Interview Dr Lillian Ng
Psychiatry Registrar, Lillian Ng, describes why Psychiatry is a specialty that interests and motivates her
When I teach medical students I tell them to keep an open
mind about psychiatry. The reason for this is because I started my
career in psychiatry fifteen years after I left medical school,
travelled, dabbled in various specialties, became a parent and
gained my fellowship in general practice. All this and seven
years of general practice led me to choose the training programme
for psychiatry (which working parents should note, can be done on a
part-time basis).
Psychiatry is, without doubt, a challenging specialty.
Crisis assessments take place in peoples' homes, police stations
and emergency departments in often onerous circumstances, at times
with an element of high risk. Patients have difficult lives,
chronic problems and experience deprivation. The interactions are
complex and dynamic. Despite the intensity and pressure, it
is satisfying to work through a process of decision making using
all the skills a registrar learns on the job - taking a good
history, gaining collateral, performing a mental state examination
and liaising with families and staff.
It is perhaps no surprise that our patients experience
stigma, yet the psychiatry profession also encounters stigma - not
infrequently from medical colleagues, with comments such as "it's
not real medicine." What I have learnt, is that all my medical
training has prepared me to consider all aspects of a person's
health. It is still essential to take a history and perform
an examination. A lot of medicine is pattern recognition and
psychiatry is no exception. In general practice, my bread and
butter was diabetes and otitis media; in inpatient psychiatry it is
psychosis and treatment resistant depression.
What is most apparent in eliciting a patient's narrative
is the sheer skill that is required to contain, empathise and be
pragmatic in decision making - skill that only comes with
experience. The concept of supervision for trainees is a
particular strength in psychiatry. This offers a space to
reflect on difficult tasks or dynamics and a source of
support. It engenders self care, the setting of boundaries,
personal growth and trains registrars to be reflective
practitioners.
Perhaps the other outstanding characteristic of mental
health services is that of working with a multidisciplinary team. I
am continually impressed by the competence and patience of
colleagues, working under difficult conditions, whose courage under
fire is heroic.
Psychiatry is high value work, often unacknowledged. It's
a gritty specialty and requires an inquiring mind and an ability to
think broadly and ethically. The training programme is excellent
and I recommend it highly. Despite the stigma that is still
attached to our patients, even when they have lost hope, those of
us who work in mental health carry hope that they can
recover. Ultimately, it's a job where you can make a
difference.