Hi, I’m Miguel, currently a CT1 in Southeast London. I would like to share my experience in securing a Core Training post in Psychiatry. I had an exceptional journey and hopefully this would inspire other IMGs to #ChoosePsychiatry.
I finished medical school in the Philippines on 2016 and completed 1-year internship on 2017. After obtaining my license I worked as an SHO in Internal Medicine in my home country. I had limited experiences in Psychiatry – a 2-week rotation during internship and an elective during medical school but this speciality has always been the field of medicine I am very fascinated about.
Application for Core Training and MSRA
After I passed PLAB1 I had plenty of vacant time to research on how to enter core training in the UK. During this time, I was made aware that the usual pathway is to join a non-training SHO post first to gain experience and familiarise oneself with the NHS and to improve portfolio. As I was reading the person specification for core training, I realised that I was eligible to apply because of my 1 year internship experience + SHO experience in Internal Medicine. I thought to myself that I might as well try, despite my limited portfolio during that time.
Psychiatry is also one of the specialties that utilises the MSRA to screen core training applicants. And this specialty being a shortage occupation (along with GP) during that time, scoring well (top 10%) in the MSRA would lead to a direct offer of a training job. With that in mind I gathered my documents and had my CREST form signed by my consultant in IM, then flew to the UK to revise for PLAB2.
Whilst preparing for PLAB2, I submitted my application for February 2020 Core Psychiatry recruitment. I was longlisted and received an invitation to sit the MSRA. I scheduled it on the 9th of September 2019.
I sat PLAB2 on 9th August. I had a month to prepare for the MSRA and it was admittedly an extremely tight timeframe when your goal is to score well. So I made a strict schedule of revising for 10-12 hours a day, sometimes more. I did not tour the UK nor fly back home. I stayed in Manchester for another month.
Reading textbooks was out of the question because of the time constraint. I mainly relied on the popular question banks– Emedica and MCQBank. I also used the Arora SRA Clinical audiobook during my rest periods. On the day of the exam, I found the Situational Judgment Test to be more challenging than the Clinical Scenarios.
Getting Core Psychiatry Offer
I was very anxious post-MSRA. I kept on telling myself I had nothing to lose because the exam was free anyway, and it was a good experience for a 2nd try, as I was not keen on pursuing my application without a direct offer because I had limited portfolio.
The surprise came after a few days when I received an email confirming an unconditional offer. Imagine my joy having a job offer even without having gained registration yet.
There were 160 available jobs for February 2020 recruitment. I wanted to train in London because I prefer city life and received good feedback about the quality of training there. Fortunately, I got accepted at the The Maudsley Training Programme, a reputable Psychiatry Training Institution attached to IoPPN, King’s College London. This was because a direct offer would allow one to be ranked ahead of other candidates, increasing the possibility that one gets his/her first choice.
I happily went back home and immediately processed my GMC registration and visa requirements.
Challenges and Start of Training
Despite having already secured a spot for a training job, I started to have internal debate with myself. I realised my pathway was indeed atypical as I had ZERO UK experience. Many people have warned me that the road might be bumpy because of this and it gave me real anxiety. Luckily, I was able to connect with other trainees who provided me with invaluable tips and advice.
I flew to the UK 2 weeks before my official start. I was initially allocated to a community job and I thought it was too premature for me to start with a job in such setting. With the help of my Educational Supervisor, my assignment was changed to an inpatient job when I started. Communication is key.
Unlike acute medical specialties, Psychiatry is rather slow-paced so there is definitely ample room for adjustment if you’re new to it. As a CT1, you are not expected to know everything andmaking any major decisions to patient care is a collaborative process and seniors will always be there to support you. It really helped that I work alongside a Clinical Supervisor and Specialty Doctor (both IMGs) who were very accommodating. They helped me ease through the intricacies of Psychiatry in the UK – mainly the social, legal and welfare aspects of the practice which were all new to me.
Every day is indeed a learning experience. I would say that after roughly 4 months of working, I have already gained some confidence. Admittedly I still don’t know a lot of things, but rest assured that there is always have a senior to call if in case of doubts. The full-day teaching on Wednesdays is also excellent and is a welcome respite from ward work.
Moving Forward and Advice to Other IMGs
I have recently received news about my next rotations – Old Age inpatient and community CAMHS, both of which were my preference. I also plan to sit Paper A on December 2020.
So is it possible to enter Core Psychiatry Training without prior experience? – Yes! If you’re really passionate about it and you meet the specifications then I see no reason to hold back. Do note the additional requirements on the new CREST form (especially the one about QI projects)..
I have a weak portfolio. – This was me a year ago. Aim to get a direct offer! Psychiatry is starting to become more competitive and scoring well in the SRA would not only let you skip the interviews, but also increase the chance that you secure your top choice! The exam feels daunting but it is achievable with the right preparation and mindset.
Is my pathway the ideal pathway? – This depends on the individual. Some would still prefer to get a Trust-grade/non-training SHO job, and that is also perfectly fine. What I did was a leap of faith and I don’t regret it one bit.
Based on my experience so far, I have yet to meet a dismissive Psychiatry consultant or senior doctor. It feels good to be in a kind and supportive environment. This is a very important aspect of training for me. It gives me the optimism that core training would be a less bumpy ride than I imagined.
All the best and #ChoosePsychiatry