Medical psychotherapy

Life as a medical psychotherapist

Your goal is to give a patient a better understanding of their difficulties and worries, their abilities and motivations. You’ll help them explore difficult experiences and painful emotions and reflect upon harmful patterns of behaviour.   You’ll see patients with a wide range of mental health conditions including:

• anxiety and depression disorders
• health anxiety and eating disorders
• personality disorders
• post-traumatic stress disorder (PTSD)
• psychotic disorders

Patients may be experiencing more than one psychological disorder or other difficulties such as anger, low self-esteem and self-harm.

Medical psychotherapists use their expertise to give psychological and relationship-oriented elements to psychiatric care. This could be recognising the impact of mental illness on a patient’s life or the role a patient’s carers and relatives play in their treatment. 

There are many different forms of psychotherapy and as a medical psychotherapist working in the NHS, you’re likely to specialise in one type while having a working knowledge of all main forms.

The main types of therapies are:

• psychoanalytic/psychodynamic psychotherapy – the relationship between the psychotherapist and the patient is used to explore past and present ways of relating to others and to enable change. Early family and other important relationships are often explored.
• cognitive behaviour therapy (CBT) – helps patients to identify unhelpful thought patterns and behaviours which may have contributed to symptoms such as depression and encourages more helpful ways of thinking and reacting to situations. The emphasis is on the present rather than the past, homework between sessions and developing new skills to get well and stay well.
• cognitive analytic therapy (CAT) – looks at the way a person thinks, feels and acts and also explores past and present in examining the events and relationships that underpin these experiences. The relationship between the client and therapist is also used to help achieve recognition and change.
• systemic therapy – looks at the relationships between individuals as part of a unit and how systems work together. Groups and family therapy are examples of this approach.
• trauma-focused therapy – such as eye movement desensitising and reprocessing therapy (EMDR), focuses on the bodily felt-sense and aims to help the patient digest or process traumatic experiences which may have caused a variety of symptoms including PTSD.

Medical psychotherapists have an extremely varied working life. You’ll work in general hospitals and outpatients, contribute to the community mental health team (CMHT) and could run units dealing with specific disorders such as eating disorders, personality disorders and trauma.

How much can I earn?

You’ll first earn a salary when you start your foundation training after medical school.  Find out details of current salary ranges for foundation and specialty training, SAS doctors and consultants on the 'Pay for doctors' page. 

How about the benefits?

• make a difference
• flexible and part-time working
• high income early in your career
• work anywhere in the world
• excellent pension scheme
• good holiday entitlement
• NHS discounts in shops and restaurants

Must-have skills

• excellent communication skills to manage a wide range of relationships with colleagues, and patients and their families
• emotional resilience, a calm temperament and the ability to work well under pressure
• teamwork and the capacity to lead multidisciplinary teams
• problem-solving and diagnostic skills
• outstanding organisational ability and effective decision-making skills  
• first-class time and resource management for the benefit of patients

In addition, medical psychotherapists need to demonstrate:

• empathy and compassion and the ability to treat others with understanding and respect
• patience – progress can sometimes be slow
• self-understanding and the willingness to learn by applying some of the principles of their therapeutic approach to their own lives

Entry requirements

Your first step is medical school. Typically, you’ll need excellent GCSEs and three A or A* passes at A level including chemistry for a five-year undergraduate degree in medicine. Many medical schools also ask for biology and others may require maths or physics.

If you already have a degree, you could study for a four-year postgraduate degree in medicine.

You’ll need to pass an interview and admissions test. You’ll be asked to show how you demonstrate the NHS values such as compassion and respect.

Some medical schools look to recruit a mix of students from different backgrounds and geographical areas, so your educational and economic background and family circumstances could be considered as part of your application.

How to become a medical psychotherapist

After medical school, you’ll join the paid two-year foundation programme where you’ll work in six placements in different settings.

After your foundation programme, you can apply for paid specialty training to become a medical psychotherapist, which will take a minimum of six years.

You may be able to train part time, for example for health reasons or if you have family or caring responsibilities.

What are my chances of starting a career in a medical psychotherapy?

In 2021, there were 32 consultants in medical psychotherapy working in the NHS in England. In 2020, there were 14 applications for four training places.

Where a career as a medical psychotherapist can take you

You could: 

• specialise or conduct research 
• teach medical students or postgraduate students in training 
• get involved in research at universities, the NHS or private sector