Psychiatry Training application guide 2022

Are you thinking about applying for psychiatry training? Whether you intend to apply this year or want to get a head start for the future, you can really boost your application with careful preparation. Here is my guide to Psychiatry CT1 applications (2021-22).

What will we cover?


Psychiatry is a wonderful specialty that allows you to combine medicine, neuroscience, psychology and high-level communication skills to make a real difference to people’s lives! Alina explains how to application process works.

Choosing a career in Psychiatry offers you diversity and flexibility with lots of different sub-specialties, the choice between hospital and community work and great scope to work part-time for those who have commitments outside of medicine.

Structure of Psychiatry training

  • 3 years core Psychiatry training + Membership of the Royal Colleges of Psychiatrists (MRCPsych) – a three-part exam
  • These years are designated CT1, CT2 and CT3.
  • Three years in higher specialty training in a subspecialty of Psychiatry
  • These years are designated ST4, ST5 and ST6. 
  • The main subspecialties are child and adolescent, forensic, general adult, old age, psychotherapy or psychiatry of learning disabilities.
  • Other subspecialties that can be included in the training are addictions, eating disorders, neuropsychiatry, perinatal and social and rehabilitation psychiatry.


Since 2018, a pilot scheme has been available for a run-through training in Child and Adolescent Psychiatry (ST1 CAMHS), avoiding having to reapply for higher training. Since 2020 the recruitment process has been fully integrated, allowing applicants to be considered for CT1 Core Psychiatry and ST1 CAMHS through a single application.

Academic Clinical Fellowships (ACF) are also available in Psychiatry training; however, these are independent of the national process and are recruited to locally by individual HEE Local Offices and Deaneries.

CT1 Recruitment Timeline

Selection Process

In previous years, the Psychiatry CT1 selection process was based on a combination of the MSRA exam result and an interview.  

However, due to the COVID-19 pandemic, the assessment and selection process will be entirely based on your MSRA exam score. Whilst this avoids the need for prepping for an interview, it undoubtedly puts more pressure onto scoring well in the MSRA. Applicants will be ranked in a single national list based on their performance. Offers are made in rank order based on this national ranking.

Note that the selection process may change for subsequent application rounds, and interviews may be reintroduced in future recruitment rounds.

Requirements for CT1 Psychiatry training application

– Full GMC registration by the time you start CT1

– 24 months clinical experience by the time you start CT1

– Evidence of Achievement of Foundation Competence or CREST (Certificate of Readiness to Enter Specialty Training)


Unlike many other specialities, there is no specific portfolio requirement for GP. Nevertheless, thinking about developing your CV remains essential if you want to secure a registrar position in your chosen subspecialty in the future.


For a comprehensive guide on the MSRA – check out this article here

As mentioned earlier – your final ranking is based entirely on your MSRA score. Therefore, preparation is key. There are two component parts to the MSRA: a Professional Dilemmas paper and a Clinical Problem Solving paper.

Professional Dilemmas (95 minutes)

Similar format to the SJT. Designed to assess your responses to challenging situations that may arise while working as a junior doctor.

Clinical Problem Solving (75 minutes)

Based on the foundation programme curriculum

The MSRA is similar to medical school finals, with the questions more clinically focused.

Three References

You will need three references for this job application. These cannot be relatives or friends, but professional references, including people who know you and have worked with you. This could include your educational/clinical supervisors, amongst others.

Competition Ratios

Psychiatry is rapidly becoming a more popular training choice. The training programme fill rate in England has increased from 67.3% in 2017 to 79.0% in 2018, 92.5% in 2019 and 99.4% in 2020. 

With this increased interest in Psychiatry, the competition ratios have increased as well.

Final Thoughts

Please note that the application process keeps changing and this information was up to date at the time of publication. Ultimately, give the official applicant handbook a good read, as the recruitment process changes slightly from year to year. Good luck with your applications!

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