September 2016

It was wonderful to read that the College, among other bodies, continues to make changes to the training system which increase exposure to psychiatry (1). As a fourth year medical student at Cardiff University, I was especially encouraged to hear that by 2017 all foundation year doctors will have some psychiatry experience. Though this will help change the medical profession’s attitude to psychiatry, it is still one part of an uphill struggle.

On the wards, I’ve found that doctors often have their guard down among students, giving us a unique glimpse into the thought processes of medical professionals.

It has surprised me how little attention some general medical wards pay to mental health. I’ve seen plenty of doctors (junior and senior) skim straight past the mental health notes of a patient. Even when they are read they are often met with a ‘just let psych deal with it’ response. Though I've seen good and bad, my experiences on placements have led me to worry that some doctors still don’t regard the mental health of their patients as a problem, or at least not their problem.

Apathy towards mental health is one thing; however, I have also met the odd (mostly surgical) consultant with a negative view of mental health. I have heard consultants joke about a patient’s mental health, even using words such as ‘mad’ or ‘crazy’. Another consultant refused to give a student time off to go to a counselling session: the same consultant also appeared unwilling to accept mental illness as an excuse to be absent.

There are also doctors whose negative views lie towards the psychiatric profession rather than the patients. When I tell doctors that I am thinking of psychiatry after I qualify I get responses such as: ‘are you sure?’ or ‘have a long hard think about that.’ A colleague of mine was once told ‘oh, but you’re a clever student.’ Psychiatry still seems to be not respected by large parts of the medical profession.

Maybe it’s just because I haven’t been hardened by the system or still hold onto some idealism yet to be eroded by a career in medicine, but it shocks me to think that these views exist so prevalently within the profession. Yet, if someone were to have the same thoughts about cardiology, people would raise an eyebrow. It is easy to be indoctrinated into these viewpoints when spending so much time around doctors who express them. The recent BASH study (2) found that this stigmatisation does in fact put off large percentages of medical students from pursuing psychiatry. My hope is that this new generation of doctors, with much greater exposure to psychiatry, will hold positive views that continue into their senior years. However, I wonder what can be done with doctors who already have a negative opinion of mental health, as some of them still hold a great deal of clout and influence over others.

The BASH article mentions that viewpoints are changing. I haven’t been around the profession long enough to comment, but despite all the bad doctors, there are many doctors who take the mental health of their patients very seriously. There are many doctors who respect psychiatry like any other specialty and many doctors who’ve reacted encouragingly to my interest in psychiatry. I feel as though there is enough good that we can beat this stigma, but it will nevertheless be a long and hard-fought battle.

References

1 Perry J, Boyle A, Wessely S. The expansion of the Foundation Programme in psychiatry. BJPsych Bull 2016; 40: 223–5

2 Ajaz A, David R, Brown D, Smuk M, Korszun A. BASH: badmouthing, attitudes and stigmatisation in healthcare as experienced by medical students. BJPsych Bull 2016; 40: 97–102

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A correction has been issued for this article: