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AMA

See all MNHQ comments on this thread

I'm a medical doctor and NHS psychiatrist. AMA

277 replies

DoctorDr · 29/07/2026 11:09

NHS pyschiatry (inpatient) with several years experience. Please ask away :)

OP posts:
ScrambledEggs12 · 30/07/2026 17:12

seanconneryseyebrow · 30/07/2026 17:04

A stigma is when something isnt true but people are being unfairly judged for something. You last sentence was manipulative. That poster was just highlighting it.

I don't understand how, my sentence was nothing to do with anything the OP had posted and nothing to do with her practice as a psychiatrist. I was saying that lack of support and stigma is a factor in the increased suicide rate.

Leaving this thread now.

All I ask is that people look beyond the stigma and see the individual being the diagnosis rather than lumping everyone together. Especially if that person is a friend or family member and needs support.

TheOcelot · 30/07/2026 17:26

Backedoffhackedoff · 30/07/2026 15:25

She really doesn’t sound vendictive. She’s started an interesting thread many people are very much enjoying. And it’s being disrupted by a handful of posters who just happen to have eupd

It's a fascinating thread and I have no skin in the game just interested. The posters who are disruptive aren't adding anything and are unlikely to be taken seriously by the rest of the people on here who are very interested in what the OP is saying and mature grown adults who know this is just an internet forum not a hospital consultation.
That's for all the insights OP.
I'd like to see more experts in whatever field on AMA rather than the usual trivia.

BeKhakiReader · 30/07/2026 18:29

summitfever · 30/07/2026 13:55

Hand you experience of use of the Flow Headset for depression and would you rate it?

The OP answered this for me yesterday, if you look back. The answer was has potential, but they’ve had to dial back some of their claims.

Carouseloflife · 30/07/2026 18:56

@DoctorDr
Do you manage to switch off at the end of your shift and if so what helps you?
Years ago I volunteered in a large psychiatric hospital for a few years as I was interested in this area as a career, but because I found it difficult to switch off I didn’t pursue it.

OldForANewMum · 30/07/2026 20:23

DosPerros · 30/07/2026 07:51

Thank you for sharing your experiences @OldForANewMum Very troubling to read.

No wish to derail the thread but I wish your post could be read by people who support surrogacy.

Hmn... well I don't know much about surrogacy, but in an appropriately controlled surrogacy situation, almost all of the points I made in relation to adoption do not apply or can be mitigated. They are really quite different scenarios (though I can imagine that there could be a degree of trauma associated with surrogacy, and certainly - particularly in countries where it's possible to pay a lot for a surrogate and desperate women have little choice but to become surrogates - it could also, if not 'done well' and appropriately controlled, result in trauma both to surrogate and child.

Imdunfer · 31/07/2026 09:05

There is apparently a severe shortage of psychiatrists.

Do you think more psychiatrists could be trained more quickly by restricting the general medical training to the stuff that is completely relevant?

I do understand that some people like the rotations, for example, but I don't see the point of the rotations when someone has wanted to be a psychiatrist right from school.

And I wonder how many great potential psychiatrists are having to become psychologists instead because they can't get the general medical degree they have to have first. Why should someone with an unresolvable blood phobia, for example, not make a great psychiatrist?

Legalmind · 31/07/2026 10:13

Imdunfer · 31/07/2026 09:05

There is apparently a severe shortage of psychiatrists.

Do you think more psychiatrists could be trained more quickly by restricting the general medical training to the stuff that is completely relevant?

I do understand that some people like the rotations, for example, but I don't see the point of the rotations when someone has wanted to be a psychiatrist right from school.

And I wonder how many great potential psychiatrists are having to become psychologists instead because they can't get the general medical degree they have to have first. Why should someone with an unresolvable blood phobia, for example, not make a great psychiatrist?

Funny you should make this comment as I had always wanted to be a psychiatrist but I faint at the sight of blood!

AnonMedic · 31/07/2026 14:10

Imdunfer · 31/07/2026 09:05

There is apparently a severe shortage of psychiatrists.

Do you think more psychiatrists could be trained more quickly by restricting the general medical training to the stuff that is completely relevant?

I do understand that some people like the rotations, for example, but I don't see the point of the rotations when someone has wanted to be a psychiatrist right from school.

And I wonder how many great potential psychiatrists are having to become psychologists instead because they can't get the general medical degree they have to have first. Why should someone with an unresolvable blood phobia, for example, not make a great psychiatrist?

I'm not a psychiatrist - my specialty is an acute surgical specialty - but the core training of medical school, house jobs (in my time!) or foundation training now, is critical for all doctors.

Psychiatric drugs have significant multi systemic effects. It's crucial that psychiatrists understand how these drugs work so they can best advise their patients. Plus there are plenty of examples of psychiatrists picking up physical illness diagnoses in patients they see within psychiatric services.

There are not enough doctors in general, and many of us (perhaps especially those of us old enough to have trained before training was reformed c.2008) are concerned that there is not enough general medical training before specialisation.

(See also discussions about PAs/ANPs/etc - all the people who are not doctors who are doing bits and pieces of work that used to be done by doctors, with all sorts of consequences...)

Imdunfer · 31/07/2026 15:48

AnonMedic · 31/07/2026 14:10

I'm not a psychiatrist - my specialty is an acute surgical specialty - but the core training of medical school, house jobs (in my time!) or foundation training now, is critical for all doctors.

Psychiatric drugs have significant multi systemic effects. It's crucial that psychiatrists understand how these drugs work so they can best advise their patients. Plus there are plenty of examples of psychiatrists picking up physical illness diagnoses in patients they see within psychiatric services.

There are not enough doctors in general, and many of us (perhaps especially those of us old enough to have trained before training was reformed c.2008) are concerned that there is not enough general medical training before specialisation.

(See also discussions about PAs/ANPs/etc - all the people who are not doctors who are doing bits and pieces of work that used to be done by doctors, with all sorts of consequences...)

Edited

They don't need to know how to fix a broken leg or treat skin cancer though, do they?

AnonMedic · 31/07/2026 16:20

Imdunfer · 31/07/2026 15:48

They don't need to know how to fix a broken leg or treat skin cancer though, do they?

And they won’t learn how to do that at medical school or in the foundation programme.

To learn how to fix a broken leg a doctor will do specialist training in orthopaedics or emergency medicine.

To learn how to treat skin cancer s/he will do specialist training in dermatology.

To spot which lesions may or may not be skin cancer, a GP will have some dermatology training. S/he will also have some training in musculoskeletal medicine, to help spot which patients need to be referred on for x-rays.

A psychiatrist, like other specialist doctors outside of dermatology and orthopaedics/A&E will not know how to manage these things. But they do need to know which of the drugs they are using will increase photosensitivity (and thus alter the risk of skin cancer), or reduce bone density (and thus increase the risk of fractures). And they will need to be able to identify which of these patients needs to be referred on, and to who, and what tests to order.

Recent efforts to dumb down medicine have been catastrophic. Patients have died because they have been managed by people who have not gone to medical school but have instead done a two year “master’s” (in inverted commas because the assessment procedures of many of these programmes have been shown to be substandard). The main risk - and super relevant to a conversation about psychiatry - is lack of insight. These none doctors don’t know what they don’t know. A quick google of the terms “physician’s associate” (someone working in specialist areas of medicine, who has not been to medical school) with “coroner’s prevention of future death reports” will make the scale of the problem clear. See also the Leng review. Anyone who wants to practice medicine needs to go to medical school.

I should add that by highlighting the danger of people who are not doctors practicing medicine I am not implying that doctors are all perfect, or that even good doctors don’t make mistakes. There are dreadful doctors, as there dreadful lawyers, dreadful plumbers etc. Good doctors sometimes make mistakes. Sometimes these mistakes have dreadful consequences. But letting someone who hasn’t been to medical school, and who hasn’t undertaken postgraduate clinical training, practice medicine is not a credible response to the facts that some doctors are poor, and that we need more doctors overall. (Investment in the quality of medical training and assessment, and improving access to medical school and postgraduate training, are both definitely needed.)

Imdunfer · 31/07/2026 17:23

AnonMedic · 31/07/2026 16:20

And they won’t learn how to do that at medical school or in the foundation programme.

To learn how to fix a broken leg a doctor will do specialist training in orthopaedics or emergency medicine.

To learn how to treat skin cancer s/he will do specialist training in dermatology.

To spot which lesions may or may not be skin cancer, a GP will have some dermatology training. S/he will also have some training in musculoskeletal medicine, to help spot which patients need to be referred on for x-rays.

A psychiatrist, like other specialist doctors outside of dermatology and orthopaedics/A&E will not know how to manage these things. But they do need to know which of the drugs they are using will increase photosensitivity (and thus alter the risk of skin cancer), or reduce bone density (and thus increase the risk of fractures). And they will need to be able to identify which of these patients needs to be referred on, and to who, and what tests to order.

Recent efforts to dumb down medicine have been catastrophic. Patients have died because they have been managed by people who have not gone to medical school but have instead done a two year “master’s” (in inverted commas because the assessment procedures of many of these programmes have been shown to be substandard). The main risk - and super relevant to a conversation about psychiatry - is lack of insight. These none doctors don’t know what they don’t know. A quick google of the terms “physician’s associate” (someone working in specialist areas of medicine, who has not been to medical school) with “coroner’s prevention of future death reports” will make the scale of the problem clear. See also the Leng review. Anyone who wants to practice medicine needs to go to medical school.

I should add that by highlighting the danger of people who are not doctors practicing medicine I am not implying that doctors are all perfect, or that even good doctors don’t make mistakes. There are dreadful doctors, as there dreadful lawyers, dreadful plumbers etc. Good doctors sometimes make mistakes. Sometimes these mistakes have dreadful consequences. But letting someone who hasn’t been to medical school, and who hasn’t undertaken postgraduate clinical training, practice medicine is not a credible response to the facts that some doctors are poor, and that we need more doctors overall. (Investment in the quality of medical training and assessment, and improving access to medical school and postgraduate training, are both definitely needed.)

Thank you for a very detailed response, it makes complete sense.

FaceIt · 31/07/2026 21:36

@DoctorDr
Thank you for this thread and the great work you do 💐

DoctorDr · 01/08/2026 13:25

Imdunfer · 31/07/2026 15:48

They don't need to know how to fix a broken leg or treat skin cancer though, do they?

Does a cardiologist?

OP posts:
Imdunfer · 01/08/2026 14:10

DoctorDr · 01/08/2026 13:25

Does a cardiologist?

I thought we were discussing psychiatry.

Cookingandfoldingthings · 02/08/2026 08:10

Morning @DoctorDr
Appreciating that you have a job, a life & need to sleep - please don’t be put off this thread by the sniping & attempts at derailing.
As PP have said, most of us are mature enough to be able to take your comments & guidance in the appropriate context.
Your generous contribution really is appreciated; I hope you have the time & inclination to come back.

Imdunfer · 02/08/2026 08:52

Should cannabis be made class A now we are clearer about it's role in psychosis?

banmusk · 02/08/2026 11:44

Imdunfer · 02/08/2026 08:52

Should cannabis be made class A now we are clearer about it's role in psychosis?

Even if it should the medical cannabis companies are making a nice profit and they will push back hard against any attempts to reclassify it.
Surely it's alcohol which should be made a class A drug?

Backedoffhackedoff · 02/08/2026 12:44

Imdunfer · 02/08/2026 08:52

Should cannabis be made class A now we are clearer about it's role in psychosis?

This is such a great question.

the other option would be (total) legalisation of medicinal grade CBD cannabis? But its not intoxicating do not sure that’s what the people want!

thc cannabis is much much higher risk for psychosis than alcohol

Imdunfer · 02/08/2026 14:36

banmusk · 02/08/2026 11:44

Even if it should the medical cannabis companies are making a nice profit and they will push back hard against any attempts to reclassify it.
Surely it's alcohol which should be made a class A drug?

Edited

Alcohol isn't currently illegal at all so that's too big a step. It's also impossible to prohibit when all anyone needs to do to create it is let fruits and vegetables ferment.

banmusk · 02/08/2026 17:01

Imdunfer · 02/08/2026 14:36

Alcohol isn't currently illegal at all so that's too big a step. It's also impossible to prohibit when all anyone needs to do to create it is let fruits and vegetables ferment.

could say the same about cannabis, ie it's extremely easy to grow it yourself

banmusk · 02/08/2026 17:03

Backedoffhackedoff · 02/08/2026 12:44

This is such a great question.

the other option would be (total) legalisation of medicinal grade CBD cannabis? But its not intoxicating do not sure that’s what the people want!

thc cannabis is much much higher risk for psychosis than alcohol

Medical cannabis contains THC, it gets you high & is exactly the same thing as recreational cannabis.

Imdunfer · 02/08/2026 17:57

banmusk · 02/08/2026 17:01

could say the same about cannabis, ie it's extremely easy to grow it yourself

It would be a lot easier to suppress the same of cannabis seeds and plants than to ships the sale of fruit and sugar..

Imdunfer · 02/08/2026 18:19

Imdunfer · 02/08/2026 17:57

It would be a lot easier to suppress the same of cannabis seeds and plants than to ships the sale of fruit and sugar..

Sale not same.

LathkillDale · 03/08/2026 07:13

It was agreed DD1 was to be prescribed Epidyolex, medicinal cannabis. We were told the THC, the psychoactive ingredient had been taken out? In the event, the consultant neurologist decided cenobamate, another new drug had better results, and he prescribed that.

Puppamumma · 16/08/2026 22:36

Should a patient who is self harming be discharged from services. Do you know of cpns who gatekeep services so much that the patient is unaware that they still had a psychiatrist?. If a patient makes a life attempt do you think their cpn getting a student to leave a voicemail and 3 weeks later at their appointment say we figured you were okay is acceptable? Eating disorder service scotland

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