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Identification of individuals with an at-risk mental state (ARMS) who are at a heightened risk of developing psychosis allows researchers and clinicians to identify what factors are associated with poorer outcomes and transitions to psychosis. A number of socioenvironmental factors are linked to an increase risk of developing psychosis, of which childhood trauma is widely acknowledged. The current review aims to examine what impact trauma has on the ARMS by reviewing reported relationships between trauma variables and transition to psychosis, ARMS severity, adaptive functioning and comorbid symptomology from both cross sectional and prospective design studies. A literature search was conducted for all relevant original research articles published in the English language up to December 2015 using 3 electronic databases: PsycINFO, Web of Science and PubMed. A total of 6 papers met the inclusion criteria and were included in the current review. Trauma was found to have a significant impact on the ARMS observed through reported relationships between trauma variables and transition to psychosis, ARMS severity, adaptive functioning and comorbid symptomology. Sexual trauma demonstrated the most consistent trauma variable to impact the ARMS. Individuals with an ARMS who have experienced sexual trauma are at a heightened risk of poorer outcomes and transitions to psychosis. Further prospective design studies are required to examine this observation further.

Aims and method Northern Ireland presents itself as an anomaly – a region in which only 31.8% of doctors enter into any training programme after completion of the Foundation Programme, but where Core Psychiatry has been consistently oversubscribed. Here, we aim to find what other regions can learn from this success. All doctors of any grade, working in psychiatry, who had been though the Foundation Programme were questioned on their motivations for becoming a psychiatry trainee. Results Sixty-two doctors currently working in psychiatry responded, including over 60% of current trainees, and 45% stated they had not considered a career in psychiatry before their foundation attachment. Over 80% preferred foundation placements in FY2 only, rather than in either foundation year 1 or FY2. Clinical implications This survey identifies that for the majority of people who ultimately chose to train in psychiatry, in a region that has consistently attracted candidates to core and higher level training, completion of a foundation psychiatry post was an influencing factor in this decision. A strong majority of doctors prefer the foundation psychiatry placement to be offered in FY2.

AimsTo improve postgraduate psychiatry education and training in Northern Ireland.BackgroundHistorically within Northern Ireland there has been a postgraduate Member of the Royal College of Psychiatrists (MRCPsych) teaching programme delivered to core trainees in preparation for MRCPsych examinations. There has been no official teaching programme for higher trainees. Northern Ireland Medical and Dental Training Agency (NIMDTA), in collaboration with the Royal College of Psychiatrists in Northern Ireland and all five Trusts developed the novel idea of introducing Postgraduate Education Fellows, to oversee and improve core training, and to develop a bespoke higher training programme.The Postgraduate Education Fellows met to collate information from various sources in relation to issues within the current teaching programme and address these along with the development of new initiatives. The fellows further act as a point of contact for all trainees within their Trust to provide advice and support with education if needed.MethodOne higher trainee was appointed to the role of Postgraduate Education Fellow in each Trust within the NIMDTA deanery for a term of 1 year.The starting point was delivering the pre-established teaching timetable and gaining feedback from core trainees to identify areas for improvement. The next phase involved piloting traditional and contemporary methods of feedback. A further development was designing a mock paper A delivered under exam conditions. Two mock Clinical Assessment of Skills and Competencies (CASC) exams were organised under exam conditions, offering other trainees the opportunity to act as simulated patients and examiners.The third aspect of this role involved creating a programme of higher trainee seminars. Baseline data were collated and identified key areas that higher trainees felt they needed further training and guidance in.ResultUsing baseline data on the current teaching programme and from higher trainees as well as incorporating quality improvement methodology, we have been making small changes to each aspect of the teaching programme and evaluating the changes made. The feedback from trainees has been positive as evidenced by quantitative and qualitative feedback. 8 candidates sat our first mock CASC with a 100% pass rate in their MRCPsych CASC examination. There has been a positive response to the higher trainee seminar programme.ConclusionThis programme has produced good outcomes to date and sets foundations for the future development of post graduate psychiatry education in Northern Ireland.