Early career doctors' experiences of psychiatry placements: A qualitative study

Abstract

Introduction

On completion of a medical degree, junior doctors in the UK undergo a 2 year Foundation Programme. Since 2016, 45% of Foundation Programme doctors are required to undertake a psychiatry placement during foundation training. During this time, recruitment to Core Psychiatry Training has fluctuated, dropping to a 69% fill rate in 2017.

Methods

With the support of the Royal College of Psychiatrists, Health Education England and the UK Foundation Programme Office, a large-scale study was formulated utilising semi-structured focus groups. These exploring participant experiences help to understand how and if the psychiatry foundation placements are valuable, and their potential influence on a trainee choosing psychiatry as a career. A framework analysis was used to analyse data.

Results

Seventy-four participants across 10 foundation schools in England participated. Experiences and perceptions were split into three broad themes; pre-placement, during placement, and post-placement. Within these, 12 sub-themes emerged. Doctors valued independence and responsibility especially if accompanied by a level of support from seniors. They also enjoyed working as part of a multi-disciplinary team. However, there were clear issues around staffing levels, stigma attached to psychiatry, and out of hours working.

Discussion

The pre-placement perceptions of psychiatry as a specialty as well as the trainees’ personal priorities for career selection were influenced by psychiatry placement experiences. The results have important implications for the recruitment to the specialty and need to be considered when designing and constructing placement aims.

Keywords:

• Postgraduate
• medicine
• work-based
• clinical

Acknowledgements

We would like to thank the RCPsych and HEE for supporting the project from which this study derives. We would also like to thank the participants for giving their time to take part in the study and discuss their experiences so candidly.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Foundation Programme: A two-year supervised work-based programme, usually made up of 6 four-month placements, undertaken by doctors immediately after medical school to prepare them for specialty training.

Core Psychiatry Programme: A three-year work-based programme designed to prepare psychiatry trainees for sub-specialist training. This is commenced after the Foundation Programme.

Additional information

Notes on contributors

Jigna Stott

Jigna Stott, MBBS, MSc, PG Dip GP, MRCPsych, is a psychiatry ST7 at South West Yorkshire Partnership NHS Foundation Trust, UK.

Jack Haywood

Jack Haywood, MBBS, BSc (Hons), PGCert, completed the Academic Foundation Programme at East and North Hertfordshire NHS Trust, UK.

Paul Crampton

Paul Crampton, PhD, MSc, is the Programme Director for the MSc Health Professions Education, Hull York Medical School, UK.