David Okai: My Working Life as a Consultant Neuropsychiatrist

What did you want to be when you were a young boy? 

A fireman.

 

Why did you change your mind?

I changed my mind around the age of about six, and from then on, I always wanted to do medicine. I think this was because I was curious as to why people experienced the things that they did in life, such as why people caught the common cold etc.

 

What 3 things do you enjoy most about your current role?

1. Patients – they are highly interesting patients, each unique in their own fashion.

2. My colleagues - all are extremely talented individuals, focused on what is best for patient care, and make work a pleasant environment.

3. The opportunity to be involved in the gradual, but progressive shaping of services around patients and their needs.
 

What are the main 3 factors that make you frustrated at work? 

1. The old historical divides. Specifically, the split between mind and body. There should be psychological medicine (psychiatry and psychology) services in all medical specialties.

2. Lack of NHS funding, when it can clearly impact on patient outcomes.

3. The reduction and, at times, poor upkeep, of NHS buildings.
 

Why would you recommend your career to a young person? What positive aspects would you highlight?

Neuropsychiatry and psychiatry in general have so many specialties, there is scope for finding the perfect clinical setup for everyone’s character and personality

 

What has been your biggest career disappointment or challenge and why, and how did you overcome it?

I was not appointed to my first consultant role in neuropsychiatry when I applied. On reflection, I was beaten by a more qualified candidate. It turned out well, as the consultant post I got subsequently led to me gaining experience in designing and evaluating services which, in turn, allowed me to eventually apply for a more senior neuropsychiatry post than the one I had originally applied for.

 

What was your best career move?

Moving to Oxford, to set up the first neuropsychiatry department within their neurosciences Centre.

 

Can you describe your work in 1 sentence?

I oversee the biological, psychological, and social support for patients seen in a neurology or neurosurgery setting.

 

What qualities do you think you need to do your job well?

First and foremost, you need to be interested in people. Secondary to this, you need a strong understanding of neurosciences.

 

What 3 words would your colleagues use to describe you?

Determined, engaging, collegiate.

 

If you could go back in time and give one piece of career advice to your younger self, what would it be? 

All the things that you thought important, truly weren’t, and the ups and downs in life can be hugely beneficial in the long term.

 

What do you do to relax/de-stress?

I attend dance congresses or events with my wife; Brazilian jiu jitsu; I spend time with my children.
 

What do you hope will be your legacy to your profession and colleagues? 

Better integration of psychological medicine within the physical interface disorders. Better pathways for national specialist services, allowing for patients to climb up, and down their ladder of clinical need.

 

Is the thought of retirement a dream or a nightmare - and why?

I’m not sure I will retire - there is some evidence that it has a detrimental impact on cognitive function and reserve. There is a life outside of medicine, and I’m sure I could fill my time with something interesting, fun and challenging.

 

If you were given £1m what would you spend it on?

A trial of a specific medication (I won’t say which one) which appears to be highly effective in the treatment of anxiety disorders in Parkinson’s disease.

 

What do you usually wear to work?

T-shirt and shorts (I usually work from home these days). When I go into the office, I wear a suit and comfy smart shoes.

 

What single change would you like to see made to the NHS?

A proper strategy on care pathways for mental health. If a treatment strategy is not working, the patient’s needs should escalate from primary care to secondary care, then on to tertiary care. Such pathways are not currently joined up in this fashion. To facilitate this, we need better joined-up medical note systems across the country, meaning patients aren’t over-investigated as they currently are.

 

Biography

David Okai is a consultant neuropsychiatrist at the South London and Maudsley NHS Foundation Trust.

He studied medicine at the University of Nottingham, qualifying in 2000 and completing his pre registration house officer training at Nottingham University Hospital the following year. He completed senior house officer rotations in medicine and A+E, in New Zealand and at Peterborough District Hospital, UK, before commencing psychiatric training at the Maudsley Hospital in 2003 and attaining his CCT in 2012. 

As a trainee he developed an interest in cognitive behavioural therapy, completing a postgraduate diploma in the therapy at the Institute of Psychiatry, London in 2008.  Parallel interests in psychology, neuroscience and in physical interface psychiatry led him to complete a doctorate in Psychological Medicine Research (MD Res), at King’s College London, University of London in 2014.  His doctorate work focused on the efficacy of cognitive behavioural therapy in complex neuropsychiatric (Parkinson's disease) presentations.

His first substantive consultant post was in Oxford in 2013, where he became the clinical lead for the psychological medicine service and went on to set up the first neuropsychiatry service within the Oxford Neurosciences Department. He returned to the Maudsley in 2019, as clinical lead for neuropsychiatry (outpatient, day case and inpatient services), and became the associate medical director for all the national services including neuropsychiatry a year later, a post he still holds. In addition, in 2021, he also became a clinical director at Maudsley Private Care.

He is a senior clinical lecturer at the Institute of Psychiatry, Psychology and Neuroscience, London and has authored three book chapters, in neuropsychiatry, neuropsychology and psychiatry. He has additionally authored many papers in neuropsychiatry including obligations in Lancet Psychiatry, Brain, Neurology, British Journal of Psychiatry, JAMA neurology, and the Journal of Neurology, Neurosurgery and Psychiatry.