The last thing I remember, I was delivering babies and drinking beer all day at medical school. Suddenly I'm a psychiatrist. I'm even wearing a woollen tie. I wander past some muddy Portakabins in yet another shitty NHS facility and try to find outpatients with a photocopied map from the postgraduate centre.

So for those of you who don't know, psychiatrists are doctors. Which is partly because we prescribe drugs, and partly a reflection of a phallocratic and prescriptive medicalisation of reality, sanity and normalcy that is a devious and undeserved historical relic. Or at least I suppose that is a thesis of yours which we may end up having to consider obliquely and at length. Hey, check it out: I'm paranoid already.

Psychiatrists don't do psycho-therapy like Frasier, or at least baby psychiatrists don't, and I can tell you this with absolute confidence because I am one and I don't know how to, and neither does anybody else I know. But I don't want to say too much and undermine the whole show. I mean, what if our power, or rather [clears throat] our therapeutic efficacy, is borne of an illusory confidence? I'm fine. I'm a pretty nice guy. I did all right in psychiatry at medical school.

This is the sound of me trying to convince myself it's going to be OK, smoking a fag outside outpatients before I go in to meet my predecessor for the handover. I drop a half-smoked cigarette into the mud. Mainly because I am shitting myself.

"Hi Mike, I'm Conrad." He is the most perfect thing I have ever seen. He is immaculate. He radiates confidence. He looks about 32. He looks like he can do anything. I am a fraud. "I've got a couple of people here I wanted you to meet before we change over. They're a bit fragile, they don't like change much. And I reckon one or two of them will probably cut in the next week, what with us changing over."

Cut? Cut their arms? Make cuts in their arms and leak blood, because I'm starting? Jesus Christ. I smile understandingly. I have to get out of here. "So shall I show you around quickly, and then introduce you to the patients?" No. I don't want to meet the patients. I'm terrified of the patients. "Great." I smile weakly. "Thanks."

So once again I meet 17 secretaries whose names I will never remember and once again he tries to get me to meet the patients. "Sure," I smile. I am a fraud. "Just run me through outpatients quickly. What... ground do you usually cover?"

He looks up. "Oh, shit. It's your first job." Yes. And I am a fraud. So he tells me about outpatients, and I write it all down, and I remember I don't even remember how to do a mental state examination properly, or any side effects of any drugs, or how to do a risk assessment, or how sections work, or what schizophrenia really is. Because I am a fraud.

"It's fine." He smiles. "Psychiatry. Six diagnoses. Twenty drugs. It's fine." He smiles, perfectly, with perfect teeth. "There are no psychiatric emergencies. Take your time, find your feet, ask for help, just be nice, smile a lot, don't run over time. Just do what you do. All psychiatrists are weirdos anyway. It's fine."

Conrad is not a weirdo. He is perfect. I want him to stay with me forever.

But you see, it's a funny thing about being a doctor, people just put you in appalling situations and you have to come up with the goods. Medical school, which is frankly a farce, was at best a subliminal education where at some stage, from these vast oceans of factual sludge, you manage to extract a fairly representative and intuitive background idea of how things work in the body. Then you supplement this with the practical stuff about what you really need to know to be a doctor, usually at three in the morning when you're the only person around with even half a clue when the punters all kick off at once and the registrar is in bed. The system works. It works fine. Just don't worry about it. I don't.

"The boss is away at a conference for a week. In fact he's usually away. That's a good thing, it means you have a lot of autonomy and you learn faster." Conrad smiles. "Here's your bleep."

I am now under remote control. "And here's your attack alarm." He presses a button and fits my ears with some pain for half a second. "Pull this pin when the crack-heads kick off, and five academic secretaries in their 50s will come rushing to your rescue. Let's go and meet the punters."