The HEE (NW) MRCPsych Course

‘Theory to Practice’

Dr Latha Hackett

Programme Director

latha.hackett@cmft.nhs.uk

Dr Gareth Thomas

Deputy Programme Director

gareth.thomas@lancashirecare.nhs.uk

Contents of this presentation

• Welcome• Introduction• Structure of the course • Experience in placement • Local Academic Programme (LAP)• Regional Academic Programme (RAP)• Curriculum• Examination • Progress test

Welcome

• Introduction to the course leads and admin team

• All trainees to introduce themselves

• Introduction to cover

– Name, job/placement

– 2 things about your background training/experience e.g. undergraduate training, any other PG training/experience

Core skills

• Successful outcome at CT3:

ARCP Outcome 1 + Pass the MRCPsych Examination

• Both required to move to Higher Specialist Training (ST)

• Common Fallacy – Pass the exam first at any cost! This is not correct…

Core skills

• Where do you gain the required core skills (knowledge, attitude, skills)?

– In placement

– Local Academic Programme (LAP) weekly sessions

– Regional Academic Programme

– Psychotherapy training – Balint groups, individual psychotherapy training in two modalities

– Personal study (lots required)

– Examination preparation

The MRCPsych Course in HEE (NW)

MRCPsych Course Background

• The course – LAP, RAP, Exams

• Training/Role of Educational Supervisor

• Evaluation

• Your responsibility as a trainee

• Future plans

Who/What you need to know?• Clinical Supervisor

• Educational Supervisor

• Psychotherapy tutor for the trust

• Directorate of Medical Education

• Medical Education Managers

• TRAINING PROGRAMME DIRECTOR

• Lead Employer – SH&KT

• Programme Support Team, HEE (Natalie Dawson, Claire

McNally)

• School Education Team (Liz Davis & Helen McEnerney)

• Royal College psychiatrist, UK – website, portfolio etc

• School Website - www.schoolofpsychiatry.net

MRCPsych Course Principles

• Psychiatrists are medically qualified doctors with a specialism in Psychiatry

• Adult learning principles with a number of teaching methods

• Achievement of core skills for core trainees:– Training close to patients, learning from patients, learning from ES, in MDT, in the

LAP

• What cannot be done locally in placements and the LAP is done centrally e.g. RAP, exam preparation sessions

• Good practice on local sites incorporated - 555, psychotherapy in LCFT

• Training offered on different sites are now comparable & measurable so wherever you train, the standards are the same

• Our aim is to support trainees to pass their exams

MRCPsych Course Aims • Connect the four training strands:

– Supervision (formal and informal) in the clinical placement

– LEP run weekly sessions (half day sessions in the workplace)

– Academic course at Medical Education, Psychiatry PGME, NMGH, Psychiatry & Hollins Park (2017) (replacing the “University run course)”

– Psychotherapy training

• And link them to all to:

– MRCPsych examinations and the exam syllabus

• Achieving:

– Consistency/parity of training across a large geographical area

– A greater proportion of training delivered in the NHS workplace

– Better prepared trainees for the MRCPsych examinations (and

therefore clinical practice)

MRCPsych Course – “Theory to Practice”

Attain Core Competencies +

MRCPsych Exam (Progress Test – Written & Clinical)

Placement/Educational

Supervisor /

Supervision - weekly

an hour

LAP - 30 ½ day

sessions a year

RAP:

CT1 = 12 days

CT2 = 12 days

Psychological

modalities

25 Balint Groups +

Long case (>20) &

Short case (12-20) in 2

different modalities

NW School of

Psychiatry

NW Psychiatry School Board

MRCPsych Course Oversight Committee

Dr Margaret Campbell, HoS, Dr R. Morgan– DME, Dr L Hackett – Course Director, Dr Thomas, dpty, Ct,1,2,3, reps, administrators

Course Director: Dr Latha Hackett

Deputy Director, Gareth Thomas

Helen McEnerney – Medical Education Administrator

Liz Davis, Education Programme Manager

Trust Leads5BP – Sarah Elliott

Cumbria – Dr Zaidy

GMW – Drs Asif Mir & Cartin Evans

Lancashire Care – Tutor rotate

Manchester Mental Health – Dr A Dierckx

Pennine Care – Dr Ema Etuk

CWP – Matthew Cahill

Mersey Care – Yenal Dundar

Module LeadsGeneral Adult –Sally Wheeler

Old Age – Dr Anthony Peters

Forensic –Dr V Sullivan

CAMHS – Dr N Aslam

ID –S Mustafa

Substance Misuse – Dr P Horgan

Psychotherapy – Dr A Dierckx

Module Leads Trust Leads

• General Adult – Dr Brijesh Desai, Lancashire Care. Dr Sally Wheeler, GMMH

• Old Age – Dr Anthony Peter, Lancashire Care

• Child & Adolescent Psychiatry – Dr Neelo Aslam, CMFT

• Intellectual Disability –Dr Sol Mustafa Pennine Care

• Forensic – Dr Vicky Sullivan GMMH, Dr Sharda, Lancashire care

• Substance Misuse – Dr Patrick Horgan, GMMW

• Psychotherapy – Dr Adam Dierckx, GMMH

• Cumbria - Dr Zainy• 5BP – Dr Sarah Elliott• GMMH (GMW)– Drs Catrin

Evans/Asif Mir• GMMH (Man)- Dr Adam Dierckx• Lancashire Care – Site tutors

rotate• Pennine Care - Dr Ema Etuk• Mersey Care - Dr Yenal Dundar• CWP - Dr Mathew Cahill

• Acute Trusts - Trainees based in acute Trusts (CAMHS) tend to join local mental health trusts

Some parallels to

PBL for Medical students in Manchester • Run on different sites with the same PBL format with PBL trained doctors

• Have handbooks prepared by a committee that PBL tutors follow – handbook for tutors and handbook for students

• Students do have some lectures centrally – e.g. statistics during their Project Option etc etc…

Funding

• 2 PA for CD

• 1 PA for Deputy CD

• 2 Sessions of Band 7

• 1 WTE of Band 4

• Consumables - £3,000

• Progress test

• etc

Supported by

• Helen McEnerney & Liz Davis

• Operational Group meets twice a year

– 2014 - July, August, October

– 2015 - January & July 2015,

– 2016 - January & June 2016

– 2017 – January & June 2017

– 2018- July & December 2018 +major reviews

Experience in placement – your role

• You are a professional• You are in charge of your learning• You have to do the learning• You need to know what you need to learn• Use every opportunity you get to learn to gain core

competencies (for PF & Exams)• Read about what you see – depth of knowledge• ES, Tutor, LAP lead, TPD, Course Director, Head of School,

Med Ed admin, mentor – all here to guide you

Educational supervision

• Set your agenda to guide your supervisor

• Explain to them where you are in your training

• What competencies do you need to gain in these 6 months

• Organise supervisors to give you CASC practice

• Every WPBA – use opportunities to practice for exams

• Discuss the LAP, RAP and psychotherapy training in supervision

• Discuss your examination preparation

• Discuss what you are learning for the exam in supervision

Programme starts – September & MarchLAP + RAP

• LAP commences with the same modules across all areas

• Mandatory 15 half days (4 hours)

• Clear guidance on what must be covered during the 6 months

• Modules could be delivered in any order as long as all were covered during that 6 month period

• LEP still has 7 sessions available to cover topics of their choice e.g. audit/communication skills etc. etc.

• Open to all trainees in psychiatry – FY, GP, CT1-3• FYs/GPs can do joint presentations with CTs

The MRCPsych Course

The Local Academic Programme (LAP)

• These are delivered by the Trust in the localities

• 15 half day LAP sessions per 6 months / semester

• The MRCPsych course has modules: GA, OA, ID, CAMHS,

Psychotherapy, Addiction Psychiatry and Forensic

• From these modules, each LAP session is given a theme i.e.

Alzheimer’s Disease or ADHD

• Ethos is to deliver MRCPsych standard training, for the Core

Trainees, but the themes should also have relevance to the other

types of trainees hence more common themes chosen in LAPs

and is relevant for Consultant PDP

The MRCPsych Course

The Local Academic Programme (LAP): Typical session

• Learning objectives outlined

• Case Presentation (linked to the theme of the day)

• Journal Club (linked to the theme with choices given)

• 555 Presentation (5 slides, 5 bullet points, 5 minutes

presentation)

• Linking ‘Theory to Practice’ Expert Led Session (ELS)

• Multiple Choice Questions (MCQs)

• Feedback form completed by everyone

The MRCPsych Course

The Local Academic Programme (LAP): In each semester

• The 15 sessions in each semester has a typical breakdown of:

– General Adult: 6 sessions

– Psychotherapy: 1 session

– Old Age: 2 sessions

– Child and Adolescent: 2 sessions

– Intellectual Disability: 1 session

– Forensic: 1 session

– Substance Misuse: 1 session

– ‘Across The Ages’ (Depression / Liaison / Psychosis / Mental illness

in the family): 1 session

The MRCPsych Course

The Local Academic Programme (LAP)

• All of the information for the LAPs is contained in centrally developed

handbooks

• The handbooks contain:

– Clear learning outcomes for each LAP

– Advice / suggestions for the Case Presentation

– Peer reviewed journals to choose from

– Titles for the 555 Presentations

– Multiple Choice Questions

– Additional reading resources for the trainees

• All these handbooks are available online (www.schoolofpsychiatry.net)

which we will discuss later

Local Academic ProgrammeTrust Attending LAP Sessions at:

NWBH (1) Hollins Park

Manchester University Foundation Trust Trainees join GMMH sessions

Cumbria (1) Carlisle

Lancashire Care (some sessions on 1 site) BlackburnBlackpool (The Harbour)Preston

GMMH (2) Prestwich NMGH

Pennine Care (some sessions on 3 sites) 1 site in Oldham from 2017

Mersey Care (1) Ashworth/Alderhey

CWP (1) Countess of Chester

Your responsibilities as a trainee

• In the first supervision give your LAP programme and the RAP programme to your ES

• Make sure you are not on the day time rota for any of these days• Discuss with your ES about the case presentation, journal club, 555

you are going to do, discuss in supervision get them to comment on your presentation

• You can gain experience in Psychotherapy as a CT2 in some placements, e.g. C&AP – CBT for short case – discuss with your ES and get a psychologist to support you

• Get into a Learning set for exam preparation?• Organise CASC practice in your placement to support learning• 70% attendance is required for both LAP & RAP – Evidence this on

your portfolio with reflective summary of your learning

The MRCPsych Course

The Regional Academic Programme

• These are 24 centrally delivered workshop days (2 years) which

cover topics in the syllabus more specific for the psychiatry trainees i.e.

genetics and neuroscience

• There is also a physical healthcare training day

• Format – workshops, PBL sessions, lectures linking theory to clinical

practice, exam practice is a theme throughout

• Core Trainee 1s

– There are 12 days (6 per semester)

• Core Trainee 2s

– There are 12 days (6 per semester)

• Run on Thursdays at the PG Psychiatry Med Ed Dept, NMGH 2016-17

The MRCPsych Course

The Regional Academic Programme

1. Behavioural science and socio-cultural Psychiatry

2. Human development

3. Basic Neurosciences

4. Clinical Psychopharmacology

5. Classification and assessment in Psychiatry

6. Organisation and delivery of Psychiatric services

7. General adult Psychiatry

8. Old age

9. Psychotherapy

10. Child and Adolescent Psychiatry

11 Substance misuse

12. Forensic

13. Learning disability

14. Research Methods, statistics, critical review and evidence-based practice

The MRCPsych Course

The Regional Academic Programme

• First 6 months (6 days)

• Introduction to the MRCPsych including the exams,

Classification, Critical Appraisal, Philosophy of

Psychiatry - 1 day

• Basic Psychology – 1 day

• Neurosciences - 1 day

• Human development - 1 day

• Psychopharmacology - 2 days

• (Every session has MCQs)

The MRCPsych Course

The Regional Academic Programme

• Second six months

– February to June 2018: 4 days for Psychotherapy,

– 1 day each for GA and OA

• Third six months

– September to November 2018: 2 days GA, 2 days OA (inc Physical health), 1 day for stats & research methodology, 1 day for Neuropsychiatry

• Fourth six months

– Feb to June 2019: 1 day each GA, CAP, ID, Forensic, Substance Misuse & 1 for review – we will use this differently depending on need

• Total for 24 months = 24 days

The MRCPsych Course

The Regional Academic Programme

• Clear what trainees will be taught

• Clear what will not be covered in the academic programme

• Run as workshops mainly with trainee participation in learning, some direct teaching

The MRCPsych Course

The Regional Academic Programme

Typical session:

• Human Development in CT1

– 9.30-11 Brain Development (Dr Coldman)

– 11.30-12.45 Motor Development (Dr Neelo Aslam)

– Sponsored lunch usually

– 1.30-2.45 – Human Development (Psychological theories) (Dr

Katharina Junejo)

– 3.00-4.15 Family Development and Parenting (Dr Alison Dunkerley)

– 4.15-4.30 MCQ’s, Reflective Practice and feedback

The MRCPsych Course

The Regional Academic Programme

Typical session:

• Eating Disorders in CT2

– 9.30-11 Anorexia Nervosa (Dr Morgan)

– 11.30-12.45 Bulimia (Dr Morgan)

– Sponsored lunch usually

– 1.30-3.00 Group work through 3 x 30 minute case vignettes

Each case 15 minute group work then 15 minute discussion.

Examples include assessment and treatment of

complications, medico legal frameworks for urgent treatment,

strategies for relapse prevention)

– 3 -4.30 MCQ’s workshop, Reflective Practice and feedback

MRCPsych Course

Exam Preparation

• Every LAP session trainees have MCQ/EMI practice

• Every RAP: MCQs

• Written practice test available on VLE

• Once yearly CASC Progress Test (at least one sat by ALL CT Trainees)

• The presentation by Dr Gareth Thomas will cover this further

• 2017-2018– supporting trainees who may have difficulties with

exams (keeping in mind the RCPsych exam results data)

MRCPsych Course

Educational and Clinical Supervisors

• Pivotal in training of trainees,

• Hence have to be well supported

• Know the curriculum and know what the exam is about

• Clear about competencies and training requirements of core trainees in their placement

• Educational supervision – to achieve consistency across the region -clinical and educational supervisor

• ES being able to link the trainees learning – LAP, MRCPsych, Psychotherapy etc in educational supervision

• We have developed a module for ES

Evaluation

• A number of research projects are in progress

– 24 month course evaluation

– Comparative study of the NW(NHS) v Mersey (Uni) course

– Written and OSCE Progress Test

• Supported by senior lecturers and an educational psychologist

NW School of

Psychiatry

Feedback

• Weekly feedback from LAP programme

• Feedback from the RAP after each session

• Feedback gathered twice in six months centrally all aspects of training

• Feedback at the end of the year, face to, about all LAP, RAP, Psychotherapy

competencies, MRCPsych exams

• Generally extremely positive

• Few recommendations

• Some cancellations – some sites have had more challenges recently

Governance of the MRCPsych

Course• Oversight committee:- Margaret Campbelll, Head of School, Richard

Morgan, DME rep, Course director and deputy director, Helen and Liz,

course administrators, Ct1, Ct2, Ct3 trainees, “User rep”. Reports are

submitted

• Feedback from trainees after every regional academic and local academic

training

• Meeting with trainees once every 6 months briefly

• Feedback about overall training from trainees once/twice a year

• Informal meetings if trainees request too

• Reports sent twice a year at least to the school board

• Evaluation of the Programme – Gareth Thomas, Dush Mahadevan, Dr

Caroline Bond, Senior Lecturer, Education psychology department, UoM

Meetings with Module leads/trust

leads/DME’s

• Once every 2 years I try to meet the local medical education

committee

• I have done the rounds of all trusts now (last 12 months)

• Will start my next round from October 2018

• Sometimes I meet more often for training issues/ queries or if

issues arise

• Module leads meet twice a year to look at curriculum

development

Attendance – 24 months overview

• ARCP they have to have evidence of achieving 70%

attendance at both local and regional training

sessions

• An email is sent to them at the end of every 6 months

from the Reg Teaching

• If a trainee is not able to gain 70% in the 12 months at

ARCP/6 months review – they can make it the

following year by attending more sessions

• Some examples of outliers– next slide

The reasons given for lack of 70%

attendance• “I did not know that I had to attend the course as a

Ct2”

• “I had to attend the ECT course which was mandatory

locally, this clashed with the regional training”

• “I did not know that I had to sign out”

• “I came in late because I was on call”

• “The job in ”x” was so busy I could not attend”

• Some of them I do not know….

How are we now addressing the

attendance issue• October 2016 – School board agreed that officially

trainees attendance will be part of the ARCP

• January/Feb sent out the first lot of attendance for

September –December RTP

• The outliers came to view….

• Helen/Liz and I meet now monthly

• One of the issues we look at is attendance

• If there are concerns – I try and meet with the trainees

(challenging)

Academic Programme review and

update on content• Module leads meeting we review all feedback we receive

• Gareth Thomas scrutinises the feedback from trainees etc

• We made changes to the course – 2 days of Critical appraisal/statistics

session, Genetics session moved to Ct1 this year

• Overall it has been very good

• Starting support for trainees who need it from September 2017

• Look at supporting SAS doctors who want to do exams

• Opening course material to FY drs who want to Psychiatry

• Major reviews take place every 2 years and tweaking during the 2 years

if required

Examination dates for 2018-2019• Paper A (June & December) 4.12.18,

• 18.6.19, 3.12.19

• Paper B (April & October) 9.10.18,

• 9.4.19, 8.10.19

• CASC (January & September) 11-14th of September

2018,

• 15-18 Jan 19,

• 10-13 Sep 19.

North of England Psychiatry Congress

November (NOEC) 2016,17,18

• It was over-subscribed a lot of Consultants attended

• Feedback really good

• Poster presentation prize – head of school/course director

Prize

• 1 for Medical student/Foundation year and 1 for Ct/St

• We need more trainees to attend as this is from their study leave

• 3rd NOEC Friday 23rd November 2018. Manchester Foundation

Trust

• Please apply and attend

Next academic year – September 18-

July 2019

• Semester 1 & 2 of the revised Local academic

Programme

• North of England Conference 2018 – Dates/ Venue

arranged on the school website

• Opening the course material/VLE to foundation year

doctors who want to do psychiatry

In summary for trainees

• There are many opportunities

• Make use of them

• Gain competencies

• ARCP competencies – Mini PAT, WPBA’s etc

• Psychotherapy experience eg. while in CAMHS CBT, FT

• CASC

Challenges & Contacts

• Attendance –sign in and sign out

• New job, finding your feet, reluctant to ask…

• But we are here to support

• Emails to keep in hand: Helen McEnerney, Gareth

and mine

• School website – www.schoolofpsychiatry.net

• Current trainees icon, MRCPsych Course

The MRCPsych Course

Any questions?