Career focus: Forensic Psychiatry & Health Tech – Dr Gauruv Malhan tells us about his portfolio career
Can you briefly tell us a bit about your medical background and career route into Forensic Psychiatry (incl current role?)
I originally had aspirations of studying music in university, but made the tough decision to pursue a career in medicine instead. After graduating from St George’s in 2011, I experienced two Psychiatric jobs within the foundation years before going on to complete core training, but I actually encountered Forensic Psychiatry quite late on. After referring on a particularly harrowing case of a patient who had killed his dog, and witnessing the process first hand of how the Forensic Psychiatrist interacted with the patient to manage their risk to self and society, I found myself completely inspired. Nearly four years later I’ve just begun my Registrar training in Forensics. Parallel to this I am the founder of www.map-em.com
What kind of roles are there for doctors in Forensic Psychiatry?
There are multiple, extremely diverse roles, which can also be rather overwhelming! As a Forensic Psychiatrist you are responsible for a number of different areas including acting as a medical expert in court for cases surrounding fitness to plead; advising on appropriate sentencing and giving expert advice around managing risk, which also includes persuading commissioners as to why patients would benefit hospital treatment over imprisonment. There are lots of hands- on elements too, like looking after patients in secure hospitals such as Broadmoor, as well as prison clinics which experience high levels of illicit drug use associated with illness and disorders through to gate keeping for secure rehab patients. The list is endless!
Describe a typical day.
I honestly don’t think there is one; it really is that incredibly varied! Though, a typical week would definitely include the following routines:
Board rounds, referral meetings all morning and academic meetings all afternoon with paperwork catch-up in between; prison and hospital referrals as well as writing up large reports; Ward rounds (minus cups of tea, unlike other areas of Psychiatry!), CPAs, additional meetings and risk assessments and special interest development, which has in my case been developing the Psychiatry guidelines forwww.map-em.com , a mobile app which I’ve co-developed along with other colleagues with the aim of helping clinicians…
Tell us about career progression, working hours and salary brackets?
It’s supposed to be a standard 9-5 job, but like all medical careers is far, far from that. The salary is standardised throughout the NHS.
What led you to decide on a career in Forensic Psychiatry ?
The combination of helping those most vulnerable within society with a real interest in how the needs of those patients are balanced with the needs of society. Also, there’s never a dull moment bar the extensive paperwork involved.
What do you think led to your success in the field?
Well, I’m still a beginner really, but I would probably attribute any successes so far to being an adaptive and flexible hands-on practitioner. A recent highlight though was providing evidence for a case held at Winchester Crown Court which was quoted in the Daily Mail!
What transferable skills and experience did you bring from your medical training ?
Lots. Firstly, I believe all of Psychiatry is ‘organic’ and should be treated as such – ie, there is undoubtedly a huge neurological basis for all Psychiatric illnesses. Medics are taught to think in a certain way compared to other professionals. Other skills include listening, empathising, etc… Further to this, all of my patients / prisoners appear to have a lot of medical problems – these problems do often interplay with their Psychiatric presentations.
Top 4 tips for others wanting to get into the field?
1, Have a great sense of humour; it’ll get you far
2, Enjoy dictating 20-40 page reports
3, Have the ability to handle yourself in court
4, A desire to want to ignore ‘bare below the elbows’ and wear a watch and cufflinks every day.
Pros/cons of career in Forensic Psychiatry (compared to medicine)?
Pro – You act as the medical expert for the criminally insane plea.
Cons – paperwork galore and coping with lots of locked doors day to day