Psychiatry Essay Writing for the RANZCP Exam

The RANZCP requires the essay to be discursive as opposed to anecdotal or argumentative. Discursive essays are objective and undertake an exploratory approach based on evidence. Present the argument in a  balanced manner taking into account diverse perspectives. After having explored the various perspectives, you may then wish to state a cautious opinion, one that indicates an openess to change if new facts were to come to light. Here is a summary by Dr Burns and Dr Ng from New Zealand, presenting a great mneumonic for you to brainstorm and come up with perspectives to fill the body of the essay.

Spend the reading time planning your essay (brainstorm using the mnemonic below). Once you have reached 40 minutes, you must stop writing. Define the terms. You can then use the mnemonic CREAM SPACE HIT.

Consider aspects of clinical experience, your own experience as a trainee is valid here (write in the third person).

Drop names of significant authors e.g. for psychotherapy essay, Shedler in American Psychologist regarding evidence base for psychodynamic psychotherapy.

How would you educate the public, colleagues and other specialties.

Consider your role as a consumer advocate and the various avenues you can use to faciliate advocacy.

What would you do if you were the clinical director of a service? How would you view this issue more broadly?  How would you deal with the media?

Are there any gaps in the essay?

Is the issue at hand influenced by socio-political factors?

How would you allocate resources effectively?

Are there cultural issues at play?

Hippocratic oath, code of ethics,  Stigma/sexuality. Know the College Code of Ethics. After all, these qualities are what the College wants you to have. You can use one of the points in any essay; e.g. psychiatrists shall respect essential humanity and dignity of every patient (with regard to culture, language, religion, autonomy, compulsory treatment, psychotherapy etc.). Know College ethical guidelines or at least demonstrate an awareness of them.

It is helpful to name drop historical names. I recommend Wikipedia for a shallow but concise picture of famous names such as Pinel for classification/ manie sans delirie, Foucault for power and discourse, Voltaire for civil rights, Parson for sick role, RD Laing for practice of psychiatry, Szasz against categorising human problems in living, Karl Popper for scientific method, Carl Rogers for unconditional positive regard in psychotherapy, Yalom for group therapy, Patricia Deegan for recovery… have a quote in your mind that you can use for the purpose of an essay. E.g. RD Laing, influenced by existential philosophy challenged the core values of a practice of psychiatry that considers mental illness as a biological phenomenon without regard for social, intellectual and cultural dimensions. He rejected the medical model of mental illness, with the view that psychiatry was founded on false epistemology, essentially an illness diagnosed by conduct but treated biologically.

It is essential to show some understanding of the history of psychiatry for any essay topic. Even if it doesn’t flow like the above quote, the reader will get the general gist. Literature is also helpful to quote – Kay Redfield Jamieson’s experience of bipolar disorder in “An Unquiet Mind.”, depiction of institutionalisation in Shutter Island and One Flew Over the Cuckoo’s nest, Janet Frame, Virginia Woolf, Mike Leigh’s directing of film which depict Eriksonian life crises etc. Who is Nancy Andreason? Kraepelin and Bleuler (with regard to phenomenology)? Keep philosophers foremost in your mind – Socrates (what is truth?) – The examined life is not worth living, Nietzsche on hardship and suffering “build your home on the slope of Vesuvius, Montaigne on self esteem “go travelling” and see diversity to learn wisdom, humility and your own limitations. These are like small nuggets for an exam.

Information Technology
Use of social media, internet and self help programs.

General Tips

You can use this structure to answer any topic. Content of the essay must be related to the topic. Do not waste time being tangential. Every paragraph should make a point, keep to the point, score a tick for each paragraph. You must be able to argue the topic from different perspectives but be able to sum up your own view in an analytical fashion.

Consider the Marks

  • Logical critical reasoning: A balanced view.
  • Flexibility ability to communicate: particularly consider the standard of a case history or formal written report; you must be able to write with reasonable grammar. Marks may be deducted for excessive crossing out which indicates poor flow. Be aware of vocabulary, some sophisticated terms and quotes will have high value for an essay e.g. anathema = detested person/thing for discourse on stigma, Illich’s view of the medicalisation of life’s vicissitudes, Deegan has described recovery as “the urge, the wrestle, the resurrection etc.
  • Judgement, maturity, ethical awareness
  • Breadth: Do not did down too deep into one theme, but rather show the examiner your breadth of knowledge combining different perspectives.

Key topics

  • Classification of illness eg PTSD, DSM V Biological vs other treatment Role of medications & pharmaceutical companies Recovery vs medical model.
  • Show the examiner that you have thought about the practice of psychiatry, particularly from an ethical point of view and that you can pen a written report about it
  • If essay writing does not come naturally, write under pressure, set a topic, brainstorm 5 minutes and write.
  • If it does come naturally, make bullet points around a topic and keep the quotes foremost in your head, it is a little like regurgitation but it indicates you have read widely even if your source is google or wikipedia at the late stage of study.

This article was written by Dr Lillian Ng and Dr Mark Burns. We thank them for their contribution.

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