Adult Psychiatry
By the end of your first year of training you shall be able to:
(i) Conduct a competent clinical interview (both initial and follow-up) with a wide range of people with mental health problems and mental illness
(ii) Perform a mental status examination and acquire a thorough understanding of the phenomenology of psychiatric illness
(iii) Perform a risk assessment of self-harm/suicide and dangerousness to others
(iv) Demonstrate an understanding of the importance of the maintenance of professional boundaries in the practice of psychiatry
(v) Demonstrate an understanding of the locally relevant mental health act and its application
(vi) Present a diagnostic formulation of a range of disorders taking into account biomedical, psychosocial and cultural factors in the person's presentation and illness
(vii) Propose a management plan that demonstrates an awareness of the place of biomedical and psychosocial interventions in the investigation and treatment of the person's illness
(viii) Implement a management plan under the supervision of a consultant psychiatrist
(ix) Understand clinical practice guidelines for the more common psychiatric disorders and apply them where appropriate
(x) Work as a member of a multidisciplinary mental health team, showing an awareness of the contribution of various members of that team
(xi) Demonstrate an ability to involve and inform people with mental health problems and mental illness and their Carers' in the assessment, diagnosis and management process
(xii) Demonstrate a basic understanding of critical appraisal in the evaluation of published psychiatric research
(xiii) Demonstrate basic competence in psychopharmacology
Child and Adolescent Psychiatry
By the end of the child and adolescent psychiatry rotation you shall be able to:
(i) Demonstrate knowledge of developmental trajectories and their importance in the assessment of children and adolescents.
(ii) Demonstrate a knowledge and understanding of the impact of psychiatric disorders and behavioural and emotional problems on the development of children and adolescents
(iii) Demonstrate an awareness of the impact of family, school and cultural factors on children and adolescents
(iv) Conduct a clinical interview with children and adolescents of different ages and their families. This requires comprehensive assessment of a minimum of five pre-pubertal children and five adolescents during the term.
(v) Demonstrate an understanding of the nature and specific manifestations of mental health problems in the young
(vi) Demonstrate (a) an understanding of the role of psychological, cognitive, behavioural and academic skills assessment in the evaluation of children and adolescents, (b) an ability to perform an appropriate physical examination, organise investigations and (c) an ability to interpret the results of such assessments and investigations
(vii) Present a diagnostic formulation taking into account developmental, psychological, educational, sociocultural and biological factors
(viii) Formulate a management plan based on the above formulation
(ix) Implement treatment using psychosocial and biomedical approaches as appropriate, under supervision
(x) Identify and work with a range of other services involved in a young person's life, such as schools, general practitioners, protective services, foster care agencies etc.
(xi) Demonstrate an understanding of the role of psychiatrists in the prevention of mental health problems.
Consultation-Liaison Psychiatry
By the end of the consultation-liaison psychiatry rotation you shall be able to:
(i) Demonstrate an understanding of the impact of medical illness and the system in which it is treated and how this affects the presentation, experience, and impact of psychiatric and psychosocial morbidity
(ii) Demonstrate the skills needed to conduct a biopsychosociocultural assessment, create a formulation, and implement appropriate treatment in the context of the general hospital including effective communication with the rest of the treatment team
(iii) Demonstrate the ability to assess reactions to illness, and to differentiate the presentation of depression and anxiety in the medical setting
(iv) Demonstrate an understanding of the combined trajectories of illness and the developmental issues of the person with mental health problems and mental illness
(v) Demonstrate an understanding of and ability to assess and treat somatisation and somatoform disorders
(vi) Demonstrate an understanding of and ability to assess and manage common neuropsychiatric disorders, with a particular emphasis on delirium
(vii) Demonstrate an understanding of the particular needs of special populations with psychiatric and psychosocial morbidity in the medical settings, including the young, the old, the indigenous and those with intellectual disability
(viii) Demonstrate an ability to assess and manage acute and emergency presentations of psychiatric morbidity in the general medical setting
(ix) Demonstrate an ability to formulate the key ethical dimensions that arise in providing psychiatric care in a medical setting.
Psychiatry of Old Age
By the completion of basic training you shall be able to:
(i) Demonstrate a knowledge and understanding of the importance of developmental issues in the assessment and management of older people
(ii) Perform an assessment of the mental state of older persons, in hospital, community and long term residential care settings. This should include an appreciation of the differences between young and old
(iii) Demonstrate a knowledge and understanding of the significance of underlying medical conditions and pharmacological treatment in the presentation of older people
(iv) Assess the competence of an older person to care for themselves and manage their own affairs and evaluate their testamentary capacity
(v) Participate in the assessment and management of older persons by a multidisciplinary team
(vi) Demonstrate knowledge of community resources including government programs, voluntary agencies, self-help groups and private facilities that are available to meet the needs of older people
(vii) Demonstrate an understanding of the key role of family members and other carers in the care of older people
(viii) Demonstrate knowledge and skills in assessment and management of issues facing some older people, including elder abuse, suicide, euthanasia and ageist attitudes.
Addiction Psychiatry
By the completion of basic training you shall be able to:
(i) Conduct a detailed assessment for problems and disorders related to the area of addictions such as substance use, abuse and dependence and gambling.
(ii) Demonstrate knowledge and skills in the assessment and management of people with combined substance use disorders and other mental illnesses.
(iii) Display knowledge of the theory of addictions, actions of psychoactive substances of abuse, as well as their psychiatric and their medical complications
(iv) Demonstrate knowledge of harm minimisation strategies, prevention strategies and other public health approaches to substance use disorders
(v) Formulate and carry out an appropriately tailored management plan for people with a substance use disorder and individuals with pathological gambling
(vi) Explain the mechanisms of action of the psychological and biological treatments available for addictions
(vii) Participate in interdisciplinary management of people with disorders of addiction.
Psychotherapy
By the completion of basic training you shall be able to:
(i) Formulate an individual's psychological issues in terms of basic developmental principles
(ii) Assess and describe an individual's personality functioning, relationship style, adaptive and maladaptive or defensive behaviours
(iii) Recognise the transgenerational transmission of relationship difficulties and psychological problems
(iv) Select an appropriate psychological therapy
(v) Integrate appropriately the psychological therapies with biological and social therapies
(vi) Demonstrate an understanding of the psychotherapies in terms of their historical development, theoretical underpinnings, research base and outcomes, including:
- Normal human development across the lifespan
- The infant-carer relationship
- Developmental psychopathology
- Attachment and other psychoanalytic theories
- Families and couples therapies
- Group psychotherapies
- Individual dynamic psychotherapies
- Structured therapies, including cognitive behavioural therapies.
ECT
By the completion of basic training you shall be able to:
- Demonstrate an awareness of prevailing societal attitudes to ECT, and how these might require particular sensitivity in preparing people and their families for this treatment
- Demonstrate an understanding of the process of obtaining informed consent for ECT and the relevant sections of your local Mental Health Legislation
- (iii) Demonstrate an understanding of the accepted indications and relative/absolute contraindications for ECT
- (iv) Demonstrate an understanding of medical/anaesthetic aspects of ECT including pre-ECT assessment, post-ECT complications (and their management) and potential effects of medication
- (v) Demonstrate competence in the following aspects of administration of ECT: electrode placement; stimulus dosing; seizure monitoring using EEG or "isolated limb" technique; recognition and management of missed, inadequate or prolonged seizures
- (vi) Demonstrate an understanding of the criteria for reaching a decision to terminate a course of ECT
- (vii) Demonstrate an understanding of management following a course of ECT, including relapse prevention using psychological or pharmacological strategies as well as maintenance ECT
- (viii) Demonstrate an adequate knowledge base in relation to ECT, including evidence of efficacy, hypothesised mechanisms of action, physiological responses and the significance of the electrical parameters utilised in ECT.
