Ashok Godavarthi

Clinical Practice

Inaugural post holder of integrated Sligo Memory Assessment and Support Service (MASS) Senior Registrar post as part of multidisciplinary team. MASS Sligo is an integrated service with neurology, geriatrician, neuroradiology and POA input, as well as Older Persons Services, operational since 2022 under Dementia Model of Care (2023). Having clinically inputted to the service while working with the POA team at consultant and registrar level, I am now in a Sen Reg clinical role leading on clinical pathway and operational developments with interdisciplinary consultant supervision while further developing my skills in assessing and managing patients with cognitive impairment and dementia. I am co-leading on developing a referral form for MASS service locally, as well as clinical pathway development and local readiness for inclusion of MASS patients in trials for use of disease modifying therapies for Alzheimer’s disease. This work can inform national development of MASS and Regional Specialist Memory Services.

Teaching Experience

I led on setting up a monthly teaching session in MASS Sligo, Aug 2023, with input to date from leading Irish experts in dementia care. I am leading on developing integrated learning group with other memory centres nationally. I have delivered Dementia Diagnostic Criteria education session to MASS MDT and wider multi-professional group from Sligo University Hospital (SUH) and Older Persons Services.

I deliver problem-based learning lectures to Medical Year 4 University of Galway students and have received formal feedback, which was very positive. I am a member of Simulation Steering Group Sligo, rolling out a multi-professional psychiatry simulation teaching programme in Sligo Leitrim Mental Health Services. I attended and completed Balint Leader Workshop on 30th November 2023, Sligo.

Audit/Research

I have applied for Ethical Approval for the follow study; Review of Memory Assessment and Support Service (MASS) Sligo: Readiness for emerging Immunotherapy treatment of Alzheimer’s Disease. Study design is a retrospective chart review aiming to guide clinical practice in MASS Sligo.

I plan to complete audit cycle on Antipsychotic Prescribing in Dementia (NCG 21), POA Service SLMHS- oral presentation of first cycle at NCHD Audit Day SLMHS. As part of NCG no 21, I am enrolled in the facilitator education programme on 30th January 2024 in Sligo to lead on rollout as a local facilitator.

I presented poster at Research Conference in Sligo University Hospital; A Case Study of Anxiety and Cognitive Impairment on Background of Covid-19 Infection and Social Isolation. I am co-lead on developing a MASS specific consent form for patients to offer engagement in research. Sligo is a Clinical Trial Site for Dementia Trials Ireland

Management and leadership

Developing and leading on clinical pathways for MASS integrated service Sligo including service development and quality improvement with feedback to National Dementia Office This includes MASS referral form development and clinical governance framework work through MASS Sligo database development and ongoing service activity review to increase efficiencies and address deficits.

I am schedule for oral presentation on local MASS Sligo Service Operations with MASS consultant Supervisor Dr C Dolan at Psychiatry of Old Age, Residential Meeting, Athlone in Jan 2024.

My work on NCG 21 antipsychotic prescribing in dementia POA Sligo will inform Clinical Pathways for new Model of Care Older Persons Mental Health, Nursing Home Liaison POA Service National Demonstration Site Sligo.

I will continue my role in leading on Psychiatry SIM training in Sligo and as NCHD lead on SLMHS Policies, Procedures, Protocols and Guidelines (PPPG) Group.

Clinical Practice

In this post I had opportunity to work as a Locum Consultant in a well-established, Specialist Psychiatry of Old Age Service, with a Consultant team providing support and mentorship (covering maternity leave) to wider MDT and NCHD members. Throughout my time in this post, I received clinical support and supervision from my consultant colleagues. This role has given me the opportunity to develop and utilise my management skills, chairing Multidisciplinary Meetings and active participation in Complex Case meetings with Neurology and Geriatric Medicine acute hospital colleagues. I thrived on the opportunity to take a clinical lead with team support on complex clinical cases. I began to develop special interest in dementia during this post. I developed care plans for dementia patients with complex medical and psychiatric needs and involved patients in their Recovery Care plans.

Teaching Experience

During this post I delivered problem-based learning lectures to Medical year 4 students of University of Galway. In my role I was a co-examiner in final year OSCE exam. I engaged in bedside teaching for NUIG medical 4 students and participated in role-play examinations for University of Galway medical year 4 students.

Audit/Research

I did a survey on safety for NCHDS and did a report with Prof McCarthy for Accreditation site visits.

Management

In this role involved in service monthly business meetings and engaged in consultant meetings.Participated in Service development with the New Model of Care for Acute Hospital and Nursing Home Liaison and the PPPG (policy procedures and guidelines) group. This role has given me huge experience in overall management of a multi-disciplinary team.

Clinical Practice

I gained further experience in managing cases in both inpatient and outpatient settings. Availed opportunity to involve in Early Intervention Psychosis team as special interest to which supervising consultant is clinical lead. I have developed a scheduled physical health screening (bloods, physical exam, and vitals) clinic once every two weeks, alternating between two clinical hubs and forwarded the findings to GP and treating mental health team. Membership exam completed in this post. Availed of the opportunity to attend level 1 and 2 DBT course during this post.

Teaching Experience

During this post I delivered problem-based learning lectures to medical 4 University of Galway Students. I have chairedmedical student Clinical presentations and presented at local journal club. Organised OSCE clinical skills practice sessions for trainees with help of Vice Dean and Clinical tutor.

Audit/Research

During this post I did literature review on first episode psychosis, which led to having scheduled clinics for physical health, monitoring in first episode psychosis team.

Management

In this post I was Actively involved with Early Intervention in Psychosis Clinical Programme (Consultant supervisor is Clinical lead for pilot site in Sligo).

Clinical Practice

Within this role I had further exposure to General Adult community psychiatry services in South Leitrim, in addition to managing acute inpatients in Acute unit and providing liaison assessments in Sligo ED. Within this team I also had the opportunity to provide assessments in rural home setting, a role that I found particularly rewarding. Availed the opportunity in administering ECT under supervision as Supervising Consultant is ECT Lead for ECTAS accredited service.

Teaching Experience

During this post I engaged in bedside teaching for University of Galway medical students and participated in role-play examinations for University of Galway medical students.

Audit/Research

While in this post I continued to focus on data collection and paper writing as co-author with aim to submit paper in Irish Journal of Psychological medicine.

Management

In this role I re-developed Acute psychiatric Assessment Proforma used in Sligo Leitrim Mental Health Services along with MDT members. Participated in local policy group meetings, suggested to update the risk assessment document that was used in Sligo Leitrim Mental health service.

Clinical Practice

This was my first Liaison post, further developed skill in managing acutely unwell patients in Emergency department and medical wards. Developed special interest in Perinatal psychiatry and was running perinatal mental health clinic with Perinatal CNS once a month under supervision of Dr Gethins. Communicated outcomes of the clinic by letters and phone calls to GP’s and Obstetrician’s. Also gained valuable experience in managing patients with complex medical and psychiatric needs, communicating with other medical professional.

Teaching Experience

Delivered presentation to ED medical and nursing staff on their teaching session regarding risk assessment and management where consideration is being given to use of the Mental Health Act. Delivered a lecture to experienced CNS’s working in Liaison team regarding documentation of mental state examination and risk assessment. Involved in bed side teaching of university of Galway med 4 students in Liaison rotation. Continued to involve in Sligo Leitrim Mental Health Service training and teaching session. Involved in Grand rounds at Sligo University Hospital.

Audit/Research

Completed audit on Mental health presentations to emergency department in Sligo during COVID 19, compared to the data from pre-COVID19. Presented the data to Community mental health team member and suggestions made on changes required. This study led to development of Crisis resolution team in Sligo. Did poster presentation in College of Psychiatry Winter Conference, Sligo university Hospital annual research conference and also did oral presentation in Liaison faculty meeting.

Management

Suggested and implemented to incorporate teachings in liaison MDT meetings. Involved in developing clinical database for perinatal mental health patients in Sligo Leitrim mental health service with Dr Gethins. Involved in meetings with ECD and NCHD lead to improve NCHD rest room and NCHD on call rota, involved in the discussions to change offsite call to onsite call with following day off, which brought in service compliance to EWTD and overall improvement in NCHD working conditions.

Clinical Practice

Within this role I had further exposure to General Adult services in Sligo town, in addition to managing acute inpatients in Psychiatry unit, Sligo University Hospital and liaison assessments in Sligo ED. In this role I got exposure to mental health difficulties within socio-economic groups, liaised with homeless liaison service and revied patients in Globe House Sligo, home for Refugee and asylum seekers. In this post got opportunity to manage substance misuse related physical emergencies. Availed opportunity to develop psychotherapy skills by undertaking a CBT case under the supervision of one of our senior psychologists.

Teaching Experience

In this role I was involved in bed side teaching of university of Galway med 4 students.

Audit/Research

In this post completed Audit cycle on Integrated care plans in inpatients unit as per mental health commission guidelines and presented to MDT members.

Management

Undertook role as local representative for European Federation of Psychiatric trainees in this post.

Clinical Practice

I gained experience working within mental health Intellectual Disability team in assessing and managing patients in residential services, out-patient clinics and teleconsultations when required due to Covid-19. Improved understanding of psychopathology and elicit symptoms in persons with Mental Health difficulties and Intellectual Disability (MHID). Liaise with family member, other specialities involved with MHID patient including General practitioners. Took the opportunity to perform capacity assessments on MHID patients under supervision of consultant.

Teaching Experience

Participated and presented in local teaching sessions.

Audit and Research

Literature search in management of patient with Autosomal recessive Disorder, Succinic semialdehyde dehydrogenase deficiency (SSADH), who was attending the service.

Management

I took on a lead role in teleconsultations and worked with supervising consultant in delivering MHID service effectively to the patients who had particularly difficult time due to huge changes in their daily routine secondary to Covid-19 restrictions.

Clinical Practice

Within this role I had further exposure to General Adult community psychiatry services in South Leitrim, in addition to managing acute inpatients in St Columba’s Hospital and providing liaison assessments in Sligo ED. Within this team I also had the opportunity to provide assessments in rural home setting, a role that I found particularly rewarding. During this role, I had the unique experience of being part of a team transitioned to remote-working for outpatients due to the Covid-19.

Teaching Experience

As NCHD lead, worked with Clinical tutor in transitioning NCHD teaching sessions online during Covid-19.

Audit/Research

I engaged in audits regarding safe prescribing in the acute adult ward and discussed the results with Prescribers.

Management

In this post I continued the role of Registrar Representative, which involved rota planning, acting as a

spokesperson for all the Psychiatry Registrars and liaising with senior medical, nursing and management

colleagues. Successfully adapted on-call rota during covid-19 balancing the well-being of Psychiatry Registrars and smooth running of the service. Secured funding for zoom teaching sessions with help from Vice-Dean.

Clinical Practice

In this role I have got exposure to management of patients with enduring mental health illness, in addition to management of patients in St Columba’s Hospital and Sligo ED. Enhanced skills in managing patients living at supervised residential services. I took opportunity in further increasing skills in prescribing clozapine when appropriate under supervision of the consultant.

Teaching Experience

I participated in Journal Club and Case presentation teaching sessions locally. Delivered Problem based learning to University of Galway medical year 4 students. Participated in role-play examinations for University of Galway year 4 students.

Audit/Research

Audit cycle completed on clinical Kardex in inpatients unit.

Management

In this post I undertook the role of Registrar Representative, which involved rota planning, acting as a

spokesperson for all of the Psychiatry Registrars and liaising with senior medical, nursing and management

colleagues. I met with the Clinical Director to address Registrar issues, and during this role assisted in

improved access to case records while on-call and improved the on-call shift structure. Worked with Clinical director and management to bring NCHD on-call to EWTD compliance

Clinical Practice

In this role I gained exposure to Adolescent cases in outpatient setting and liaised with Galway inpatient team when required. During my time in this role, I had experience in managing eating disorders and I gained valuable perspective in managing this patient group with complex medical and psychiatric needs. In this role got exposure to managing adolescents with ADHD.

Teaching Experience

Participated in journal club and case presentation teaching sessions.

Audit/Research

Management

Managed own caseload under supervision of consultant. Involved in improving the ADHD clinic structure.

Clinical Practice

In this role I further gained experience working within a General Adult CMHT assessing and managing patients in inpatient, outpatient, Day Hospital, and domiciliary visit. Worked within the Sligo on-call rota providing emergency assessments in ED and managing acutely unwell St Columba’s inpatients. Took the opportunity to manage and conduct MDT meeting in supervised residential unit.

Teaching Experience

This primarily involved leading problem-based learning sessions for medical students and providing teaching sessions on communication. Participated in journal club and case presentation teaching sessions.

Audit/Research

Case review on a patient with prolonged admission in inpatient and developed management plan under supervision of consultant.

Management

Involved in meetings as NCHD representative on well-being of NCHD’s.

Clinical Practice

This was second post of my Psychiatry BST training. I got experience in identifying and treating mental illness in elderly patients, an area in which I began to develop an interest in POA during this post. This post involved managing inpatients, outpatient clinics, day hospital care and specialist liaison consults to medical and surgical patients.

Teaching Experience

Participated in journal club and case presentation teaching sessions.

Audit/Research

Audit completed on discharge summaries St Columba’s Hospital, presented the results to medical colleagues.

Management

In this post I took the opportunity to participate in national meetings with Prof McCarthy as observer.

Clinical Practice

This was my first post of my Psychiatry BST training. I gained experience working within a General Adult

CMHT in assessing and managing patients in inpatient, outpatient, Day Hospital and Home-Based settings. I

worked within the Sligo on-call rota providing emergency assessments in ED and managing acutely unwell inpatients.

Teaching Experience

Participated in journal club, psychology, and case presentation teaching sessions.