Slam it to the Left and Shake it to the Right – on getting through the Competency Based Fellowship Program (CBFP)
Time to read: 4 minutes
It’s been about a year since I finished my training. Although I never felt that competent, I’ve had some time to reflect on the five years I spent trying to be a competent psychiatrist.
This article is basically a series of highlights from the three articles published in Australasian Psychiatry. [Evans and Suetani, 2017], [Parker et al., 2017], [Kim et al., 2018]
I will start by talking about how to navigate through the program, talk a bit about supervision, and finish off with training welfare.
NAVIGATING THROUGH THE CBFP
There is not much that I can tell you about the Competency Based Fellowship Program (CBFP) that is not on the seemingly endless black hole that is our College website.
When you break it down, the CBFP, in a nutshell, goes something like this. It should take you five years. You need to complete three external examinations – Extended Multiple-choice Questions (EMQ), Modified Essay Questions (MEQ) and Observed Structured Clinical Examinations (OSCE)– and two external assessments – psychotherapy case and scholarly project.
To squeeze all these things in five years is a challenge, and we haven’t even mentioned advanced certificate requirements.
I recommend building a system (refer to How to Fail at Almost Everything and Still Win Big by Scott Adams) and habits (refer to The 7 Habits of Highly Effective People by Stephen Covey) that will allow you to yield multiple benefits from your effort.
Be more organised than your supervisors and training directors – remember nobody cares about your training as much as you do.
Draft a map of what your next five years should look like (e.g. when to sit exams, when to submit assessments, how to prepare for these), and adjust as you go through.
ON BEING SUPERVISED
Supervision is an essential part of your training but it’s often done in a fluffy manner. While I appreciate the importance of philosophical discussion over skinny soy latte, I think supervision should be more substantial and concrete.
As a trainee, especially in early stages, it is difficult to be assertive about the process.
Enter Supervision Agreement. It’s a handy document that one of my supervisors introduced to me in my last year of training. In essence, there is a section on what your expectations from the rotation are, and there is a section on what their expectations on you may be (for me, as a consultant, I expect my registrar to be punctual, be efficient with blood test results and GP letters, and be nice to case managers).
You set up concrete goals in forms of Entrustable Professional Activities you want to achieve from the rotation, as well as any external assessment you want to knock over in the next six months. You, with your supervisor’s help, will then sign, seal, and deliver it.
Take your time formulating your expectations before your first supervision session. Find out what your supervisors can offer through previous trainees, google, or even ask them directly.
Make sure you take charge of your supervision process. Actively seek feedback from your supervisor, act on them, and build autonomy but do not work outside of your comfort zone.
FROM WORDS TO ACTION
There’s been a lot of attention and effort put into the issue of trainee welfare. You have little control over things like system and cultural issues.
One thing you can do is to build what Simon Sinek calls the circle of safety. It is an environment you create for yourself where you feel confident that you have the support you need to overcome the challenges you may face. Build the circle by working on three distinct peer networks.
People above you and below you professionally form your vertical peer network. Have supervisors and mentors you can have casual chats with, and help out junior registrars below you, maybe even buy them skinny soy latte.
Your registrars and colleagues around you form your horizontal peer network. A study group is a good example of a horizontal peer network but you don’t always have to catch up about an essay question.
Most importantly, work hard on building your external peer network. This is your friends, family, people who couldn’t give a hoot about what Freud thought about Jung.
At the end of the day, CBFP is really just another hoop you have to jump through. It may feel like the biggest deal in the world when you are trying to jump through it, but you will probably forget about it soon after the completion.
Because life will keep throwing you more hoops for you to jump through, it’s important to keep things in perspective. Your external peer network will help you with this.
Sometimes you have to slam it to the left and shake it to the right to spice up your life.
Take time off if you need to, don’t take on too much work, and seek help if you need to.
When you combine these three networks – vertical, horizontal, and external, you have your circle of safety.
Within that circle, you will feel comfortable enough to practice being a competent psychiatrist that you’ve always dreamed of.
TAKE HOME MESSAGE
Have fun, don’t take yourself (or CBFP) too seriously. The CBFP is tough. Psychiatry is tougher. It may take you longer than five years, but who cares?
I am yet to meet anyone who is cruising through the CBFP, but most of us will get through eventually. Onwards and upwards.
To learn more you can visit the Exams and CPD section of the hub for many more articles and videos.