Your placements are linked to the GMC outcomes which you will be familiar with: 

1. The doctor as a scholar and a scientist.

Apply to medical practice biomedical scientific principles, method and knowledge.

• Recognise links between symptoms and underlying neuropathophysiological function i.e. have an understanding of underlying neuroanatomy, pharmacology and physiology
• Relate underlying neuropharmacological mechanisms to therapeutic/medication options to be considered   – understand the main neurotransmitter systems in the CNS
• Understand the basic neurochemical theories of depression, schizophrenia and dementia
• Know the main indications for, effects of and side effects of antidepressants, antipsychotics, mood stabilisers and drugs for treating dementia.
• Understand mechanisms underlying the experience of emotion, attention, memory, perception and learning.
• Understand the significance of genetics in mental disorder.

Apply psychological principles, method and knowledge to medical practice.

• Understand the role of human development and the life cycle in relation to biological, social and psychological origins of mental disorder.
• Understand the significance of stress and life events in the development of mental disorder.

Apply social science principles, method and knowledge to medical practice.

• Understand the meaning of “illness” to society and individuals and how it can impact on behaviour.

Apply to medical practice the principles, method and knowledge of population health and the improvement of health and health care.

• Be alert to and screen for common mental disorders in non psychiatric as well as psychiatric settings.
• Be aware of the increased risk posed to the physical health of individuals with mental disorder due to the illness itself, lifestyle issues (e.g smoking and diet), medication side effects etc and how to best manage these in psychiatric and other settings.
• Be aware of strategies employed by patient, family and team to minimise relapses
• Have some awareness of the public health issues related to mental disorder and drug and alcohol misuse.

Apply scientific method and approach to medical research.

• Be aware of evidence based practice in psychiatry

2. The Doctor as a practitioner.  

Carry out a consultation with a patient.

• Be able to differentiate mental health problems from the range of      normal responses to stress and life events.
• Be able to evaluate and describe patients presenting with abnormal      fears and anxieties, pathological mood states, problematic or unusual      behaviour and medically unexplained symptoms which may have a      psychological origin.
• Take a full history from a patient with mental disorder (including      relevant personal, family, social, drug and alcohol history, past      psychiatric and medical history, current circumstances and supports)
• Evaluate information about family and other relationships and how      they impact on an individual (may involve getting information from other      sources)
• Carry out a mental state examination including a cognitive assessment if indicated. Understand the definitions of common psychopathological features and how to elicit them.
• Carry out a physical examination including a  neurological examination if appropriate

Diagnose and manage clinical presentations.

• Consider the appropriate investigations in relation to excluding organic disease which may be causal, co-morbid or coincidental in patient with mental disorder.
• Carry out investigation of specific complications of mental disorders determined by the core problem e.g. in eating disorders and alcohols / drug misuse
• Be aware of different management options for patients with specific mental disorders considering the immediate,   short and long term plans.
• Recognise multidimensional management plans for patients with mental  disorders i.e. the physical, psychological and social aspects of their care (see biopsychosocial model)
• Be aware of the main psychological interventions for common mental disorders and how they fit with overall treatment plans.
• Be able to identify core features and common symptoms of mental disorders, use this and other information to make a differential diagnosis and use relevant national guidelines and local protocols to make decisions.
• Observe clinicians discussing treatment options and plans with patients, carers and other members of staff, including whether to use mental health legislation

Communicate effectively with patients and colleagues in a medical context.

• Be able to write up, summarise and present a psychiatric case including making a formulation based on history and mental state examination, which helps to guide differential diagnosis
• Be able to use an empathic interview style which is suitable to engage individuals who may be reluctant, distressed or disturbed.
• Develop skills already acquired in active listening, reflection and summarisation, understanding and responding to non-verbal communication, using open and closed questions and building a rapport.
• Be able to develop a therapeutic relationship with patients and understand why this may be of particular importance in psychiatry.
• Be aware of and show sensitivity to the concerns that patients and their families may have about the stigmatising nature of mental illness.
• Be able to liaise with members of multidisciplinary team and recognise the importance of this way of working in psychiatric and other clinical settings.
• Observe clinicians discussing with patients and their families the nature of their illness, management options and prognosis.
• Demonstrate empathy in relation to the impact of the illness on the patient and family members
• Present cases to other clinicians and get feedback.

Provide immediate care in medical emergencies.

• Be able to evaluate any potential risk an individual presents to themselves and other people, particularly following an episode of deliberate self harm.
• Demonstrate an awareness of how to assess suicidal risk, recognise suicidal ideation in all patients and consider appropriate action.

Prescribe drugs safely, effectively and economically.

• Recognise what baseline investigations are required prior to commencing treatment e.g. lithium or Clozapine
• Be aware of the requirements for physical health monitoring patients with chronic mental disorders and on long term medication

Carry out practical procedures safely and effectively.

• Observes the administration of Electroconvulsive Therapy (ECT) or, if unavailable during your block, see the DVD of ECT.
• Take the opportunity to take blood, give intramuscular injections and do objective measures of side effects of medication at Clozapine and/or depot clinics.

Use information effectively in a medical context.

• Find, appraise and apply information gained from reading relating to a specific clinical case.
• Some patients will have extensive case notes which may require to be read and summarised to facilitate understanding of the case and past history.
• Some patients may be unable to give a full history and information may need to be ascertained from other sources.

3. The doctor as a professional.

Behave according to ethical and legal principles.

• Be especially aware of the sensitive nature of some of the information and be alert to issues of confidentiality
• Demonstrate an awareness of issues related to capacity, consent and confidentiality with patients with mental health problems.
• Be aware of ethical principles and the values that underpin them.
• Demonstrate an awareness of relevant mental health legislation e.g. Mental Health (Care and Treatment) Act Scotland 2003 and Adults with Incapacity Act.
• Be aware of stigma and its impact on patients, families and society

Reflect, learn and teach others.

• Recognise that mental disorders may present in any clinical setting and be alert to this as main or co-morbid problem  in non – psychiatric settings.
• Develop a framework for recognising and making an initial assessment of  common mental disorders.
• Reflect on your own attitudes to patients with mental disorder and think about that how might influence your approach.
• Reflect on your own mental health (and that of other people around you) and on the issues that might impact on it.

Learn and work effectively within a multi-professional team.

• Recognise the multidisciplinary nature of the care of patients with mental disorders and how different professionals and agencies work together to manage individuals with severe mental illness.
• Recognise the roles played by agencies outside health in the support and management of individuals with mental disorder e.g. local authority and social services, voluntary sector etc. and the role of the doctor (psychiatrist, GP and others) in co-ordinating care.

Protect patients and improve care.