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Appendix 1 - Specific competencies

  • pp 485-489

Summary

Competencies for all psychiatrists

As specified for all doctors, plus the following.

• Full biopsychosocial assessment of patients, across the age range, with physical health problems, physical symptoms and mental health symptoms or psychological distress, including:

• somatisation/medically unexplained symptoms

• adjustment disorder

• the interrelationship of depression and anxiety on chronic medical conditions, for example diabetes, asthma, chronic obstructive pulmonary disease.

• Mental state examination in difficult circumstances:

• intensive care units

• breaking bad news

• variable conscious level

• lack of privacy.

• Assessment of self-harm across the age range, including children

• To advise competently on the treatment of patients with chronic mental health problems while in the general hospital

• Knowledge of medical and surgical treatments and conditions that have an impact on mental state

• Anxiety, depression and psychotic states in in-patients in medical and surgical settings

• Assessment of general medical and surgical admissions

• Demonstrate knowledge of management of alcohol and substance misuse problems in medical and surgical settings

• Diagnose psychiatric symptoms in the presence of confounding severe physical illness and biological symptoms (e.g. cancer, renal disease, severe trauma)

• Implementation of appropriate management plans, including the use of basic psychological, social and environmental interventions as well as psychotropic use from the British National Formulary

• Use risk assessment to advise management plan

• Review notes and drug cards, including investigations and results

• Awareness of medical, surgical and nursing assessment and management plan in the general hospital and its interaction with mental state

• Assessment of patient in A&E

• Identification of medically unexplained symptoms

• Identification, investigation and advice on the immediate management of delirium

• Basic management of patients with eating disorders in medical and surgical settings

• Criteria for referral and signposting to other mental health services including liaison

• Management of behavioural disturbance in medical and surgical settings including:

• assessment

• environmental measures

• use of appropriate drug treatments

• management of delirium tremens

• management of other drug withdrawal states.