During my Liaison Psychiatry work:

Provided liaison psychiatric assessments and treatments to this district general hospital’s ethnically diverse population, serving one of the most deprived boroughs in England – with an official population of 1/3 million. 60,000 patients attend NUH A&E each year, with monthly average 220 mental health assessments in A&E, 160 substances only and 60 inpatient referrals. Newham is both the poorest and youngest London borough with London’s highest levels of HIV and TB infection, diabetes and alcohol-related admissions. Weekly general outpatients clinic/medically unexplained symptoms clinic. Other referrals comprise self-harm, neurological (stroke unit), cancer & cardio-respiratory patients.

My team (Newham Psychiatry Liaison Team) was nominated in 2013 as the team of the year by the East London NHS Foundation Trust.

Research Activities:

Honorary Research Associate at Institute of Psychiatry 2008-2010

• “An evaluation of the effectiveness of a liaison psychiatric service integrated into a diabetes clinic.” Retrospective case-control study, Institute of Psychiatry.
• I collected data from case notes, including socio-demographic details, type of diabetes mellitus and HbA1c, over a 12 month period. Our results demonstrated that a liaison psychiatry service integrated into a diabetes clinic is associated with improved glycaemic control in people with problematic diabetes and concomitant psychiatric morbidity.
• Conducted and presented the study: ”Self-harm in people under eighteen in City and Hackney”.  The results elucidated a number of interesting findings including: demographic information, previous contact with mental health services, the method of self-harm used and the adherence of management to NICE guidelines. The data were presented as a poster at the Liaison Psychiatry and Psychotherapy Conference in Glasgow and published in the Faculty’s Newsletter (May 2011).
• Worked with Dr Peter McCrae and Dr Susham Gupta had prepared a review on Community Treatment Orders. Findings were that “Community Treatment Orders is a common practice now in England and Wales and their effectiveness not supported by research evidence. There are potential clinical factors that could hamper the effect delivery of CTOs and explain the gap between the research findings and clinical practice.  It is premature to suggest that these orders are not effective and the time is now ripe for a proper debate on this issue to guide clinical practice and ensure patients’ rights are maintained”. 
• Worked with Dr Norman Poole on a review on Capgra’s syndrome.

Audits:

• I have been involved in an audit for medical clearance of patients referred to Psych Liaison A&E at Newham University Hospital.
• CPA, Risk assessment , Records Keeping Audit February 2013 (Trust Mandatory Audit)
• Medication Audit- communication with the GPs , presented in the monthly Audit meeting and service meeting, this audit was also presented in the medication safety committee in East London Foundation Trust, other CMHTs will use the audit to audit their medications and communications with their GP practices. The findings suggest that the communication with the GPs needs improvement and meetings have been held to discuss how this could be achieved.
• I have collected data for the court diversion scheme for service evaluation and development.
• Self-Harm in people under 18 in City and Hackney 2011, this has demonstrated interesting demographics, adherence to national guidelines in regards to suicide prevention and compliance with the NICE guidelines.  
• GP letters Audit at CAMHS. This was further taken and incorporated in the service development to improve communications with the GPs. We examined case notes for adherence to standards relating to service policy and timely communication with GPs. The audit cycle was completed and the results demonstrated an improvement compared to the previous audit.  Our data was presented at the local departmental meeting. To improve standards further we implemented a change in policy so that cases could only become “active” once the relevant assessment information had been communicated to the GP. The Trust incorporateded our recommendation into service policy.
• Prescribing audit for oral medications in the community, Home Treatment Team May 2010
• Prescribing and Administration audit for depot medications in the community, MHCOP 2009.
• Audit in Psychiatry and Diabetes at King’s College Hospital July 2008 “An Evaluation of the Effectiveness of an Integrated Diabetes and Mental Health Service.
• P.P Ramanuj, J. Valka*, G. Mikellides†, D. Hopkins‡, R. Malik‡ and K. Ismail§
• Department of Psychological Medicine, Institute of Psychiatry; King’s College London”
• Conducted a clinical audit for Orthopaedics (Hip Firm) in October 2007.

Presentations:

• Presented in Grand Round at Kings College Hospital a surgical case in 2008.
• Presented at Journal Club City and Hackney October 2008.
• Presented a case of autokabalesis at Mile End Hospital January 2010.
• Presented at Journal Club Mile End Hospital Sep 2009
• Autumn 2009 Meeting of the Association of British Clinical Diabetologists

Provision of a dedicated diabetes psychiatry service is associated with significant improvements in glycaemic control and psychological outcome among attendees

• Case Presentation ‘’A serious suicide attempt causing brain damage’’ City and Hackney.
• An Evaluation of the Effectiveness of an Integrated Diabetes and Mental Health Service.

P.P Ramanuj, J. Valka*, G. Mikellides†, D. Hopkins‡, R. Malik‡ and K. Ismail§

Department of Psychological Medicine, Institute of Psychiatry; King’s College London,

FEB 2011

• Self-Harm in people under 18 in City and Hackney service meeting of CAMHS in City and Hackney
• MARCH 2011 Self Harm in people under 18 in City and Hackney, poster presentation at the Annual meeting of Liaison and psychotherapy faculties of the Royal college of Psychiatrists
• Regional Poster Presentation: RCPsych South Eastern Division, 2011 – awarded 1st prize. “Delivering expert psychological care: A retrospective analysis of its effectiveness in improving diabetes and mental health outcomes.” Co-author, I collected the data and contributed in formulating the study for publication.
• Presented a case in Royal Society of Medicine, BME meeting October 2013.
• Medication Audit presentation Monthly meeting Tower Hamlets Centre for Mental Health  June 2013
• Medication Audit presentation Service Meeting, Isle of Dogs CMHT, June 2013
• Chairing Journal club Tower Hamlets Centre for Mental Health   July 2013
• Chairing Journal club Newham Centre for Mental Health September 2013
• Chairing Case Presentation Newham Centre for Mental Health October 2013
• Presented at the Grand Round at Newham University Hospital June 2014.
• Presented various presentations during my work in Cyprus Mental Health Services Feb 2015-present
• Presented rTMS in TEPAK
• Presented rTMS in Pancyprian Psychiatric Conference 2018

Teaching experience:

• Special Scientist at the University of Cyprus 2017-

• Honorary Assistant Professor 2015 St George’s Medical School, University of London/ University of Nicosia

• Honorary Clinical Lecturer 2013- Barts & The London School of Medicine and Dentistry, Queen Mary, University of London

I greatly value the importance of teaching colleagues and students in order to impart knowledge and inspire the next generation of psychiatrists. I have received excellent verbal and written feedback.

My experience includes:

• Formal Lecturing: Medical student lectures on Urology King’s College Hospital.
• Grand Round presentation in Surgery. King’s College Hospital, 2008.
• Formal Teaching Training: “Teach the Teacher course for Doctors’’ 2 day course, 2011.
• Formal Small Group Teaching and Tutorials: Medical student teaching on Personality Disorder and Anxiety Disorders. Allied health professional teaching on psychotropic use in Personality Disorders, 2013.
• Workshops: Communication skills and psychiatric assessments for undergraduate medical students, 2011-2013.
• Tutorials on Personality and Anxiety Disorders 2012-2013. Lectures on Psychotherapy I, Personality disorders for 4th year Medical Students attached to Bart’s and the London Medical School 2011-2013. I have attended a workshop to improve my communication skills. I have led a workshop on communication skills for medical students.
• Informal clinical teaching: In my daily clinical practice I take every opportunity to teach colleagues.
• Several case and journal club presentations.
• Examiner: I was an examiner for pre-pilot OSCEs in Clinical Communication Proficiency Assessment for EU doctors and assessed 4th year clinical student essays (Bart’s and the London Medical School). I am also an examiner for 4th and 5th year OSCEs for the Queen Mary University.
• I acted as a candidate in a video for the Royal College of Psychiatrist for the CASC Exam in order to be used as an educational material for the examiners.
• Leading/Coordinating a Focus Group for Supervision for Core/Higher Trainees for the London Deanery, and I was acknowledged for my involvement in the report.
• I have organised and taught core psychiatry trainees in workshops for the CASC, MRCPsych exam 2013, received excellent feedback.
• Also taught medical students (graduate entry) at Newham University Hospital on Psychiatric themes 2013 and regularly taught medical students as part of their placement at Newham Centre for Mental Health.
• I was commissioned by the Royal College of Psychiatrists to prepare an online module on Personality for the MRCPsych exams, and was published online.
• Provided a teaching session at Francis House for the use of psychotropics in bipolar disorder in a group of patients with bipolar disorder June 2014.
• Teaching medical students during their placement for the St George’s Medical School, University of London/ University of Nicosia.
• I organised a number of lectures and presented them to the Psychiatry Trainees in Cyprus.

Meetings/Courses:

• ILS (Immediate life support), (resuscitation council, UK) 31 July 2007
• Attended the annual meeting of the Royal College of Psychiatry (Faculty of Liaison Psychiatry) 19-20 March 2009 , Prague.
• Attending weekly the Local academic afternoons at the City and Hackney Centre for Mental Health.(Journal club, Psychotherapy, Case Presentations)
• Attending the monthly meeting at Bart’s Hospital every first Wednesday of each month
• Attended Maudsley Annual Review of Psychiatry April 2010
• 02-04/11/2011 Annual residential Meetings, Faculty of liaison Psychiatry and Psychotherapy
• 19-20/05/2011 HCR-20, PCL-SV
• 18/5/2011 Risk management session
• 3/11/2011 The art of psychiatry, trainee Conference, London Deanery
• September 2011 Online CPD Royal College of Psychiatrists ‘’ Polypharmacy’’
• CPD Royal College of Psychiatrists ‘’managing stress and avoiding burnout: Part 1’’
• CPD Royal College of Psychiatrists Risk assessment and management of violence
• Teaching the Teachers 2011, 2 days Course by Oxford Medical, London
• Attended introductory course for Section 12
• International Congress of the Royal College of Psychiatrists
• 10 – 13 July 2012, Arena and Convention Centre, Liverpool, UK
• London Deanery Psychiatry Trainees November 2012
• Consultant Interview workshop January 2013
• Striving for excellence, a Leadership and Management course
• Medical Council on Alcohol 14.11. 2013
• London deanery Psychiatry trainee’s conference, Psychiatry 2020, 2013
• Leadership for STRs/ SPRS 2.3.2013
• Striving for Excellence Management Programme  23.04.2013
• I have completed a number of online training themes offered by the RCPsych on CPD.

• RCPsych online CPD Teaching clinical Skills 3.7.2013

• RCPsych online CPD GHB  4.7.2013

• RCPsych online CPD Safe Lithium 4.7.2013
• Attending trust academic meetings monthly and medical grand rounds weekly
• Attended the Liaison and Addictions Conference of the RCPsych 4-6 June 2014 in Leeds
• Represented Cyprus in the Health and Justice Conference (WHO Europe, Public Health England) in Bishkek, Kyrgyzstan 27-29 October 2015
• Attended 4th Psychiatric Congress of Eastern Europe and the 3rd Congress of Preventive Psychiatry in Athens 12-15 November 2015.
• Transcranial Magnetic Stimulation, Maastricht University 2 days course 2016
• Transcranial Magnetic Stimulation, Magventure, Larnaca 2 days course 2016
• Attended 6 days Course on Eating Disorders organised my Cyprus Mental Health Services and Cyprus Psychiatric Association.
• Represented Cyprus in the Governmental Meeting in the European Commission on  Alzheimer’s/ Dementia followed by attending the Dementia Conference in Bratislava 2016
• Eating disorders course Cyprus 2017
• Represented Cyprus in the Governmental Meeting in the European Commission on  Alzheimer’s/ Dementia followed by attending the Dementia Conference in Malta 2017
• Represented Cyprus in the Vulnerable adults meeting in Venice 2017 in the European Commission
• European programmes for research and innovation 2018

Management Experience

I possess excellent management and leadership skills. Whilst serving as a military Officer in Cyprus, I demonstrated my ability to successfully lead and manage a team. I have demonstrated clinical Leadership by “acting up” to lead ward rounds on behalf of my consultants and during my on call commitments, receiving positive feedback.

As the Trainee Representative at the Royal London and Mile End hospitals, I demonstrated organizational leadership and management skills. I attended training committee meetings and participated in discussions to improve the local MRCPsych course. I oversaw junior medical cover for three sites, devising and implementing the on-call rota. I contributed substantially to the service working group and the future of rota development by devising a ‘’blueprint’’ for the subsequent year. I received excellent feedback on this role from my colleagues.

I appreciate the value of a multidisciplinary team which provides a variety of expertise and skilled contributions, aimed at providing a positive outcome for the patient. During my ST4-5 placement in Isle of Dogs CMHT my consultant left for another post and I was leading the team under the supervision of the clinical director and I also received excellent feedback from the team.

I have also led patient’s discussion forums and co-facilitated creative groups.

I was the ST4-6 representative Royal London and Mile End hospitals August 2012-2013. I have attended meeting and discussions around invitation for tender for the Newham Drug and alcohol services. I was involved in the preparation for the invitation for tender for the drug and alcohol service for Richmond (discussing care pathways, bidding process, attending meetings, liaising with managers and preparing for the application process). I have been a member of the working hours’ group in the Trust, discussing issues around working conditions/hours. I have attended a meeting held by the Quality Assurance visit from the Medical School at Mile End Hospital (Queen Mary University). I took part in the Liaison nurses’ (band 6-7) selection process (being on the panel/ discussion groups/marked tests) for the RAID for Newham/Homerton University Hospitals.

I helped in the service development for the Court Diversion Scheme, organised IT support for the team at Thame’s Magistrates Court following discussions with the Tower Hamlet’s Clinical Director, attended interagency meetings and steering groups for an alternative to the custodial sentence for the women project and received excellent feedback from the clinical director.

I have also completed a Leadership and management course.

I was in charge of an acute admission male ward in Nicosia which accepts patients from all over Cyprus with different mental health problems such as psychosis, alcohol and drug misuse, personality and affective disorders. I also helped in the development of the Psychiatric department in the Central Prison in Cyprus.

I was the chair and facilitator for the mental health awareness week in Cyprus for the 2015 and 2016.

Also I am a member of the National Cyprus Committee on Alzheimer and a member of the executive committee of Cyprus Psychiatric Association. As part of my job I join and at times lead committees in different times according to the needs of Cyprus Mental Health Services.

Currently working as a Consultant Psychiatrist at the Centre for Transcranial Magnetic Stimulation rTMS and also working in the Cyprus Mental Health Services in Outpatient Clinics and Addictions.

UEMS Cyprus representative

European Councils meetings on Dementia -Representing Cyprus

Psychiatric National Association executive board member 2016-2018

Publications / Work in Progress:

• “Self-harm in People under eighteen in City and Hackney” (Mikellides et al), (http://www.rcpsych.ac.uk/PDF/Royal%20College%20Newsletter%20May%202011.pdf).
• Poster presentation at the Faculty of Liaison Psychiatry RCPsych Newsletter, May 2011. I reviewed the published literature and national guidelines related to this area, then devised, conducted and wrote the audit study for publication.
• “An evaluation of the effectiveness of a liaison psychiatric service integrated into a diabetes clinic.”Retrospective case-control study, Institute of Psychiatry.
• Various articles on newspapers  ‘’Phileleftheros’’-Simerini etc.
• I have an online publication by the Royal College of Psychiatrists UK on Personality http://tron.rcpsych.ac.uk/learningmodules/personality.aspx