Royal Blackburn Hospital Psych Review

Royal Blackburn Hospital, new building

Hi everyone! I’d like to give a review of my Psych Rotation at Royal Blackburn Hospital in Blackburn, England.

About Blackburn

Blackburn is located in Lancashire county in northern England. With a population of 105,000, Blackburn is about 25 miles north of Manchester, the UK’s third largest city, and 226 miles north of London. The best way to get here is to fly into Manchester and take a train to Blackburn.

Blackburn is right in the middle of some of England’s most gorgeous natural regions: The Lake District, Peak District, the Ribble Valley, The Pennines, and Yorkshire Dales (think Harry Potter and the Deathly Hallows). Blackburn is also in close proximity to Scotland and Wales, and just across the water from Ireland and the Isle of Man, making these places very accessible to visit.

Blackburn is a city with a large working-class population, and it is culturally diverse, with the second largest South Asian (i.e. India, Pakistan) population in the UK.

Hospital

The Royal Blackburn Hospital is a 950-bed NHS hospital located outside of downtown Blackburn. The East Lancashire Hospital NHS Trust, of which Royal Blackburn Hospital is a part, sees 456,000 outpatients and 97,000 inpatients each year and employs over 6500 people. The Royal Blackburn Hospital has new facilities, mostly built in 2006. The Learning Centre on the hospital campus has classrooms, seminar rooms, and an auditorium where we attend Problem-Based Learning sessions, lectures, and skills sessions. As AUC Students, we can do any (or all) of the five core rotations here (Psych, Peds, IM, OB/GYN, Surgery).  The Royal Blackburn Hospital also offer electives in subspecialties in medicine, surgery, pediatrics, and OB/GYN.

Most of the time, you may be rotating at Royal Blackburn Hospital, but sometimes you may also be assigned to go to other locations affiliated with the hospital for part of the rotation. The hospital provides all the transportation for you, so if you are assigned to rotate at RBH’s sister hospital, Burnley Hospital, or at the annex at Daisyfield Mill, they will provide free transportation to get you there.

Housing

The hospital can arrange housing for AUC students. The dorms here are single rooms, furnished with a bed, bedside table, study desk, bookshelf, drawers, wardrobe, chair, sink, and mirrors. Each room has a heater, and comes with blanket, bed sheets, pillow, towels, and clothes hangers. The pillows are a little flat though, so if you come, I would suggest either buying one here or bringing your own. All of us AUC students live together on the same end of the hallway in the dorms. We each have our own bedrooms, but we share a bathroom (2 showers, 2 toilets), as well as a kitchen and TV lounge. There are stoves, microwave, and fridge in the kitchen, there are plates, silverwear, and cups available for us to use. There is also an iron and ironing board for us to use for free, as well as coin washers and dryers. The showers and toilets are cleaned everyday, and every week, a housekeeper comes by to deliver clean bed linens and towels for free, as well as dump out your trash for you. They also come clean your room once a week. The rest of the dorms are occupied by UK medical students from Manchester, staff, and doctors. The dorms are usually not completely occupied, so there really isn’t any problem with noise. The dorm rent is £195/month, which is around US $300/month.

The student/staff dorms on the Royal Blackburn Hospital campus is just a few steps away from the hospital, along with the classrooms, medical library, cafeteria, and gym. The gym and library are open 24/7.

Rotation Schedule

I am rotating 1 week with the Crisis Response and Home Treatment Team (CRHTT), 2 weeks with the Complex Care Treatment Team (CCTT), 1 week in the men’s inpatient psychiatric ward, 1 week in the women’s inpatient psychiatric ward, and 1 week in the inpatient Psychiatric Intensive Care Unit (PICU), which is for patients with extreme or difficult cases. I think this is a good schedule as I will get to see different aspects of Psychiatry from more manageable cases to more difficult cases, to the acute cases and chronic cases. The attendings and departments you are assigned to will vary from student to student depending on which attendings are available. I know some other students who rotated here who were also assigned to the pediatric psychiatry unit.

My main preceptor is Dr. Adelekan. He had come to the AUC Clinical Symposium on the island last May to represent Royal Blackburn Hospital and to meet with students, so he was very familiar with AUC and the students. I rotated my first week with Dr. Adelekan, and later had a different attending at each unit that I rotate in, but I ultimately report back to him in the end. As I am the only student currently in Psych here from AUC, he had taught me one-on-one when I rotated in his unit. Dr. Adelekan has had more than 30 years of experience in the practice of Psychiatry and he explains things thoroughly and methodically. For each patient I see, he asked me to do a write up, including patient history, working diagnosis, differential, and treatment, kind of like what we were taught to do in ICM on the island. Dr. Adelekan also gave me material to read and study.

Average Day

I go on my rotations five days a week from Monday to Friday. Each morning from around 9:30am to 12pm, I attend ward rounds in which the consultant doctor, nurse, social worker and other members of the health care team reviews and assesses a select number of patients seen that morning, on average around 4 patients per morning. The assessment may be for any reason: A new patient who needs to be assessed and have a full history taken, a patient who is doing well and is going through discharge planning, or simply a patient who needs a routine review. For each patient, the health care team will usually read the patient’s history, update the doctor on recent encounters with the patient, and then the team will discuss what they want to discuss with the patient, what to tell the patient, and what approach to take to talk with the patient. The patient will then come in to the interview room where the doctor will talk with the patient and find out how the patient is doing with the current treatments, and inform them of any treatment plan changes.

From 12pm to 1pm, I usually go eat lunch at the cafeteria in the hospital. It’s only a few steps away from the Psych Ward, so it’s very convenient to go to. The food is ok, as good as hospital food can get, but it’s convenient and fills the stomach, which is most important… they have a salad bar, hot foods, sandwiches, as well as prepared snacks and desserts.

At 1pm I usually return to the ward, and talk to patients, take full histories and conduct mental status examinations. I would then meet with one of the ward doctors and present the history, and he/she will give me feedback, teach me different topics, and give me some material to read up on. I usually come home around 4pm, but they won’t stop you if you want to stay longer, or come back earlier to study.

Lectures

Every Wednesday afternoons at 1pm, I go to Teaching Sessions given to Junior Doctors at the hospital. As it is located at Royal Blackburn Hospital’s sister hospital, Burnley Hospital, in Burnley, the next town over, I take a half-hour free bus ride there. During the teaching session, there is usually a unique case presented by a junior doctor and discussed, as well as a journal club in which a junior doctor presents research studies pertaining to the practice of Psychiatry. Sometimes, there may also be workshops that teach certain skills for Psychiatrists.

The AUC Clinical Leads at Royal Blackburn Hospital (Dr. Sibley and Dr. Coutts) do their best to have a unique curriculum for AUC students that differs from the curriculum for the University of Manchester medical students who also rotate at the hospital. Every Thursday afternoons at 1pm, I go to Problem-based Learning (PBL) Sessions. These sessions are held exclusively for us AUC students, and we are all required to attend it, even though we may be rotating in different specialties. During the PBL session, Dr. Sibley and/or Dr. Coutts usually goes over a typical Step II-style case and we discuss how we should approach the case, what we should think of, what our differentials should be, and how to test for them or treat them. We would also go over cases that we’ve seen ourselves so far in our rotations and discuss it in the group.

In addition, the AUC program at Blackburn has set up two Sim Man sessions exclusively for the six of us AUC students who are there right now. They have also set up a morning visit to the Children’s Hospice for us, which I will go to next week with a group of my AUC colleagues. Currently they are also working out a few additional skills workshops for us that are optional.

Overall Impression

This is my first rotation, so I haven’t had other rotations to compare it with. However, I like the rotation and I feel the attendings are very willing to teach, and direct you to see interesting cases. I feel the attendings are very flexible in tailoring what you do on the ward to what you want to get out of the rotation. They will ask you what you want to gain from the rotation, and they’ll do their best to make it happen.

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