Case study

Consultant forensic psychiatrist — Nick

Nick went to medical school with the aim of becoming a GP but was won over by psychiatry. Find out more about what he does and why psychiatry appeals to him

How did you get your job as a psychiatrist?

During my undergraduate hospital placement, I was struck by how effective and important psychiatric treatment can be in transforming the lives of people affected by mental disorders. I was drawn to the holistic approach to the care of patients.

After graduating, I worked in a range of training specialties, including a busy London accident and emergency department and as a submarine medical officer with the Royal Naval Reserve.

These experiences confirmed my original suspicion that psychiatry was for me. I began my specialist training and from my first day in forensic psychiatry I knew that this was the right choice.

What's a typical working day like?

Every day starts with a communications meeting in the hospital where we discuss significant recent events. I generally see individual patients on the ward, but we also have a ward round once a fortnight, as well as regular review meetings.

Most of our patients are admitted directly from prison and I spend time assessing them within this setting. I also provide advice and guidance to the criminal courts to help them manage mentally-disordered offenders appropriately. Working with legal professionals is mentally stimulating and adds further variety to my job.

It's important to stay up to date with the latest scientific and legal developments, and a significant amount of my time is devoted to academic meetings. I also teach and run the training programme for forensic psychiatrists in my region.

What do you enjoy about your job?

I enjoy working with a range of experienced and committed professionals to make sure that we deliver the best care and treatment to highly complex, and often challenging patients with very severe mental disorders.

What are the challenges?

One of the greatest challenges is the fact that many patients don't recognise that they're ill and do not want treatment. In almost every case this is followed by a period of sustained recovery during which we can work closely with the same patients, who now recognise their mental health problems, to prevent them from reoccurring.

How is your degree in medicine relevant?

Forensic psychiatry is concerned with uniquely complex ethical and medicolegal problems and the ethical framework developed during medical training is extremely helpful in approaching these complex issues.

What made you choose forensic psychiatry?

The patients we treat are often some of the most complex, dangerous and challenging people in the criminal justice system, at least before treatment.

As forensic psychiatrists we have huge power to influence, treat and manage our patients for the better.

How has your role developed?

I have been running the training scheme for forensic psychiatrists in the East Midlands for some years as I enjoy teaching; I want to continue to do this in the future.

One of the great advantages of a career in medicine is the range of opportunities and scope for developing your skills. I hope to be further involved in the management of secure services in years to come.

What advice can you give to others?

Concentrate on your medical degree first. Without this, you're never going to be a doctor of any sort.

During your training spend time exploring different medical specialties and work in a range of different places around the UK and abroad.

If you decide that forensic psychiatry is for you, visit the training schemes and spend time with the training programme director and current trainees to get a feel for what the work involves.

Once you start training, make the most of opportunities to study widely and look at gaining a Masters degree in the subject that fascinates you. Masters degrees in law are popular with forensic psychiatrists.

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