IMG Guide to Speciality Training (ST) in Psychiatry- By Dr Maryam Tariq

In this blog Dr Maryam Tariq is sharing her journey as an IMG doctor of passing MRCPsych while working outside UK and securing ST training in the UK.

Introduction:

Hi, my name is Dr Maryam Tariq, and I am currently working as an ST4 dual trainee in General Adult and Old age Psychiatry in Humber Teaching NHS FT.

This Blog can be a useful guide for IMGs aspiring to join training pathway in UK on the basis of MRCPsych.

To start with, I did my initial FCPS training from Jinnah Post Graduate Medical Centre, Karachi Pakistan and then in mid-2020 went to Dublin on a 2-year CPSP/HSE scholarship programme.

I rotated in two different General Adult psychiatry posts, Psychiatry of old age and Rehabilitation psychiatry; for 6 months each. I believe my training in Dublin has immensely helped me to find my ground here in NHS as a higher trainee.

Passing MRCPsych:

For a brief background, I did my Paper A in 2018 and paper B in 2019 from Pakistan. For both Paper A and B, I had to fly to Oman as in pre COVID times these exams were not online. I personally had to go through a lot of trouble to get my visas approved and that itself can be a full story for another blog. But I would urge everyone to take these exams while they are online and can even be taken at home.

For Paper A, I studied for 2 months and did SPMM notes and Question banks of both Psych mentor and SPMM, also did SPMM mocks. For paper B, I studied for around 2.5 months and relied only on SPMM (notes, Question bank and mocks). I had some research background, so critical appraisal notes and videos by SPMM were sufficient for me, but I would strongly advice to go for other available resources as well if you find critical appraisal difficult.

I then cleared CASC in September 2021 from Dublin, I gave this exam online (lucky me😊) and used GET THROUGH MRCPYSHC by ZHANG and SPMM scenarios and videos. For clinical exam, depending on your pace you will need an average of a minimum of 3 to 6 months.

Moreover, it is imperative to join the online CASC groups and have supervised sessions by seniors and more preferably by examiners. I cannot emphasize enough that practice is the key to clear this exam so practice scenarios as much as possible.

Getting GMC Registration:

MRCPsych is a recognised post-grad qualification for the GMC in relation to getting full GMC registration. After passing full MRCPSych, you can show English competency exam (IELTS or OET) along with EPIC verification of documents and apply for the GMC registration. GMC may ask you to attend an ID check face to face in one of their offices.

GMC registration is not required at the time of application of the ST jobs but need to be in place for you to start the ST job.

Based on GMC registration gained via MRCPsych, you can also apply for non-training jobs in Psychiatry in case you have time, or you do not want to start ST training straightaway.

Applying for ST training in Psychiatry:

Apart from the exams while I was in Dublin, I had my goals set to achieve the required competencies to apply for specialty training at ST4 level in psychiatry. I gathered my certificates for organizing World Mental Health Day 2018 and 2019 and 53rd Annual Symposium in JPMC. I remained actively involved in research, critical appraisals, teaching and QIPs both in Pakistan and in Dublin. These capabilities contributed to my score during the self-assessment round.

For getting Higher Training post in UK, the route is simple and if you have your membership exam, the required OET/ILETS score/Working in an English-speaking country for the past 2 years and a completed Certificate C, then there is no reason why you can’t be shortlisted for a reputed training program in one of the following specialities.

Single Specialties: (3 years of training)

 •Child & Adolescent Psychiatry

•Forensic Psychiatry

•General Adult Psychiatry

•Medical Psychotherapy

•Old Age Psychiatry

•Psychiatry of Intellectual Disability

Dual Specialties: (More than 3 years of training)

•Dual Child & Adolescent Psychiatry/Medical Psychotherapy

•Dual Forensic/Medical Psychotherapy

•Dual General Adult/Forensic

•Dual General Adult/Medical Psychotherapy

•Dual General Adult/Old Age

•Dual Psychiatry of Learning Disability/CAMHS

•Dual Forensic/Child & Adolescent Psychiatry

Just to bear in mind that the DUAL specialities are more competitive and there are less seats available across deaneries. Dual training will also increase your time in training.

Check out this website for the current round and information related to ST application.

Higher Psychiatry Training | Medical Education Hub (hee.nhs.uk)

I will focus on elaborating on certificate C here as it is the most fundamental document which you need.

What is Certificate C and why international doctors need it?

Certificate C is the core competence equivalence report which is required if you are applying from outside UK and have not done core training in Psychiatry from UK.

I believe a new version of Certificate C will be released for the August 2023 recruitment to reflect the new RCPsych 2022 Curricula. This document can be signed by any of your consultants if you have worked with them for a minimum continuous period of three months whole-time equivalent in the last 3 years before your advertised post start day.

If your consultant is not registered with GMC, then you must submit the current evidence of their registration with their respective authorities. For example, if your consultant is from Pakistan, Ireland or India then proof of their registration with CPSP, IMC etc.

Other elements of selection process:

The other elements of recruitment process are adjusted CASC exam score, online generic interview and verified self-assessment score; each having the following weightage:

  Verified self-assessment score    17.5%
  Online generic interview    32.5%
  Adjusted CASC exam score    50%

Self Assessment Domains:

Your self assessment score is based on the following 10 domains.

1 – Undergraduate Training – Additional Degrees

2 – Undergraduate Training – Prizes and Awards

3 – Postgraduate Medical Qualifications

4 – Postgraduate Training – Prizes and Awards

5 – Postgraduate Training in other specialties (7 working years)

6 – Clinical Governance, Audit and Quality Improvement (6 working years)

7 – Research

8 – Teaching

9 – Academic Publications

10 – Presentations and Poster Presentations (6 working years)

Please note that domains 5, 6 and 10 are time limited. If you have had a career break or worked less than full time, then you will need to provide a summary of your employment history so that the recruiters can see that your evidence falls within the equivalent time period.

After submission, a clinical assessor (Consultant Psychiatrist) will verify the scores you award yourself in each domain of the ST4 Psychiatry self-assessment form. Make sure that you score yourself accurately at the time of application. I will strongly suggest reading the following instructions before submitting your application form.

https://www.nwpgmd.nhs.uk/st4_psy_train_current_record

How to apply:

• All applications must be submitted via Oriel

 (https://new.oriel.nhs.uk/web/)

• This is the newer version of Oriel (Nov 2020) and so you will need to register for an account before you can submit an application.

• Aim to submit your application well before the closing date as late or incomplete applications are not accepted.

Online Interview:

You will be interviewed over MS Teams. It is a 15-minute interview and the scenarios are pre published in advance. You will be given 6 minutes on each scenario. Please expect to be prompted / asked probing questions. It is advised not to script your response or be heavily reliant on notes. Check the scenarios here:

https://www.nwpgmd.nhs.uk/st4_psy_train_current_record

Adjusted CASC Score:

May be no one told you this, but your CASC score is extremely important. I believe one of the reasons I was able to secure Dual speciality training post was due to a good CASC score, so please keep this in mind while appearing for your exam.

How CASC scores are adjusted:

Your CASC exam scores will be adjusted to be comparable between diets and between days within specific diets. The college will use a pass mark of 50% for the recruitment process, this is based on the expectation that the adjusted CASC scores are lower than the original marks obtained in CASC. For example, if the cut-off % for passing is 65% on your day of examination and you scored 65%, then your adjusted CASC would be 50%. You are required to upload evidence of your result to Oriel when applying, or if appearing in the upcoming Diet, you can provide proof of passing later on.


I hope this was helpful. I recently started my journey in August 2022 and so far, I am quite satisfied with my decision. The trainees are well supported and have their own Educational Supervisors, Clinical Supervisors and Training program Directors to support them get through ARCPs. So far, I am blessed to have a good support system in Humber Teaching NHS FT and enjoying working in NHS.

If you have any queries re exams, recruitment process or training in UK, feel free to email me at: mariamtariq27@hotmail.com

For any recruitment related queries, you can also email the recruitment team on the following address.

Psychiatryrecruitment.nw@hee.nhs.uk

I wish all of you the very best for the application process and an awarding training journey ahead in UK.

This blog was written in Nov 2022 and the recruitment process may change with time.


Published by Raja Adnan Ahmed

I am a Consultant Psychiatrist working in South Wales. I am interested in raising awareness of mental illness, fighting the stigma around mental health and also medical education. I am passionate about supporting junior doctors & IMGs.

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