It is a rewarding specialty because you are given the privilege of
listening to patients’ ideas and stories, and you are able to make a
real difference to their lives. The discipline is an academic one,
concerned with the philosophical and ethical sides of medicine, and
there are never easy answers. Psychiatry is strongly team-based and
less hierarchical in structure than many clinical fields. Colleagues
and fellow trainees are generally extremely supportive of one
another.
You must be able to cope with the intellectual rigours of this
discipline, and you should possess good problem solving skills. It
is important to have very good interpersonal skills, a level
of maturity with good intuition and self-awareness, and you must be
able to relate to people of all backgrounds.
The typical schedule will vary according to the area or subspecialty
of psychiatry: the routines of a specialist working in an in-patient
unit, for example, differ from those of a community psychiatrist.
Some work may be clinic-based and some may involve domiciliary
assessment or liaison with a wide variety of agencies. Common
factors across the discipline will usually include clinical
assessments, team-based reviews and management planning, supervision
of other professionals and trainees, and active clinical teaching.
Research and academic roles are available.
Psychiatry has made significant advances in the last 50 years with
the development of increasingly effective pharmacological and psychological
treatments and social and cultural rehabilitation and recovery approaches.
Knowledge with regard to causes of mental illness has expanded, and the
specialty is on the threshold of further discoveries. It is a priority to
achieve de-stigmatisation regarding the general public perception of those
with psychiatric disorders.
Christchurch is currently the only location in New Zealand where
there is a sufficient number of psychiatrists for the size of the
population. There are still shortages elsewhere, so finding a job at
the end of training should not be a problem.
There are opportunities to work overseas during training, but you
need to check with the College in advance that the proposed training
programme is suitable for accreditation. Breaks in training are
relatively easily accommodated, but there are overall limits beyond
which the currency of earlier training can expire (e.g. an 8 year
limit in basic training).
Women make up a good proportion of psychiatric consultants, it is
common to undertake training part time while bringing up
children. The College supports part time training but recommends
an initial full-time year to gain some experience of the specialty
before switching to part time. Job sharing posts are usually
available, and there are a small number of 0.5FTE posts in Auckland.
On call cover is call-back from home. The general consensus is that
after-hours commitments are not too bad: it would be usual to be
rostered on-call for one evening in eight, and for night shifts
about one week in eight. Weekend shifts (about one in four) are
usually split so that you do not work the entire weekend. With the
ability to work part-time and take parental leave breaks, psychiatry
training accommodates those with families well.
There is a great deal of administration, but this problem is common
to most specialties in medicine. Litigation does not pose a major
problem, but you could expect to receive a few complaints during the
course of your career. Note that all the services are now
using electronic records, so an ability to type and manage computer
interfaces is required theses days. You also need to be able
to drive when on call.
A great deal of support is provided to assist trainees in
achieving their training goals. There is a strong emphasis on
supervision, coaching and the apprenticeship model. Auckland has an
increasingly strong reputation for providing a good quality academic
programme and support for trainees to complete the College Case
Histories and examinations.
