Old age psychiatry

Old age psychiatrists provide specialist and holistic assessment, treatment and ongoing care for older people experiencing mental health problems such as dementia, personality disorders and schizophrenia. 

You’ll work with patients experiencing cognitive problems and psychological problems because of the ageing process.

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In this video Dr Alex Bailey, Consultant old age psychiatrist, gives an insight into his working life and also the nature of the demands and rewards that come from working in the community with elderly people and the type of person that it would suit as a career.

Life as an old age psychiatrist

A patient’s mental health can be affected by any physical problems they experience, which is why NHS old age psychiatrists take a holistic approach and need a sound knowledge of general medicine. Old age psychiatry is considered the most ‘medical’ of psychiatric specialties.
 
You’ll need detailed knowledge of the way in which older people metabolise medication, since this can change as part of the aging process. The interaction of physical health medications, as well as the high rate of polypharmacy (use of multiple medicines) in this population, means that you’ll also need a high level of pharmacological expertise.
 
As part of a holistic approach, you’ll need to understand the legal and philosophical issues regarding, for example, human rights, end-of-life decisions and informed consent. As an old age psychiatrist, you’ll balance clinical decisions with ethics.
 
Common mental health disorders you’ll treat include:
  • cognitive impairment
  • dementia
  • functional disorders (such as depression or psychosis)
  • organic disorders (such as memory loss)
  • personality disorders
  • schizophrenia

Mental health and social problems often go hand-in-hand. Consequently, you’ll collaborate widely, for example with GPs, occupational therapists and voluntary organisations. 

The emphasis is on care in the community and delivering care that allows a patient to remain living at home. You’ll need to work closely with a patient’s family and carers, promoting independence and choice.

Mental health problems in older people differ greatly compared to the younger population. And with an aging population and an increase in dementia and mental health problems, there is a growing demand for first-class old age psychiatrists.

How much can I earn?

You’ll first earn a salary when you start your foundation training after medical school. The basic salary ranges from £32,398 to £37,303. Once you start your specialty training in the NHS, you can expect to earn a salary of at least £43,923, which can increase to between £93,666 and £126,281 as a consultant.

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, old age psychiatrists need to demonstrate:

  • empathy and compassion and the ability to treat others with understanding and respect
  • a holistic approach to medicine and ability to apply medical and psychiatric skills
  • excellent listening skills
  • to be willing to build relationships with their patients

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 an old age psychiatrist

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 an old age psychiatrist, 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 old age psychiatry?

In 2021, there were 529 consultants in old age psychiatry working in the NHS in England. In 2020, there were 57 applications for 60 training places.

Where a career as an old age psychiatrist 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

Other roles that may interest you

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