How to Become a Psychiatrist

What does a psychiatrist do?

A psychiatrist is a medically qualified doctor specialising in psychiatry, which involves diagnosing, treating and preventing mental health disorders. They can work with people with various problems, such as anxiety, depression, schizophrenia, bipolar disorder, addictions, eating disorders and more. They can also support those with physical conditions affecting their mental health, e.g. long-term, painful or terminal.

Psychiatrists can work in various settings, such as hospitals, prisons, patients’ homes, owned practices and the community. They can also specialise in many areas of psychiatry, e.g. general adult, forensic, child and adolescent, older persons/age, learning disabilities and psychotherapy (talking therapies). Therefore, what psychiatrists do will depend on where they work and their specialisms.

A psychiatrist aims to help treat and manage the symptoms of mental problems, conditions and disorders. They improve patients’ psychological and physical well-being, help with their recovery and promote overall good health. In some cases, psychiatrists can even save lives, i.e. in an emergency where a patient may harm themselves or others.

Psychiatrists will have many duties, including conducting research, meeting with patients, assessing patients, making diagnoses, getting information from other sources, conducting psychiatric tests, prescribing medication, recommending other treatments, monitoring and reviewing treatments, supervising and training, referring to other healthcare professionals, etc. The role will also have an element of administrative work, such as maintaining confidential records and writing reports.

Psychiatrists can work with patients of all ages, i.e. children, adolescents, adults and older people. They may collaborate with other healthcare professionals, such as hospital doctors, GPs, psychiatric nurses, counsellors, psychologists, occupational therapists, pharmacists, etc. They may also liaise with other external stakeholders, such as relatives, friends, social workers, probation officers, prison staff, educational staff, the Care Quality Commission (CQC) and Local Authorities. They can also work with the police, coroners and legal professionals if something happens to a patient.

A psychiatrist can work for different-sized organisations. They mainly work for the NHS in community mental health teams (CMHTs). They can also work for other employers, such as private healthcare companies, locum doctor agencies, charities and independent providers. Some psychiatrists choose to have their own practice and become self-employed.

Psychiatrists can work in various settings, such as NHS or private hospital wards, psychiatric units, outpatient clinics, GP practices, health centres, university medical centres, residential facilities, prisons, educational establishments, patients’ homes and even their own homes or practices.

Responsibilities

Psychiatrists’ responsibilities will depend on many factors, including their role, who they work for, where they work and the area in which they specialise.

Some examples of their day-to-day duties may include (this list is not exhaustive):

Conducting research and keeping up to date on the field of psychiatry.
Meeting with patients who have various mental health issues.
Carrying out initial assessments of patients’ mental and physical health, which can involve:
– Asking patients questions about their mental health problems, background, thoughts, life, social situation, past health issues, etc.
– Conducting scans, blood tests and examinations to rule out other health issues that could be causing the problem.
Keeping accurate and detailed confidential records of patient interactions.
Diagnosing mental illnesses using various analytical methods.
Acquiring information from various sources, such as GPs, relatives and social workers.
Developing management plans for patients’ treatment and recovery.
Conducting various psychiatric tests.
Prescribing medication where necessary.
Recommending other treatments, such as cognitive behavioural therapy or counselling.
Monitoring and reviewing treatments regularly and adjusting treatment plans where necessary.
Referring patients to other healthcare professionals where necessary.
Working as part of a multidisciplinary team, i.e. psychologists, psychiatric nurses, counsellors and occupational therapists.
Writing reports where required, e.g. if there is an incident or death.
Supervising and teaching junior staff (with more experience).

Working hours

A psychiatrist can expect to work around 40 hours a week, usually Monday-Friday, 9 am-5 pm. However, some may need to work unsociable hours, such as evenings, nights, weekends and bank holidays on a rota. There may be a requirement to be on-call for emergencies.

Flexible working may be possible for some psychiatrists, e.g. part-time hours or a job share. There are even working-from-home opportunities or hybrid jobs with particular roles. Some may be self-employed or work as locums on short-term contracts.

Travel and overnight stays may be necessary for some psychiatrists, i.e. working in the community. Overseas work may be an option, e.g. working for medical charities and relocation opportunities.

What to expect

Being a psychiatrist and helping people with various mental health problems is extremely rewarding. Individuals can go home at the end of the working day knowing they are helping to make a significant difference to patients’ health, happiness and well-being. In some cases, their diagnoses, treatment and support can save lives, especially for those at risk of harming themselves and others.

The role would suit individuals with a passion for helping improve the lives of people with mental illnesses and those with a scientific mind and interest in mental health. They will need to keep up to date on current research in psychiatry and understand the issues and needs of each patient they see. Using knowledge learnt, seeing treatments work and watching patients improve can be fulfilling.

According to the NHS, mental illness is increasingly common, and approximately 25% of Britons experience a mental health problem annually. Therefore, there is a demand for psychiatrists and other qualified mental health professionals in the UK. If individuals decide on psychiatry as a career, they are likely to have decent job security.

There are psychiatrist jobs nationally and different areas in which to specialise. Salaries are competitive compared to other career choices, even at the entry level. However, it does reflect the level of education, training, time and commitment needed to become a psychiatrist.

If an individual decides to have their own practice and become self-employed, they can have control of their business and workload and work around their own needs. If they have their psychiatry practice at home, it reduces the need to travel, which can improve their work-life balance. Also, being your own boss can be exciting and fulfilling.

Boredom will never be a problem for psychiatrists, as their role is fast-paced, and they will see many patients from all backgrounds with various mental health problems. One appointment may involve helping an individual with severe depression, and the next, assessing a patient who is showing symptoms of psychosis. They will also spend time learning, researching and educating. Of course, this will depend on a psychiatrist’s role and specialist area.

Even though being a psychiatrist is rewarding, and there are many positives associated with the role, they may also face challenges, for example:

Study, exams and competition – becoming a psychiatrist can take over ten years. They will need a degree in medicine (4-6 years) and must undertake foundation training (2 years) and psychiatry training (6 years). Therefore, individuals must prepare for intense study, work-based learning, tests, exams and registration. Getting into medical school is also competitive, and there are no guarantees that an individual will be successful.
High workload – depending on their specialisms, psychiatrists may have multiple caseloads and will see many patients during the day, which can be stressful. They must juggle different demands, and work schedules can often be erratic.
Work-related violence – psychiatrists can face abuse and even physical violence when working with patients with mental health problems. Some patients can be volatile and unpredictable, putting people at risk of physical harm. Psychiatrists will learn how to deal with these situations during training, but individuals must be aware of the risks associated with this profession.
Mental demands – psychiatrists may see many patients throughout their shifts, which can put time pressures and stress on them. Each patient will have varying mental health issues and needs; some may require emergency care. Psychiatrists will need to be capable of working in these challenging environments. They have a lot of responsibility, and making mistakes could worsen conditions and cost lives. Dealing with mentally ill patients and their families can be emotionally demanding. It can also be frustrating if patients are not improving as anticipated.
Physical demands – the role can also be physically demanding, especially when working in hospital wards and specialised units. Psychiatrists may be on their feet for most of the working day, seeing different patients. Their working hours can also be long and unsociable, which can cause fatigue.

Every career choice has pros and cons, and prospective psychiatrists must know what to expect before deciding whether it is a suitable role. There is no doubt that working in psychiatry and with mentally ill people is challenging and stressful. It is also mentally and physically demanding. Competition for roles is fierce, the working days can be long, and there can be a risk of violence. However, there are many positives and helping others is why individuals become psychiatrists.

When considering whether to be a psychiatrist, individuals should look at the pros and cons. They should also ensure they have the necessary personal qualities to carry out the role and responsibilities required.

Personal qualities needed to be a psychiatrist

Some of the personal qualities that a psychiatrist requires will include (this list is not exhaustive):

A passion for helping people and improving their quality of life.
Knowledge of medicine, healthcare, mental health and psychology.
Knowledge of related legislation and standards.
Knowledge of health and safety.
Knowledge of equality and diversity.
Knowledge of confidentiality, data protection and the GDPR.
Having a caring attitude, sensitivity, empathy and understanding.
Having confidence, patience, tolerance and a reassuring manner.
Having a non-judgemental and person-centred approach.
Having self-awareness, including examination of own thoughts and values.
Excellent interpersonal skills, i.e. dealing with patients and other healthcare professionals.
Excellent verbal communication skills.
Excellent counselling and active listening skills.
Observational skills.
Problem-solving skills.
Decision-making skills.
Leadership skills.
Research, investigation and analytical thinking skills.
Organisational skills.
Good time and resource management.
Being motivated and committed to helping people.
Being positive.
Being open-minded.
Being thorough and having attention to detail.
Being flexible and open to change.
The ability to work both in a team and alone using own initiative.
The ability to communicate and interact with people of all ages.
The ability to understand people’s behaviour and reactions.
The ability to challenge positively.
The ability to be resilient in emotionally demanding situations.
The ability to gain people’s trust, respect and confidence.
The ability to develop relationships and build rapport.
The ability to accept criticism.
The ability to work well under pressure and remain calm in stressful situations.
The ability to use IT equipment and software competently.
The ability to follow policies, procedures, instructions and risk assessments.

Qualifications and training

Qualifications

To become psychiatrists, individuals must first become doctors. They need to:

Complete paid or voluntary work experience in a healthcare environment before applying for medical school.
Complete a degree in medicine recognised by the General Medical Council.
Complete two years of foundation training.
Register with the General Medical Council (GMC).

Please visit our career guide on How To Become A Hospital Doctor for further information on work experience, the qualifications needed and the registration process to become a doctor.

Psychiatry training and specialist registration

Once individuals have completed their degree and foundation training and have registered as a doctor with the GMC, they will start their six years of training in psychiatry, which is in two parts as follows:

Three years of core training in psychiatry – individuals will work in various psychiatry settings and sub-specialties, e.g. in hospitals and the community. The aim is to increase understanding of the specialty and gain as much experience as possible. Individuals must pass the MRCPsych exam to move on to the next training stage. Further information on core training is on the Medical Education Hub.
Three years of higher training – if individuals pass their exams, they will move on to the next stage of training, which focuses on their chosen psychiatry sub-specialty, e.g. child and adolescent, forensic, general adult, old age, psychotherapy or psychiatry of learning disabilities. Further information on higher training is on the Medical Education Hub.

After completing six years of psychiatry training, individuals gain a Certificate of Completion of Training (CCT), which allows them on to the GMC’s specialist register as fully qualified psychiatrists. They can then apply for psychiatric consultant positions or work as Specialty and Specialist (SAS) Doctors.

Training courses

Learning does not stop with experience or once someone becomes qualified. Undertaking postgraduate qualifications (part-time) and relevant short training courses can help individuals enhance their employability and keep their knowledge and skills current. It can also help them with entry to medical school.

We have many approved mental health courses that can be useful for individuals looking for a career as a psychiatrist. Other topics that may be relevant include (this list is not exhaustive):

Safeguarding.
Equality and diversity.
Disability awareness.
LGBTQ+ awareness.
Infection control.
PPE in healthcare.
COVID-19 awareness.
Customer service skills.
Introduction to health and safety.
Workplace stress awareness.
Violence at work.
Workplace first aid.
Fire safety awareness.
Understanding GDPR.

Professional bodies, unions and associations, such as the Royal College of Psychiatrists (RCPsych), the GMC, the Doctors’ Association UK (DAUK), the Hospital Doctors’ Union (HCSA) and the British Medical Association (BMA), can advise on reputable training courses. They also have memberships, events, support services and guidance that can help psychiatrists and give them the means to continue their professional development. Continuing professional development (CPD) is mandatory for GMC registration renewal (revalidation). Also, see CPD courses for doctors for further guidance on CPD.

The training a psychiatrist will require will depend on where they want to work, their specialties and the CPD requirements for GMC registration. As well as looking at professional body websites, it is worth looking at several job advertisements to identify the qualifications and other training needed for specialist roles. Jobs are on RCPsych Jobs Board, Health Careers, NHS Jobs, BMJ Careers, JobsMedical, NHSScotland Jobs, HealthJobsUK, HSCNI Jobs, Bupa Careers and other job sites, such as GOV.UK Find a Job Service, Glassdoor, LinkedIn and Indeed. Also, look at recruitment agencies, as they may offer locum jobs.

More relevant training and competence will open up more opportunities for psychiatrists. Refresher training will also be required, as it is mandatory for revalidation and keeps knowledge and skills current.

Criminal records checks

Psychiatrists must undergo a criminal record check, as they may have contact with children and vulnerable adults. A criminal record, caution, warning, or conviction may deter prospective employers and affect GMC registration. However, employers should account for the seriousness of the crime, when it occurred and its relevance to the role.

The organisation that holds criminal records will depend on the country within the UK, for example:

England and Wales – Disclosure and Barring Service (DBS).
Northern Ireland – AccessNI.
Scotland – Protecting Vulnerable Groups (PVG) scheme.

Driving

Some psychiatrists will drive as part of their role, especially when working in the community. Therefore, they should have a full clean driving licence.

Where do psychiatrists work?

Psychiatrists can work in many different settings, including (this list is not exhaustive):

Schools and universities.
Hospitals, e.g. wards.
Health centres and local clinics.
GP practices.
Psychiatric and secure units.
Residential homes.
Advice and support centres.
Their own home or private practices.
Offices and treatment rooms.
Patients’ homes.
Rehabilitation units.
Research facilities and sites.
Prisons.
Courts and other legal settings, e.g. coroners.

Most psychiatrist opportunities are with the NHS. Individuals can also work for:

Independent providers of NHS services.s.
Private hospitals and mental health care providers.
Universities.
Research organisations.
Charities or non-profit organisations.
Themselves (self-employed).
Recruitment agencies as a locum.

Most opportunities tend to be in cities and large towns.

How much do psychiatrists earn?

The exact salaries for psychiatrists will depend on the following:

Where they are in their training.
Their location, i.e. if they are in London, they will receive a supplement.
Their experience.
Their chosen specialty.
Whether they are employed or self-employed.
Their working hours, e.g. full-time, part-time, locum or flexible.
Whether they work for the NHS, privately or for other employers.

Here are some examples of salaries for England (these figures are a guide only and are subject to change):

Junior doctors in Foundation Year 1 (F1) – £29,384 a year.
Junior doctors in Foundation Year 2 (F2) – £34,012 a year.
Doctor starting specialty training – £40,257 to £53,398 a year.
Specialty doctors – £50,373 to £78,759 a year.
Specialist grade doctors – £80,693 to £91,584 a year.
Qualified consultants – £88,364 to £119,133 a year.

Data from NHS pay for doctors.

Doctors in training receive additional payments for overtime and an enhancement for working nights and weekends and being on-call. Salaried doctors will also receive further benefits, e.g. pension scheme, sick pay, holiday pay and maternity pay.

There is potential for psychiatrists to earn more if they work in the private healthcare sector or as a locum. Experienced psychiatrists may earn higher salaries if they combine clinical work with research and teaching or become a consultant and combine NHS work with private.

Further information on pay is also on the British Medical Association’s website.

Types of psychiatry to specialise in

As mentioned, once an individual has completed their core training, they move on to higher training and choose a specialty.

There are many to choose from, including (this list is not exhaustive):

Child and adolescent psychiatry – working with mentally ill children and young patients up to 18 years old and specialising in associated disorders, e.g. depression or behaviour. They can be hospital or community based, e.g. in schools liaising with educational psychologists and teachers.
Forensic psychiatry – in this field, psychiatrists will work in secure units and hospitals and prisons but may also be out in the community. They work with patients who have committed crimes because of their mental health issues or have developed problems because of their past offending. They may also act as expert witnesses in court.
General adult psychiatry – specialising in assessing, diagnosing and treating patients between 18 and 65 with various mental disorders. These psychiatrists typically work in hospitals. There are also sub-specialties within this area, e.g.:
– Eating disorder – specialising in patients with eating disorders and associated mental health conditions.
– Liaison – working in hospital inpatient wards and the accident and emergency department with patients with various mental health problems.
– Rehabilitation and social – working with patients with longer-term and complex mental health problems to help them remain in their homes.
– Substance misuse (addiction) – specialising in patients with alcohol and/or drug addictions. They can work in hospitals or the community.
Medical psychotherapy – in this area, psychiatrists use various forms of psychotherapy (talking therapy) to help patients with their mental health disorders.
Old age psychiatry – here, psychiatrists predominately work in community settings but may also be hospital-based. They work with patients over 65 and specialise in mental health conditions associated with ageing, e.g. dementia.
Psychiatry of learning disability – specialising in patients with learning disabilities, e.g. Down’s syndrome and cerebral palsy. They work mainly in the community.

Further information on specialties is on:

All different psychiatrist roles will require differing knowledge, skills, experience and qualities. Some may need specific qualifications, e.g. postgraduate and additional training for specialised areas. Psychiatrists must know how to assess, diagnose and treat different mental health problems, monitor patients, prescribe medications, recommend therapies and maintain medical notes and records. Any additional areas of expertise will depend on what an organisation is looking for (if employed) and the type of work an individual wants.

If psychiatrists do not carry out their role effectively and competently, it can cause a patient’s mental health illness to worsen and may even cost lives. It can also affect a psychiatrist’s reputation. In serious cases, they may have their registration and licence to practise revoked (struck off). Therefore, whatever the type of role, psychiatrists must have the necessary competence to carry out the work professionally and safely. They should also know the limits of their competency, i.e. asking for help when something is beyond their expertise and not working outside of their scope.

Professional bodies

Standards, technology, medications, treatments, therapies and laws are updated regularly. Therefore, psychiatrists must keep ahead of the latest developments and changes to remain legally compliant and carry out their roles effectively and safely. CPD gives psychiatrists the knowledge and skills to keep up to date with these changes and understand their responsibilities. It also helps them stay registered with the GMC and allows them to progress in their career.

Joining a professional body, union or association (as mentioned) can help prospective and current psychiatrists enhance their skills and overall career. These can offer different levels of membership, CPD, access to industry contacts, support, advice and networking events.

There is ample opportunity for career progression within psychiatry. With more qualifications and experience, a psychiatrist could go on to lead a team or manage a department. As a consultant, there are opportunities to become a clinical lead, clinical director or medical director. Alternatively, they may become self-employed with their own practice, do locum psychiatry or work in private practice.

Knowledge, skills and experience in psychiatry can also lead to a career in different areas. For example, a psychiatrist may want to work in education and training and teach trainee doctors. Alternatively, they could move into clinical research and development or other areas of healthcare.