Visiting

Our work may be based in a secure hospital at Arnold Lodge, but we are very keen to welcome professional visitors and to show them the work that we are proud to do.

Coronavirus update – 4 June 2020

The coronavirus situation is still changing daily. We seek advice from relevant infection control authorities and follow their guidance.  If you want to come and spend time with us, please get in touch. We have some availability for medical students in 2021 and hope that these placements can go ahead.

We are hoping that as many placements can go ahead as possible during 2020 but right now we are unable to host visits from medical students for infection control reasons. We will update as needed here but get in touch if you have any questions. Please let us know if you need to cancel a placement you have already booked.

I am a medical student and want to visit

I am a doctor working in the UK and want to visit

I am an international doctor and want to visit

Medical students and junior doctors are welcome to visit – for a day, a week, a month or more, or anything in between. We offer the chance to join us in our work and are very flexible.Clinical and academic placements are offered, with a chance to mix and match the time spent in each area. All visits are hosted at Arnold Lodge. We cannot arrange visits to The Wells Road Centre or to Rampton Hospital. Please email charmaine.everson@nottshc.nhs.uk for more information on visiting Arnold Lodge.

Arnold Lodge has an active research group and a strong record of publications together with good links to the Universities of Nottingham and Leicester as well as to the Institute of Mental Health. Medical students coming to Arnold Lodge are encouraged to take part in research whilst they are here, if this is of interest to them. There are a number of “off the shelf” research projects that you could become involved in. These all have the appropriate ethical/research governance approval and the data is collected but are just in need to data analysis and writing up. This if you are interested and able to devote 1-2 days per week of your placement to this then you should be able to get a project done and a first draft written up whilst here; with a strong chance of producing something suitable for publication.

Dr Simon Gibbon, Consultant Forensic Psychiatrist, Arnold Lodge

Medical Student Electives in Forensic Psychiatry

We welcome enquiries from medical students who have an interest in psychiatry and want to find out more about spending all or part of their elective in a forensic mental health setting. Medical students from the United Kingdom and overseas are warmly welcomed.We know that many medical students, even those coming to the end of their undergraduate studies, are very unclear about what career path they want to take. We have plenty of experience and advice to offer. All visits are hosted at Arnold Lodge and we cannot arrange visits to other hospitals such as Rampton Hospital.

It is important to stress that we offer electives for medical students who want additional experience beyond their standard psychiatric undergraduate placements. We cannot offer placements that count towards your medical degree. We will be unable to sign off documents confirming that you have the full experience expected of a substantive undergraduate placement because our service is very specialised. Please come for your elective but don’t come expecting a replacement for your standard undergraduate experience. University of Debrecen undergraduates take note!

What does an elective with the scheme cost?

Nothing. As a state funded, non-profit National Health Service organisation, there is no cost or charge of any kind for elective placements – no admin fees, no booking fees, no tuition fees, no arrangement fees. It’s completely free.

Is there a competitive application process?

No – but for all bookings made from March 2020 (currently booking for placements starting January 2021) we have decided to limit our visitors to just one medical student at once to make sure that everybody has a high quality experience. There may be two people visible in the online calendar but only one will be a medical student – the other will be a visiting doctor. Please find dates on the calendar when there is no medical student booked in and – if the dates are free – then you can come. Please don’t ask if we can slot you in as a second medical student because this isn’t possible.

As with any healthcare setting, certain background checks are necessary, including an identity check and a check with the Disclosure and Barring Service (similar to the former Criminal Records Bureau check). If a placement is arranged, medical students are given an honorary contract with the host Trust for the duration.

VERY IMPORTANT: Your criminal records check (from the country you are visiting from) MUST be less then 3 years old. We do occasionally have problems if people want to come and don’t have a police check or if it is out of date – we have had to cancel visits in these circumstances.

For UK medical students and doctors there is a DBS update service that you can register with for £13 per year. This will make sure that your DBS check is always up to date and is highly recommended.

Wherever you come from in the world, we will need a police certificate. These can take a long time to get hold of in many countries (Egypt, Pakistan and Malaysia especially, in our experience) and you will need to email us a copy before you arrive. We will also need to see the original on the first day that you arrive at Arnold Lodge.

 Is any accommodation available?

We can provide information about accommodation at nearby hospitals in Leicester and on AirBnB – please get in touch for further details. The accommodation is not free, but most people now use AirBnB which offers a range of local options with prices to suit most budgets. We don’t provide accommodation but we can put you in touch with other organisations which do.

What will I be able to see during the elective?

We don’t want you to see, we want you to join in! Our hospital is a relatively small specialist forensic mental health hospital. You will be welcomed as part of a team and will feel included and involved in the work of the team. The hospital stands in its own grounds and is not simply a wards or units within another larger hospitals. We provide a highly specialised service. Most importantly, you will be closely supervised during your time with us. All visits are hosted at Arnold Lodge and we cannot arrange visits to other hospitals such as Rampton Hospital.We can offer a wide range of experiences during your time, often including, but not limited to:

• Assessments of patients in a range of prisons
• Sessions with members of the Offender Health Service, providing regular mental health care in prisons
• Assessments at low, medium and high secure hospitals
• Experience of different in-patient services, including mental illness, personality disorder and specialist services for both men and women
• Attendance at the Crown Court to see forensic psychiatrists giving oral evidence in Court
• Interviews, assessments and reviews with in-patients, including feedback following multidisciplinary team meetings
• Friendly, involving and focused ward rounds/multidisciplinary team meetings, which are actually understandable and interesting
• Assessments and interviews with out-patients
• Assessments of patients for medicolegal purposes, as Expert Witnesses for solicitors, the Crown Prosecution Service and HM Courts Service
• Involvement in risk assessment and formulations of offending behaviour, including tools such as the HCR-20 and RSVP
• Effective multidisciplinary working with Chartered Clinical Psychologists, Social Workers, Registered Mental Health Nurses and Occupational Therapists
• Why not help out the patients with some of our community rehabilitation activities? The allotment needs some attention!

If you want to hear what Tara Ludhra, a medical student from Southampton University, had to say, read Tara Ludhra’s elective report..

Patients often have severe and enduring mental illnesses such as schizophrenia or bipolar affective disorder, together with personality disorder(s), a history of substance and/or alcohol misuse and a significant history of involvement with the criminal justice system. The level of morbidity is high, and we rarely become involved with patients with disorders such as depressive or anxiety disorders of the sort that are common in General Practice and some other psychiatric settings.

Is this right for me – how can I get the most out of the experience?

You will be in charge of your own timetable whilst you are with us. We provide details of all the many opportunities on offer – you have to take the initiative, contact people and make things happen. You will find everyone friendly and supportive, but you will have to phone and email people and actively plan and arrange your time. Otherwise you will have a few very, very quiet weeks sitting in the office! As with all of life, the more you put in, the more you get out. Carpe diem!

That’s a lot – is there anything you don’t do?

We don’t prescribe electroconvulsive therapy (ECT) very often at all. You are unlikely to meet patients who have had ECT and very unlikely to be involved in ECT. We also have relatively little contact with General Practitioners (GPs) or with general psychiatric services. Most of our referrals come from prisons and other secure hospitals. All visits are hosted at Arnold Lodge and we cannot arrange visits to other hospitals such as Rampton Hospital.

What happens during a typical week?

The weekly routine varies widely according to the hospital, but there is a general pattern. One day is usually reserved for the Clinical Governance Programme (an academic programme or grand round in general medical terms), as well as meetings to plan forthcoming discharges, admissions and referrals.

One day will be set aside for the Multidisciplinary Team Meeting (a ward round) which may take anything from 3 hours to 5 hours. These are not like the classical MDT meeting of medical student nightmares, with complex, incomprehensible technical discussions between academically inclined histopathologists about classification and staging of malignancies you have never heard of and patients you will never meet. These are focused, clinical meetings, often involving the patients themselves, to plan treatment of specific problems relating to mental health and risk. You should feel included and welcome in these meetings, and you will be involved in discussions with the patients both within and outside these meetings, including giving feedback to the patients about the outcome of the meeting.

Other days will involve Care Programme Approach (CPA) meetings, with the members of the clinical team as well as patients, carers, commissioners, prison healthcare staff, probation officers, advocates, solicitors and often others as well. These meetings review the patient’s progress over the last few months and plan the treatment for the next few months.Much of the rest of the time is unstructured. Clinics are relatively uncommon in forensic mental health services and we do not have any operating lists!

The rest of the time will be spent meeting patients on the wards, helping with group activities and therapies in the hospital and carrying out assessments in other hospitals and prison. Our trainees have a busy and varied timetable of teaching others and being taught. You will be welcome to attend these teaching opportunities and to help out.

Can I help with an audit?

The answer is definitely yes. Our hospitals are lively clinical and academic communities, with a healthy and stimulating level of research and audit. There are always audits underway and your help with these would be most welcome. All work will, of course, be supervised and you will be given full credit for your contribution. Taking part in clinical audit as an undergraduate can be a useful way to gain points to help with the application process for Foundation Year jobs. Many Foundation Year schemes use a points-based system to allocate applicants to jobs, and involvement with audit is often awarded significant points.

The timetables for medical student placements are flexible. There will be significant time for self-directed activities and plenty of time to help with an audit if this is of interest. Depending on the timing of your placement, you may be able to co-present the audit at a Clinical Governance programme with one of our trainees.

Can you give an example of a typical patient?

We cannot give examples of real patients as we are committed to maintaining confidentialty, but a search of Google News for “forensic psychiatrist court uk” will make for interesting reading.

Mr Smith, a patient with a long history of partially treated psychosis, substance misuse and emotionally unstable and dissocial personality traits, has been difficult to engage with treatment in the community. After several/many years of unsuccessful treatment and relatively minor criminal behaviour, a social crisis leads to increased use of illicit substances and a serious criminal offence, for example homicide, arson or sexual offending.Mr Smith is arrested, interviewed and remanded into custody at a local prison. The prison staff become aware that his behaviour is grossly disordered and that he appears mentally unwell. He is assessed by a forensic mental health team from a secure in-patient unit and quickly transferred to an admission ward in the secure mental health hospital, under The Mental Health Act 1983.On admission, he is floridly psychotic, with auditory hallucinations, paranoid delusions and marked self-neglect. He does not believe that he is unwell and refuses oral medication. An antipsychotic depot injection is prescribed. Mr Smith is unhappy and feels that he is being held against his will and persecuted by hospital staff, who he believes are poisoning him.Expert opinion is requested by the defence and prosecution, which identifies partially treated paranoid schizophrenia. After reading reports and hearing oral evidence in Court from the trainee forensic psychiatrist, the Judge imposes a Section 37/41 Hospital Order with Restrictions and Mr Smith returns to hospital for treatment.Over the next few months, with intensive help, support and encouragement from the multidisciplinary team, who often meet his family, Mr Smith makes a very significant recovery from the psychotic illness and develops an understanding that the hospital staff are there to help. Mr Smith and his family take part in education to develop their understanding of mental illness and to learn about the dangers of substance misuse in their particular case.Several years after the index offence, Mr Smith moves to a less secure hospital and then out into the community. After some time living in supported accommodation, he returns successfully to independent living, stable on medication and with robust support from a community forensic mental health team. The Section 41 Restriction Order remains in place to ensure that the option to return Mr Smith to hospital for prompt treatment is available in case of a relapse of the illness. He returns to live a full life without the substances and alcohol which were such a problem previously.

Is there anything else to do in Leicester?

Yes – have a look at the Guide to Leicester by Emily Cole, a medical student from New Zealand. If you’re from overseas, remember that London is just an hour away by train…

How do I apply?

Like you, we are busy people, so we like to keep things simple, quick and easy.

1 Identify a slot on the visitors’ calendar here. We can accommodate a maximum of one medical student at once, so find a time when no medical student is listed as visiting. (Sometimes more than 1 student is listed as visiting at once, due to exceptional circumstances. Please find a time when there is no medical student listed – we are unable to accept requests to exceed our maximum of one student at one time. Please don’t ask!) Medical students and doctors are clearly differentiated in the online calendar – we plan to have one medical student and one doctor at the same time, but not two medical students.

2 Email charmaine.everson@nottshc.nhs.uk with your CV and the exact dates you would like.

3 Wait for your confirmation email.

4 Find or apply for a police certificate in your home country – you will need to send us a copy before you arrive and bring the original on your first day. **The certificate must be less than 3 years old when you arrive or you won’t be allowed to come in to the hospital**

4 That really is it. Feel free to email with any questions you have at any stage. We will be in touch 2-3 months before your arrival.

FAQs

You already have one medical student visiting when I would like to come. Is there any way I could be accommodated?

Sadly, this will not be possible. We have set a maximum of one medical student at once to make sure that we can offer a varied and interesting experience. One really is the maximum. Sorry! We plan to have a medical student and doctor visiting at the same time but never more than one medical student. Medical students and doctors are clearly differentiated on the calendar.

We want this process to be streamlined – we do not need these other things that people sometimes ask about:

• Immunisation histories
• Certificates of good conduct
• Your medical records
• To carry out physical examinations on you to make sure you are healthy (people actually ask about this – please don’t!!)
• Academic references
• Letters of recommendation

Where have people visited from?

We have been delighted to have visitors from all over the world. Many medical students have visited from Leicester, Nottingham and Derby, our three nearest medical schools. We have also hosted medical students from Liverpool, Southampton, London, Cardiff, Yorkshire, Keele, Plymouth, Sheffield, Birmingham, Warwick and Dublin.

Visitors on placements from Europe have come from Hungary, Spain, Portugal, Poland, the Republic of Ireland and Cyprus.

From Australia, we have seen students from the Universities of Melbourne, Monash, Newcastle, Western Australia, Tasmania, New South Wales as well as James Cook University.

Other countries have included Malaysia, New Zealand, South Korea, Brazil, Hong Kong and the United States of America.

We welcome people from all over the world. Some of the Consultant Forensic Psychiatrists working in our area are keen to extend a particular invitation to visitors from the 53 countries within the Commonwealth. Feel free to contact Dr Obinwa at the Kedleston Low Secure Unit in Derby directly in relation to placements at  Kedleston.

What do medical students say about visiting?

Lauren Jones, University of Nottingham, UK

My four week elective placement at Arnold Lodge was one of the most interesting experiences I have had. There was a chance for independent organisation of activities so I could choose how to spend my time depending on my interests, including audit work and gathering data for research. I was also able to visit court, the prison service, observe an inquest and learn about the role of the different disciplines within the MDT meetings. The staff were very helpful and welcoming and also eager to teach. The time I spent at Arnold Lodge gave me an insight into a unique specialty with plenty of opportunities to become involved with – I only wish my placement could have been longer!

Stephen Tan, University of Malaya School of Medicine, Malaysia

I looked at Australia for my elective but it was really expensive. I looked at King’s College and Imperial College in London but the application processes were really long. The posting overall was fantastic and the opportunity to do an audit was great. I was able to see most if not all of the activities listed.

Natalie Puchalski, University of Newcastle, Australia

I will remember this experience as a highlight of my medical studies!

Emily Cole, University of Auckland, New Zealand

Jasmeen Kang and Miyah Frank-Beaumont, University of Leicester

We didn’t know a great deal about the field of Forensics but were lucky enough to be able to spend a day at Arnold Lodge.Sitting in ward round was really informative and we were
able to see patients later in the afternoon. We’ve learned a lot more about how exciting a career in Forensic Psychiatry can be and are grateful for the opportunity!

Famia Askari, University of Leicester

I thoroughly enjoyed my time at Arnold Lodge and am grateful to the staff for being so welcoming and making us feel like part of the team. I appreciate the time spent explaining the workings of the facilities, patient backgrounds and answering any questions I had (no matter how basic!) After previously visiting Rampton I was curious to see how Arnold Lodge would compare and it was fascinating to see the similarities in security features, such as the design of the seclusion rooms and personal alarms. I was fortunate enough to be part of the extensive multi-disciplinary ward round and it was great to see a variety of healthcare workers involved including not only doctors and nurses but also an OT and clinical psychologist (to name a few). It was truly an example of holistic medicine and a chance to see the BioPsychoSocial model applied to patient care. I found the medico-legal aspects particularly interesting which prompted ethical questions regarding sectioning and provided useful revision for my mental health block. Although I was only there for the day, it was an enriching experience and the visit has definitely inspired me to explore Forensic Psychiatry further and strongly consider Psychiatry as a future career. 

Marie Bolton, Final Year Medical Student, University College Dublin, Republic of Ireland

During my placement I had the opportunity to interact with a myriad of clients in an array of forensic psychiatry facilities. I spent the vast majority of my placement interacting with clients, both male and female, within Arnold lodge – accompanying the medical team, attending multi-disciplinary team meetings (MDTs), client feedback sessions, occupational therapy interactions and psychology group therapy sessions. These interactions provided me with the opportunity to traverse the clients’ journeys, affording me the chance to gain a deeper insight into the patients as individuals – not static beings. Individuals for whom bio- psycho- and social factors alongside socio-cultural and economic issues had shaped their lives. Furthermore I was afforded the opportunity to attend out-patient clinics which were based in a low secure facility and also attend the local Magistrates’ Courts. Thus I had the opportunity to traverse journeys akin to that experienced by the clients – through the courts, through the various secure facilities into community care. A special thank you to all the staff who ensured my elective was a thoroughly enjoyable educational experience. I felt incredibly fortunate to have been afforded such a wonderful opportunity and I would recommend an elective at Arnold Lodge unconditionally.

Rose Winter, The Hull York Medical School

I spent the whole of my 7 week elective period at Arnold Lodge and found it a thoroughly enjoyable experience. During my elective I spent time with women’s, personality disorder and male mental illness services. As well as this, I spent time with forensic psychiatrists in prison and at high and low secure forensic units.

There are a huge variety of different things to see at Arnold Lodge and I tried to see as much as possible to gain a wider knowledge and understanding of the subject. The culture is very multi-disciplinary and teams include nurses, social workers, psychologists and occupational therapists. It’s really interesting to learn about the roles of each member of the team, in a way that you may not get the chance to in other areas of medicine. There are a number of other places to visit outside Arnold Lodge such as prison, other units, Court, etc. which the staff were more than happy to help organise. All of the staff I met on my elective were really helpful and I would thoroughly recommend an elective at Arnold Lodge. It is a great opportunity to learn about a specialty that we very rarely get to experience during our training.

Claire Bunning, final year medical student, University of Leicester

I had a great time during my three week elective at Arnold Lodge medium secure unit and found this an invaluable experience to broaden my knowledge of Forensic Psychiatry. I had previously spent two days at a low secure unit and was keen learn more, as this is an area of medicine which I find interesting but which is sadly only briefly focused on during medical school. During my elective I was able to visit various prisons throughout the East Midlands with the Psychiatrists during their assessments. I attended the ward rounds of the different areas e.g Male PD Service and Male Mental Illness Service, seeing how they differed and also allowing me insight into the patients, their histories and their management. I was also able to attend a Mental Health Review Tribunal and take part in a patient practise session for a patient led session on bullying as part of the recovery college programme. There was the opportunity for learning with regard to the academic programme on Mondays (with a free lunch!), I also attended PSPT teaching de-escalation and break away techniques and the MRCPsych Forensics day. The staff at Arnold Lodge were all friendly, welcoming and approachable and keen to answer any questions I had and to let me tag along with them. I would highly recommend Arnold Lodge as an elective destination.

Ian Peake, 5th year medical student, University of Nottingham

I decided to use my elective period to gain some experience in Forensic Psychiatry, since I have a strong interest in Psychiatry in general, but had little exposure to the Forensic sub-specialty during my undergraduate placement.I spent all six weeks of my elective based with the team at Arnold Lodge medium-secure unit in Leicester. I was able to see the management of patients across the Male Mental Illness, Personality Disorder and Women’s services. This took the form of speaking with patients on the wards, reviewing patients in seclusion and attending ward rounds and CPA meetings with professionals from other disciplines. I was also able to follow members of the team as they visited patients in other locations across the midlands. Seeing patients in high-secure units, young people’s medium-secure units and prisons was a great way to gain a wider understanding of the service. The secure units I visited were all well-resourced and staffed by multi-disciplinary teams who were welcoming and helpful, taking the time to explain concepts to me and answer any questions. I thoroughly enjoyed my time in Forensic Psychiatry and would recommend the service in the East Midlands as an elective destination for anyone interested in Forensic or Psychiatry in general.

Daphne Cohen, 6th year medical student, University of Otago, New Zealand

I thoroughly enjoyed my 4 weeks at Arnold Lodge and I can highly recommend it as an elective destination! I found it very easy to organise and they were keen to have medical students. I was primarily with the Male Mental Illness team, but staff from the other services (Women’s and Personality Disorders) were more than happy for me to spend time with them. Everyone here is very approachable and happy to explain their work, so don’t be afraid to ask! There’s a lot to see and do – most of my time was spent seeing patients either at Arnold Lodge or travelling to other units across the country with the team to carry out assessments and reviews. There’s also an academic programme on Mondays which is a good opportunity to refresh some Psych knowledge, and plenty of time with the team discussing patients, making treatment decisions and getting a feel for the day-to-day challenges of running Arnold Lodge. The MDT is central to the work done here and I found talking to the non-medical team members helped me gain a more complete theoretical and practical understanding of mental illness and its treatment. While security is an ever-present concern, as other students have said, at no time did I ever feel unsafe. Arnold Lodge is a lovely modern building and a pleasant environment to work in. There is also a lot of opportunity to mix learning with leisure, so if you’re new to the UK like me take the time to explore and travel. Forensic psychiatry is a subspecialty most medical students will not have the opportunity to see – make the most of it!

Anne Frawley, 4th year medical student, Szeged University, Hungary

Before beginning my placement at Arnold Lodge I really had no idea how a modern psychiatric unit ran, let alone a specialised forensic psychiatric unit. Like most people not directly involved in psychiatry I imagined psychiatric medicine to be a slow paced, ineffectual poor relation of modern medicine that made little impact in the day to day lives of its patients. However, nothing could be further from the truth; the unit at Arnold Lodge is a thoroughly modern facility which embodies the ethos of patients working in partnership with medical and legal professionals, social workers and independent advocacy groups to promote recovery, sustain heath and equip patients with the life skills so as to enable them attain their full potential in life. The work in a medium secure forensic psychiatry unit is never dull and it requires an acute medical acumen to diagnose and treat patients with complex medical, social and psychological issues. I found the staff at Arnold Lodge very open and welcoming; the clinical team encouraged and facilitated me to actively participate and observe a wide range of treatments options that are available at Arnold Lodge. An average week begins with the Monday morning communications meeting whereby all branches of staff are invited to attend and share their experiences of how patients progressed over the weekend. Also, potential admissions and discharges are discussed as well as upcoming Care Programme Approach (CPA) and Mental Health Review Tribunal (MHRT) meetings. A CPA is a biannual legally enshrined forum where patients, their family, their legal team or anyone that the patient wishes to represent them may discuss in conjunction with medicine, nursing, psychology, occupational therapy and social work departments how best to proceed with future care. Sometimes patients have a good insight into their problem and then there is little discord. However, when dealing with patients who are floridly psychotic or who have limited insight into their problems then the CPA meeting is challenging and it takes considerable effort and skill to build up a therapeutic relationship of trust and harmony so as all parties can reach agreement on the best treatment option. As well as clinical skills, psychiatry requires determination and resolve as some interventions that promote sustainable recovery require lots of time. This can be years in some cases although a rapid recovery is often very clear in some conditions also, such as the early phase of acute psychosis, especially when the appropriate medicine is used, so I guess the take home message is “Yes – the drugs do work”. Another common occurrence in a forensic psychiatry unit is the MHRT. This is a forum where patients can challenge the length of their confinement or any other aspect of their care. The challenge is made to an independent panel comprising of independent legal, medical and community representatives. It is a very fair system which ensures patient autonomy is not breached either knowingly or unknowingly. Although security is an ever present concern when walking into a ward every effort is made to make it resemble home life as much as possible. A range of activities are provided so as to teach patients how to have meaningful relationships in the personal and social spheres; as well as teaching them skills to cope with the activities of daily living and general problem solving skills. Additionally research takes place at Arnold Lodge and I had the opportunity to participate in this work. As in all branches of medicine, psychiatry follows an “evidence based approach” so as to critically evaluate current therapies and to offer better therapies in the future, and the staff at Arnold Lodge are fully supportive of this approach. I would like to conclude by stating that my elective experience here at Arnold Lodge has been a resoundingly positive experience, which has given me a fascinating insight into the world of metal illnesses and the range of therapeutic options that exist to treat them. I found interviewing the patients themselves and understanding their histories very insightful in aiding my understanding my understanding of mental illness. I found the patients to be capable, intelligent human beings who had insight into their problems and, when empowered with the right tools, could actually actively participate in their own recovery.

Rachna Joshi, 4th year medical student, Penninsula College of Medicine and Dentistry

I would definitely recommend Arnold Lodge as an elective destination for anybody who is interested in, or even curious about, the world of Forensic Psychiatry. This is the perfect opportunity to experience a sub-speciality that most medical students rarely have the chance to see.I spent most of my elective seeing inpatients as well as going to Court hearings and participating in initial assessments. There was a lot of freedom with the timetable and plenty of opportunities to pursue any particular interests such as the Women’s Service, the Personality Disorder (PD) service or understanding the structure of the medico-legal system. Leicester is a very multicultural city which is sometimes reflected in the patients you may see. There may be language barriers, cultural differences and religious practices you may never have heard of, but which play an important part in these patient’s lives. Dr. Taylor and the team are approachable, friendly and keen to teach. The elective was easy to organise and the staff were very flexible to suit the dates I was available. Overall, I found my time at Arnold Lodge inspiring, educational and enjoyable! I was well-supported throughout and would certainly recommend it!

Laura Harvey, Cardiff University

I’ve had a wonderful 4 weeks at Arnold Lodge, it’s been a perfect opportunity to gain insight and experience in Forensic Psychiatry, something that wasn’t offered at my Medical School. During my placement I’ve gained experience in both low and high security hospitals; had the opportunity to meet patients at both Leicester and Nottingham Prisons, and I’ve even attended a psychiatry conference with my team. I’ve also had opportunities to understand the medico-legal side of the career by attending court hearings and assessments, and meeting with patients’ Barristers and Solicitors. At Arnold Lodge the majority of my time has been spent with the Male Mental Illness team, but I have also been able to attend Personality Disorder assessments, and spent time with the Women’s Service. My Arnold Lodge experience has been not only welcoming, engaging and relaxed, but the full support and help from the team and Consultant have allowed me the freedom to timetable any specific opportunities I wanted get out of the placement.For anyone interested in gaining an understanding and experience of Forensic Psychiatry I would highly recommend spending time at Arnold Lodge wholeheartedly.

Junior Doctors

We welcome doctors who want to spend some time with us in Forensic Psychiatry. The Royal College of Psychiatrists has developed the concept of “Taster Weeks” which we are proud to support. We offer taster weeks within many of our services, coordinated by experienced and enthusiastic Consultants. Many doctors have visited us for variable periods of time. We are happy to host your visit for an hour, half a day, a full day, a few days, a week or longer. We really are flexible and are happy to work around your schedule. We know how difficult it can be with rotas, nights and so on. These problems seem to be getting worse for junior doctors these days. 

If you are considering a career in psychiatry or simply want to know more about our small and highly specialised branch of medicine, simply get in touch. We offer the chance to get involved in small, clearly defined research projects and to take part in audit cycles. You will receive full credit for all work done, which can help with future career prospects. All visits are hosted at Arnold Lodge and we cannot arrange visits to other hospitals such as Rampton Hospital.

For enthusiastic doctors, perhaps with an interest in research, there is a real prospect of an academic publication in a peer-reviewed journal. Smaller pieces of work are welcome as contributions for this website. 

Like many places, we have great trouble recruiting high quality Speciality Doctors in Forensic Psychiatry. If you are looking for a Speciality Doctor post, please get in touch. We welcome expressions of interest in locum Speciality Doctor posts as well as substantive Speciality Doctor posts. There’s no commitment at all but it is worth a quick email to charmaine.everson@nottshc.nhs.uk.

We have hosted visits for trainee doctors from Cyprus, Brazil, Taiwan, Spain, Greece, Portugal, France, Italy and elsewhere.

How do I apply as a junior doctor?

Like you, we are busy people, so we like to keep things simple, quick and easy. You probably don’t have the luxury of a 4-6 week placement like a medical student looking for an elective, so the best thing to do is to drop an email to charmaine.everson@nottshc.nhs.uk. We can then get in touch and find the most convenient time, as well as make sure that the experience is tailored to your interests. You are welcome to come for a morning, a day, a few days, a week or longer – we are flexible. Feel free to ring 0116 207 7786 if you prefer, but email is generally better. All visits are hosted at Arnold Lodge and we cannot arrange visits to other hospitals such as Rampton Hospital.

Dr Adnaan Haq, FY Doctor

Placement at Arnold Lodge – January 2015

Many many thanks for an absolutely fascinating week in forensic psychiatry. I never considered a career in psychiatry but the taster week in forensics has truly opened up my mind. Forensic Psychiatry is by far and away the most interesting specialty I have come across, and the excitement of going to see a patient for an assessment was exhilarating, insightful and just plain cool!

Dr Mark Harris, FY1 Doctor

Placement at Arnold Lodge – September 2013

I was recently fortunate enough to undertake a taster week placement at the Arnold Lodge Medium Secure Unit in Leicester. This placement provided valuable insight into the sub-speciality of Forensic Psychiatry and certainly strengthened my resolve to pursue a career in this fascinating sub-speciality following the completion of my foundation training. During my placement at Arnold Lodge I was able to gain important insight into the role of the forensic psychiatrist in both a clinical and medico-legal context. Alongside the consultant and his team, I visited patients on the wards and in seclusion and gained valuable insight into the complex and varied needs of the patients within the unit. The experience really impressed upon me the skill required by the clinician when interacting with patients with complex psychiatric histories and illnesses. I was able to participate in interesting and informative discussions while at Arnold Lodge and learned a great deal regarding clinical assessment and management in the forensic setting. I thoroughly enjoyed my taster week placement at Arnold Lodge and am hoping to visit the facility in the future to enhance my experience and knowledge of Forensic Psychiatry. The consultant and the rest of the team were welcoming and enthusiastic and certainly ensured that my placement was informative, educational and inspiring. I would certainly recommend that any medical student or foundation doctor with an interest in forensic psychiatry consider a placement at Arnold Lodge as overall the experience was fantastic.

Dr Andrew Aziz, CT2 doctor

I really enjoyed my taster week at Arnold Lodge. I got to see forensic psychiatry up close and was given a great insight into what it involves. The patients are very complex and needs are very different. The benefits of the facility is we have time to rehabilitate and treat their mental illness. In my short time, I saw patients who had committed serious crimes secondary to their mental illness but were now functioning well with mental illness much improved after the treatment.Dr Taylor and Dr Langley are so welcoming and I would advise any doctor to do a taster week in forensic psychiatry here as it is so different to both general adult psychiatry and the hospital medicine we see now.

International Fellowships in Forensic Psychiatry

Forensic psychiatric services are relatively uncommon on the global scale. Many countries have no dedicated forensic psychiatric services and only limited provision of mental healthcare in custodial settings. We are fortunate that these services are well-developed in the United Kingdom. Compared to many other areas of the world, the governance and support structures are well established and the practice of forensic mental healthcare is high quality, well integrated with the criminal justice system and subject to robust regulation and oversight. Expert multidisciplinary care is central to effective mental health care provision and the United Kingdom can be proud of the high quality of care which patients receive. Staff in the UK forensic mental health system are highly trained in effective Prevention and Management of Violence and Aggression (PMVA). Use of PMVA techniques is proportionate, sensitive to patients’ individual needs and usually avoided altogether by an empathic, sensitive, patient-centred approach.Relative to many other countries, challenging behaviour is managed sensitively by empathic, collaborative and highly trained staff, rather than high doses of medication .

Staff work with patients to help them to develop the skills to manage their own difficulties and frustrations. Compared to other countries, the use of seclusion facilities is highly regulated.  Adequately resourced and expert multidisciplinary care ensures that seclusion is used as an option of last resort, and never simply for the management of self-harming behaviour. We welcome visitors from overseas who are looking to create or develop forensic mental health services in their own countries. You are welcome to visit our services and learn and work alongside us to develop more effective services. Trainee psychiatrists are particularly welcome and can expect to gain wide experience of forensic mental health settings relevant to their own experience and the development needs of their services. We can provide a high quality experience tailored to the needs of individuals, but we do not provide funding for placements. All visits are hosted at Arnold Lodge and we cannot arrange visits to other hospitals such as Rampton Hospital.

How do I apply for an International Fellowship?

1 Identify a slot on the visitors’ calendar here. We can accommodate a maximum of one doctor at once, so find a time when no doctor already listed as visiting.

2 Email Charmaine Everson with your CV and the exact dates you would like.

3 Wait for your confirmation email.

4 That really is it. Feel free to email with any questions you have at any stage – especially about visas, insurance and other arrangements. We will be in touch again 2-3 months before your arrival regarding identity checks. You will need a police certificate.

5 We would love to hear about how your country’s system differs from the UK. It would be great if you would give an informal talk at the academic meeting in our hospital whilst you are with us.

Dr Marianna Tantele, Cyprus

My name is Marianna and I am a senior psychiatry trainee in Cyprus. As part of our training we are encouraged to pursue a 4 month clinical attachment to qualified psychiatric services of our choosing. My special field of interest is in Forensic Psychiatry. I chose to come to the UK because of the high standard of services provided in the country. Time spent in East Midlands Forensic Services gave me a valuable opportunity to get a good understanding about Forensic Psychiatry Services in the UK. I was mainly based in Arnold Lodge which is a medium security hospital in Leicester. During my placement there i had the chance to:

• Attend multidisciplinary team ward rounds, including giving feedback to patients
• Participate in in-patient interviews and risk assessments
• Attend Care Programme Approach meetings
• Attend Tribunals
• Take part in assessments for access for secure services
• Attend the Arnold Lodge academic programme
• Go to various interesting courses, conferences and psychotherapy supervision meetings
• Visit various prisons and Young Offender Institutions
• Visit Rampton High Secure Hospital in Lincolnshire

Additionally I spent time in other clinical settings including

• The Wells Road Centre in Nottingham
• Community forensic services in Nottingham and Lincoln

Prison mental health services

Furthermore I was exposed to numerous interesting medicolegal assessments. Finally I was very lucky to attend Crown Court proceedings where forensic psychiatrists gave oral evidence in court as expert witnesses.This was a really worthwhile and unforgettable experience for me for many reasons.

• Had a good overview about forensic psychiatry services
• Felt really welcome and looked after
• Met inspiring people
• Had the chance to get to know England better