Psychiatry work load

[DrIng]

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I would be itnerested in people could descrie what an average day s like for a psych reg/resident. I'm interested in how the experience is different in different places.
In Australia for example your average work day is from 8:30am -5pm with a day or so a week off for lectures/supervision etc and maybe one evening shift till 10pm a week and one 6 hour weekend shift a month or so. Apart from the few months where you do a block of 12 hour night shift. residency takes 5 years. (and you get into the program 2 years after graduation i.e. 2 preliminary years... Yuck)
Any experience that people could report from elsewhere both in the US and in Europe (i.e. Ireland and the UK) or Canada would be appreciated... Thanks.

 

[cyanocobalamin]

I would be itnerested in people could descrie what an average day s like for a psych reg/resident. I'm interested in how the experience is different in different places.
In Australia for example your average work day is from 8:30am -5pm with a day or so a week off for lectures/supervision etc and maybe one evening shift till 10pm a week and one 6 hour weekend shift a month or so. Apart from the few months where you do a block of 12 hour night shift. residency takes 5 years. (and you get into the program 2 years after graduation i.e. 2 preliminary years... Yuck)
Any experience that people could report from elsewhere both in the US and in Europe (i.e. Ireland and the UK) or Canada would be appreciated... Thanks.

I'm rotating through psych in the US, the residency is 4 years. This is after 4 years college, 4 years medical school. On inpatient wards I've noticed the residents arriving in the 7am hour, pre-rounding & writing notes. 8am is sign-out (new arrivals, departures). 9am is rounding with the attending and then whatever work needs to be done. Most residents are out by 5, seems like they have didactics now and then in the afternoons. Call is maybe 4 times a month or so which is overnight call. Interns (1st year post graduate) take more call. Chiefs (4th years) take little call or home call.

Psych residents rotate through neuro and medicine. They do not have a preliminary year in medicine or a preliminary transitional year like neurology, anesthesiology, dermatology, or radiology.

 

[john182]

In Ireland you can apply to the training schemes after the 12 month intern year.

Training schemes in UK and Ireland are or have to be approved by the Royal College of Psychiatrists. Usually it is a 3-4 year scheme. E.g., the absolute minimum time you can be on to sit your final part 2 exam is 30 months - but to sit the exams you need to be *on* the scheme. So, assuming you beat the odds and got all your exams on time, you;d be done in 36 months. With a 30% pass rate there's lots of attrition and around 1/3 of people who start in psych in Uk just go straight to staff grade posts after the 2 year requirement. Another 1/3 don't continue after part 1 exams done.

After that, you would decide on subspeciality - either going research/lecturing or try and get an SpR post. Single-Speciality SpRs are 3 years and Dual-Speciality are 4 years (e.g., Old-Age and Gen Adult).

Day to day, work is 9-5. Call can vary from 1 in 5 in a busy scheme that is understaffed to once a month or even not at all in some rotations like Child or Leanring Disability, Homeless, etc., .It can be inhouse or outhouse. Call is the traditional overnight 9am Monday to 5pm Tuesday stuff. The EWTD is trying to limit this but in UK it created havoc as it's only good for surgery and so on, really fecks up continuity of care in psych. We are still in old system in Ireland as are some Uk places simply because average hours per week are well within limits except for the maximum 13 hrs in a row rule.

There is a day release for a lecture course (obligatory attendance to get credit for the rotation and be allowed to sit the exams). Work varies - in some rotations you could have 30 inpatients, others might have 3 inpaitents but 3 clinics a week.

Most teams are made up of a consultant and then 1-2 SHOs/Registrars.

So everyone will have done 6 months internal medicine and 6 months general surgery (any speciality). Most people would have done a few rotations in A/E or gen med then before getting on psych scheme - this is simply because of the increasing amount of biological issues and a clueless just-finished-intern is not someone to entrust with an epileptic patient on clozaril the day after interning. Seems to be that in fact, only a mninority of new trainees are direct from intern and a lot fo the psych trainees themselves use psych as a stepping stone to GP, etc., .

I think the stats are that only 1 in 5 people who start psychiatry actually stay in to a consultant level 15 years later.