Training in child and adolescent psychiatry

Over the course of three years, trainees will spend two years in specialist community CAMHS (Tier 3) and one year in highly specialist (Tier 4) services, including inpatient settings.

Following the Trust’s CAMHS transformation, Tier 3 services include five borough-based community teams, a Wandsworth Children with Learning Disabilities team and two Trust-wide specialist teams for Neurodevelopmental Disorders (ADHD and Autistic Spectrum Disorders) and Eating Disorders.Tier 4 services include the Adolescent Resource Centre (inpatient unit and assertive outreach team), inpatient Eating Disorders service and the national service for Deaf CAMHS.

The posts are located in the South West London & St George’s Mental Health NHS Trust, which operates over 150 services from locations in Kingston, Merton, Richmond, Sutton and Wandsworth. This spread allows a wide range of experience; the Trust serves a very diverse population of approximately 1 million people in South West London, with a mix of affluence and deprivation, although on average the population the Trust covers is more affluent than in other London regions. The sites include:

• Springfield University Hospital, Tooting
• Tolworth Hospital, Tolworth
• Jubilee Health Centre, Wallington
• Barnes Hospital, Barnes
• Birches House, Mitcham

There is a weekly academic programme, which is trainee-led and facilitated by a consultant psychiatrist. This is organized on a termly basis by Bea Vickers, Academic Programme Director, and the Academic Steering Committee. The academic programme covers the curriculum over a three-year cycle. Attendance is compulsory as per curriculum requirements.

The teaching takes place on Thursday afternoons. Three times a month there is a facilitated “Reflective Practice”, or “Balint” Group which encourages the development of reflective, systemic thinking with an emphasis on individual roles within wider systems.

There is also regular on call discussion and monthly CBT teaching and supervision of cases by one of the consultant psychiatrists.

There are opportunities to gain experience in various modalities of psychotherapy including cognitive behavioural therapy (CBT), family therapy, mentalisation-based therapy (MBT) and exposure and response prevention.

Trainees are supervised throughout these experiences through regular meetings with a consultant psychiatrist or experienced clinical psychologist.

Trainees are given one day per week (pro rata) for research.

As a curriculum requirement, trainees are expected to complete a literature review within 18 months of commencing training, which should be to a publishable standard.

The Trust is actively involved in research and there are opportunities for trainees to participate in this in order to obtain research experience and publications.

The scheme has a Research Coordinator (Dr Nicolette Gentili), who takes an overview of all trainees' research experience across their training. Trainees will also have a research supervisor for their individual projects. In conjunction with their clinical supervisor and training programme director trainees may choose, after completion of their literature review, to utilize allocated research time for other structured clinical experiences.

London posts

The higher training on-call rota is consists of a 40% banded full shift rota. Trainees complete on-calls at either evenings (5-9pm), weekend days or nights. Out of hours cover is provided to the inpatient units at Springfield University Hospital and the Section 136 suite.

CAMHS Liaison Psychiatry cover is provided to St Helier Hospital, Kingston Hospital and St George’s Hospital.

The on-call rota is joint with Adults with Learning Disabilities. Trainees are second on call. The on-call Consultant psychiatrists in CAMHS and Adult LD are available for support and supervision.