Intended for healthcare professionals


Five minutes with . . . Anna Conway Morris

BMJ 2018; 361 doi: (Published 12 June 2018) Cite this as: BMJ 2018;361:k2570
  1. Abi Rimmer
  1. The BMJ

The East of England’s training programme director for child psychiatry explains what the visa cap means for services

“In the East of England, we have four vacancies in child psychiatry and one applicant. She first applied for the specialty trainee year 4 (ST4) level post in February but she is from India and didn’t get a visa despite having a great recruitment score. She has applied for a visa every month since, but has always been refused. She is our only candidate, so the situation is absolutely desperate.

“Not getting a visa has also meant that she has lost a deposit on a house and missed out on earnings. It’s been an absolute disaster. She is an excellent candidate and I’ve been devastated that I haven’t been able to hire her.

“If we don’t get a visa for her within the next month then we won’t have any new child psychiatry registrars in the whole of the East of England. That means that Cambridgeshire, Bedfordshire, Hertfordshire, Essex, Norfolk, and Suffolk—a huge chunk of the country—will not have any new starters in child psychiatry at ST4 level.

“Almost all the candidates that we have now are from overseas. At national recruitment there are hardly any EU candidates, and while there are some UK candidates they don’t want to come to the East of England. So many of our candidates are from India, other commonwealth countries, or elsewhere, but I am worried that word has got round already that it’s difficult to get visas and they will stop applying.

“We need child psychiatry registrars because they see young people in emergency departments out-of-hours, so places like the emergency department at Addenbrooke’s Hospital will be affected if they are not available.

“They also work in our services in the community and help with the clinical work, but the main impact is on out-of-hours rotas.

“These doctors from India are absolutely essential to our workforce. They are committed to the NHS and they are really well trained. When they come to work in the NHS they make a life here in Britain and most of them stay on and fill consultant vacancies.

“Because of the shortage of trainees in psychiatry, trusts are paying for locums—if they can find them—and for existing doctors to do extra shifts. But many shifts remain uncovered and in some cases consultants are having to act down, which is causing a lot of unrest.”


  • Anna Conway Morris is a consultant in child and adolescent psychiatry and training programme director for the East of England for child psychiatry.

  • See The BMJ’s Scrap the Cap campaign at

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