Old Age Psychiatry
Old Age Psychiatry, or Geriatric Psychiatry, involves managing older adults with mental health conditions such as dementia, depression, and schizophrenia.
Entry Route into Old Age Psychiatry
Applicants must have completed the two-year Foundation Programme before they are eligible to apply for training in Old Age Psychiatry. The training programme for General Adult Psychiatry involves two stages:
- Core Psychiatry Training (CT1-3) over three years, and
- Specialist higher training in psychiatry (ST4-6), also over three years but requiring full MRCPsych to be completed during higher specialist training.
Job Progression as an Old Age 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 General Adult Psychiatry. Trainees must demonstrate at least 36 months of full-time experience in psychiatry, excluding foundation modules, before they are eligible to apply for ST4 posts. Dual training programmes are available but they may vary each year. Examples of dual training programmes include Older Adult Psychiatry and General Adult Psychiatry.
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 Old Age Psychiatry Roles
Trainees who are interested in an academic career can apply for an academic clinical fellowship at ST1-2. This may lead on to a clinical lectureship at ST3, or trainees can continue on the ST clinical training programme after ST4. However, opportunities in academic old age psychiatry are limited.
Competition for Geriatric Psychiatry Posts
In 2017, the competition ratio at ST4 was 0.88, with 16 applications for 4 posts. The competition ratio at CT1/ST1 was 1.26, with 623 applications for 495 posts.
In December 2017, there were
- 556 consultants,
- 34 associate specialists,
- 156 speciality doctors,
- 6 staff grades,
- 130 speciality registrars,
- 128 core trainees,
- 32 F2 trainees, and
- 25 F1 trainees.
Salaries in Old Age 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 Geriatric Psychiatry Specialist
A significant amount of the work involves managing patients with dementia and memory problems. Old Age Psychiatrists work closely with other agencies such as social services, occupational therapists, and other healthcare professionals such as general practitioners. There is an emphasis on managing patients in the community, and enabling them to stay in their own home – although some old age psychiatrists may work in acute general hospitals.
Consultants who work in community mental health teams visit patients at home or in residential nursing homes. Those based in hospitals attend regular ward rounds as well as running outpatient clinics. Teaching medical students and junior colleagues, and attending multidisciplinary team meetings are an important part of the working week. Consultants generally take part in an on-call work.