Forensic psychiatrists manage patients with mental disorders in prisons and secure hospitals. A forensic psychiatrist may also work with offenders in the community.
Entry Route into Forensic Psychiatry
Applicants must have completed the two-year Foundation Programme before they are eligible to apply to train in Forensic Psychiatry. The training programme for forensic psychiatry involves two stages:
- Core Psychiatry Training (CT1-3), which takes three years to complete, and
- Specialist higher training in psychiatry (ST4-6), which takes three years to complete, but requires trainees to complete the MRCPsych examinations during higher specialist training.
Job Progression as a Forensic Psychiatrist
During core training, trainees complete multiple four- to six-month placements in different areas of psychiatry.
During specialist training, trainees complete three 12-month placements in areas that are relevant to Forensic Psychiatry. Higher speciality training also includes training in the subspeciality of liaison psychiatry. Trainees must demonstrate at least 36 months’ full-time experience in psychiatry, excluding foundation modules, to be eligible to apply for ST4 posts.
It may also be possible to train on a dual training programme. Examples of dual training programmes that have previously been available include Forensic and Child and Adolescent Psychiatry, and Forensic and Medical Psychotherapy.
Trainees can apply for consultant positions six months before obtaining their CCT, and there are opportunities to work in management as a clinical lead, or a clinical or medical director. There are also formal opportunities to become involved in the education and training of junior doctors by working as
- a director of medical education overseeing postgraduate medical training,
- a training programme director responsible for the education of trainee doctors in the local region, or
- an associate dean responsible for managing the training programme.
Academic Forensic Psychiatry Roles
Trainees interested in an academic career can apply for an academic clinical fellowship. Alternatively, trainees can continue the ST clinical training programme after ST4 level.
Competition for Forensic Psychiatry Posts
In 2017, the competition ratio at ST4 was 1.02, with 46 applications for 45 posts. The competition ratio at CT1/ST1 was 1.26, with 623 applications for 495 posts.
In December 2017, there were
- 318 consultants,
- 8 associate specialists,
- 79 speciality doctors,
- 2 staff grades,
- 74 speciality registrars,
- 68 core trainees, and
- 2 F2 trainees.
Salaries in Forensic Psychiatry
The salary for NHS consultants ranges from £76,000 to £102, 500, and for speciality doctors from £37,500 to £70,000. The salary for doctors in training ranges from £26,350 to £45,750.
A Day in the Life of a Forensic Psychiatrist
Forensic psychiatrists work in secure settings such as high security hospitals, medium and low security units, and prisons. Most patients have been through the criminal justice system, but a few patients may be referred from NHS organisations if their behaviour poses a risk to others and they cannot be managed safely in less secure settings. Forensic psychiatrists may also be involved in giving advice to the prison service, the courts, and their colleagues.
A typical week may involve a combination of clinical work, teaching, and clinical governance work. Consultants working in medium secure units will be responsible for up to 15 inpatients, although this varies depending on the level of security and other clinical responsibilities. There is an on-call rota for forensic psychiatry, and trainees may also participate in out-of-hours work.