Issue 1

Life as a Senior House Officer

Andy asked me to write something for the Caswell Chat, but where do I start? I suppose that a basic description of what an SHO is would help. SHO stands for Senior House Officer, and it is a grade through which all doctors pass, regardless of specialty. To become a Consultant in Psychiatry, a doctor first enters SHO training (Basic Specialist Training) on a College-approved rotation, and this lasts around three to four years. During this period, they must sit and pass the Membership Examination of the Royal College of Psychiatrists, after which they are eligible for Higher Specialist Training. This Higher Training lasts for anything from three to five years, and successful completion allows the doctor to apply for a Consultant post. I myself have spent three years in Psychiatry before coming to Caswell, in General Adult, Old Age, Learning Disability and Child and Adolescent Psychiatry.

So what exactly does an SHO do? Good question, because it is pretty difficult to define. At Caswell, the main duties of the SHO are ensuring the physical well-being, and monitoring the mental health, of the patients in their team. In addition, they are responsible for producing reports for Case Conferences, and co-ordinating any medical interventions deemed necessary (such as investigations or treatment regimes). A morning is also spent each week at HMP Parc, where mental health screening assessments are undertaken. This workload is similar in some ways to that of the SHO in generic services, but very different in others. So what differences have I noticed between Caswell and other places in which I have worked? Believe me, there are plenty. The biggest difference would be the amount of time I have available to spend with patients.

Although I now have a similar number of inpatients as I would have in General Adult Psychiatry, there is far less throughput. Patients who are admitted to Caswell tend to stay for far longer than they would in generic services. In addition, SHOs do not undertake outpatient clinics at Caswell, thus freeing up more time to spend with patients, and so relationships can begin to be formed – this would be impossible in many environments, and is refreshing to say the least. There is far more written work than I have had to do previously. Reports can take some time to prepare, and this is a new skill which I have yet to master. Otherwise, much of the work is similar to that in other SHO posts in Psychiatry generally, for example looking after the physical health of inpatients.

But what of Caswell Clinic itself? The atmosphere is good; morale amongst the staff is high, and the service is generally well resourced. I was struck by the friendly approach of everyone when I arrived, and impressed with how well and how smoothly everything ran. Having the Social Work Department on the same site is a real plus, and the range of activities offered by the Occupational Therapists would put many larger units to shame. Add to this the dedicated Nursing Staff and the team spirit, and you have a Psychiatric Service as it should be run. Yes, I suppose I do like it here.

Dai Morgan SHO