“THE only wards where you won’t find a consultation-liaison psychiatrist are the psychiatric wards,” quips Dr Christopher Ryan, consultation-liaison psychiatrist at Westmead Hospital, Sydney, and a clinical senior lecturer at the University of Sydney.

Consultation-liaison psychiatrists are called in to help manage patients in general medical or surgical wards who have psychological or mental health problems associated with their medical condition.

They are called to any hospital ward where a patient has a psychiatric illness affecting a medical condition, or a medical condition causing psychological problems.

“Quite often the patient will be suffering a psychological reaction to general illness and the medical team are unsure whether the reaction is secondary to the illness or is a mental illness in its own right, and want an opinion”, Dr Ryan says.

“We see plenty of cases of delirium and depression, but also anxiety, post-traumatic stress syndrome and personality disorder,” he says.

Dr Ryan says the variety of cases makes the job interesting — you don’t know what kind of patient you’ll be seeing from one day to the next.

It’s also a good job for doctors who like working in teams, as they are liaising with medical staff, specialists and registrars, and nursing staff, he says.

Compared to other areas of psychiatry such as general, child and adolescent psychiatry or forensic psychiatry, consultation-liaison psychiatrists retain their exposure to general medicine.

Consultation-liaison psychiatrists mainly hold staff salaried positions in public hospitals, although some do sessional consultancy work in private hospitals.

Most positions are in the major metropolitan hospitals, but some involve session work in regional base hospitals, often on a “fly in, fly out” basis.

Positions usually involve a 40-hour week with some on-call work, typically one weekend in ten, Dr Ryan says.

Salaries range from $150 000 to $225 000 a year.

A typical day for a consultation-liaison psychiatrist involves being called in by a medical team, being briefed by the team, seeing the patient and developing treatment recommendations for the patient.

Further information is available from the Royal Australian and New Zealand College of Psychiatrists.

The full version of this story will be published in MJA Careers on 13 December 2010.


Posted 29 November 2010

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