Psychiatry of Learning Disability
Psychiatry of Learning Disability is the management of patients with learning disabilities in need of psychiatric treatment. A learning disability psychiatrist is likely to work in both specialist units and the community.
Entry Route into Psychiatry of Learning Disability
Applicants must have completed F1-2 before they are eligible to apply to train in Psychiatry of Learning Disability. The training programme 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 membership during higher specialist training.
Job Progression as a Psychiatrist of Learning Disability
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. Sub-specialties within Psychiatry of Learning Disability include Child and Adolescent Psychiatry, and Forensic Psychiatry, and whilst it may be possible to apply for dual training programmes, the availability may vary from year to year.
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 Psychiatry of Learning Disability Roles
Trainees interested in an academic career can apply for an academic clinical fellowship at ST1-2. This may lead to a clinical lectureship at ST3, or trainees can continue the clinical training programme after ST4. However, opportunities in academic Learning Disability Psychiatry are limited.
Competition for Psychiatry of Learning Disability Posts
In 2017, the competition ratio at ST4 was 0.86, with 24 applications for 28 posts. The competition ratio at CT1/ST1 was 1.26, with 623 applications for 495 posts.
In December 2017, there were
- 256 consultants,
- 9 associate specialists,
- 59 speciality doctors,
- 2 staff grades,
- 40 speciality registrars, and
- 49 core trainees.
Salaries as a Learning Disability Psychiatrist
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 Learning Disability Psychiatrist
Most Learning Disability Psychiatrists manage patients aged 18 years of age and older, although some specialise in children. Psychiatrists deliver the majority of patient care in the community. However, some is conducted in specialist in-patient facilities – for example, the care of patients with challenging behaviour problems and significant intellectual disability.
A considerable proportion of the work involves direct clinical care, including ward rounds, running outpatient clinics in hospitals, clinical audits, and reviewing patients in community clinics. Regular attendance at multi-disciplinary team meetings is also an important part of the working week, as is the teaching of medical students. On-call work may be linked to General Psychiatry rotas, or there may be a stand-alone rota for patients with learning disabilities.