Table 3

Excerpts in curricula and assessments relating to eating disorders in relevant postgraduate training in the UK

Core training
 Core psychiatry
  • Examination syllabus: ‘The prevalence/incidence, aetiology, presentation, treatment and outcome of eating disorders (anorexia nervosa, bulimia nervosa)’.

MCQ in paper B
CASC station
No ARCP requirement
Run-through training
 General practice
  • 3.04 Care of Children and Young People:

    • ’This means that as a GP you should:…Manage and appropriately treat common and rare but important paediatric conditions encountered in primary care, such as… Mental health problems such as attention deficit hyperactivity disorder, depression, eating disorders, substance misuse and self-harm, autistic spectrum disorder and related conditions'.

  • 3.06 Women’s Health:

    • ’This means that as a GP you should:…Recognise common signs and symptoms of, and know how to manage, gynaecological disease; be the first port of call for pregnancy, eating disorders and other conditions confined to or more common in women…’

Maybe included in the Applied Knowledge Test
No ARCP requirement
 Paediatrics curriculum
  • Understand the emotional dimensions of eating disorders and recognise and initiate treatment.

Not assessed
Higher specialist and subspecialty training
 Endocrinology and diabetes mellitus
  • The endocrine consequences of anorexia nervosa and bulimia.

  • Lists the features suggestive of an eating disorder.

  • Can take a relevant history and perform an appropriate examination in order to be able to identify the likely cause for anorexia/weight loss (including psychiatric conditions).

  • Arranges relevant investigations, interprets results and organises appropriate management plan.

  • Explains and discusses potential causes with patient, especially those with non-organic conditions.

SCE mini-CEX
 Sport and exercise medicine
  • Disordered eating, bone health and female athlete triad.

Not assessed
 Reproductive medicine
  • Anorexia nervosa/exercise and lifestyle-related disorders.

Not assessed
 General adult psychiatry
  • Specialist experience in EIP, AO, crisis, eating disorders, neuropsychiatry is part of the curriculum at ST5-6 level. These include:

    • Liaise with and make appropriate and timely referral to other specialist services.

    • CBD of a case presentation of a typical patient the trainee has fully assessed within their specialist area including a collateral history.

    • To conduct a risk assessment, instigate a treatment plan and supervise the progress of patients in their specialist area.

    • To be familiar with the range of psychotherapies available to patients in this specialist area.

CBD, CP, Mini-PAT, supervisor’s report
(eating disorders is optional among a range of specialist experience)
 Child and adolescent psychiatry
  • ILO (H) 5.3—assesses and manages eating disorders in adolescence:

    • Can make a diagnosis of an eating disorder in an adolescent with a typical adult presentation.

    • Can assess physical risk in an adolescent patient with an eating disorder.

    • Can diagnose and manage typical cases of eating disorders in childhood and in adolescence.

    • Can decide appropriateness of inpatient admission.

    • Can work with families in which there is a child or young person with an eating disorder.

    • Can organise a service for child and adolescent eating disorder patients.

    • Can apply and supervise CBT, family therapy or other specific therapies appropriately.

    • Management strategies for cases of eating disorder and possible treatment interventions—risk assessment (for both physical health and mental health issues).

    • Knowledge of medicolegal frameworks and the appropriate use of compulsory treatment.

    • Knowledge of appropriate thresholds for community treatment and consideration of inpatient treatment.

    • Current knowledge of evidence base for treatment of eating disorders in children and young people and their comorbidity.

    • Knowledge of NICE guidance, knowledge of systemic family therapy and application to treatment of eating disorders, knowledge regarding individual psychotherapeutic approaches, appropriate psychopharmacology.

(Case log)
 Forensic psychiatry
  • Assessment of risk in a complex case in a specialist area (eg, EIP, AO, crisis, eating disorders, neuropsychiatry, etc) if not conducted in ST5.

Mini-ACE or CBD
(eating disorders is optional)
 Medical psychotherapy
  • Evaluation of an original research paper in a specialist area (eg, EIP, AO, crisis, eating disorders, neuropsychiatry, etc) if not completed in ST5.

(eating disorders is optional, but only as non-clinical)
 Liaison psychiatry
  • Demonstrate detailed knowledge of epidemiology and common presentations of psychiatric and psychological problems in medical, surgical and elderly medical settings. Particular emphasis should be given to the following:

    • Anxiety disorders, acute stress and adjustment disorders, delirium, dementia, eating disorders, factitious disorders, somatoform disorders and malingering, mood disorders, personality disorders, psychiatric manifestations of medical and neurologic illness, including medication effects.

    • Physical symptoms exacerbated by mental illness.

 General surgery
  • Causes and consequences of nutritional deficiency, including eating disorders.

Not assessed
  • ARCP, Annual Review of Competence Progression; GP, general practitioner; NICE, National Institute for Health and Care Excellence; WPBA, workplace-based assessments; MCQ, multiple choice question; CASC, Clinical Assessment of Skills and Competencies; CBD, Case Based Discussion; SCE, Specialty Certificate Examination; MCR, Multiple Consultant Report; CP, Case Presentation; mini- PAT, Mini-Peer Assessment Tool; EIP, Early Intervention in Psychosis; AO, Assertive Outreach; ST, Specialist Training; ILO, Intended Learning Outcomes; DONCS, Direct Observation of Non-Clinical Skills.