In 2009, Prof Robert Howard, Dean of the Royal College of Psychiatrists (RCPsychUK) said, “Catastrophic is the word I would use for the shortage we are now facing” when he talked about over reliance on overseas doctors due to shortage of psychiatrists in the National Health Service, NHS.
In reality, this is not a unique problem of just an individual country. It certainly is not unique to just doctors when it comes to staffing. It is a pandemic. The matter of recruitment of health care staff is a worldwide matter. The shortage of medical doctors is an international challenge in both developed and developing countries. The World Health Organisation (WHO) has estimated that there is a worldwide shortage of 2.3 million physicians, nurses, and midwives, which is expected to persist in many developing countries.
In 2014, Farooq et al published a cross-sectional survey results looking at career plans of final year medical students from 20 countries and factors that influenced their psychiatric career choice. 15% of the medical students seriously considered psychiatry as a career.
In 2015, Stuart et al published a paper titled Images of Psychiatry and Psychiatrists and found that 90% of respondents considered that psychiatrists were not good role models for medical students in 15 academic teaching centres in the United Kingdom, Europe, and Asia.
Meanwhile, in 2013, a group of bright young and enthusiastic European Federation of Psychiatric Trainees in Zurich and formed what we now know as the Recruitment and Positive Image of Psychiatry (RPIP) Working Group. The RPIP working group in its statement recognised that:
“Recruitment of medical students towards the psychiatric profession is an important issue in many European countries. This issue is closely linked to the image of the psychiatric profession. As psychiatric trainees, we come into direct contact with medical students. EFPT therefore believes that psychiatric trainees should be involved in actions that can improve the image of the psychiatric profession and wants to provide a platform for the exchange of ideas and successful initiatives.”
How visionary were this group of young psychiatric trainees from all across Europe? Very.
Amongst the early action plans of the RPIP Working Group were:
1) Creating of a guide for initiatives to encourage medical students’ interest in psychiatry
2) Looking at image of the psychiatric profession and to reasons why (not) to choose psychiatry
3) Monitoring of recruitment evolution
RPIP Working Group efforts have evolved over the years. There has been a strong focus on research in trying to understand the gaps and challenges pertaining to recruitment. Another strong focus of RPIP is in promoting positive image of Psychiatry through various promotional videos targeting medical students, other medical specialities and the general public.
The debut production of promotional videos titled “Psychiatric Clichés” is a set of four promotional videos created by AFFEP (Association Française Fédérative des Étudiants en Psychiatrie) in cooperation with RPIP WG in 2014. The videos aim at dispelling the prevalent myths and prejudices related to psychiatry and psychiatrists.
Dr Howard Ryland, current EFPT President who is also a member of the RPIP Working Group, in 2016, presented on Recruitment in Psychiatry – an International Perspective at the RCPsychUK International Congress, which was well received.
Apart from recruitment focus, the RPIP Working Group looked at the matter of retention. It took on a more inspirational path from 3 different perspectives through a series of videos titled Role Model, aimed at Psychiatric trainees.
The videos mentioned above are available on YouTube and through links on the EFPT website making it accessible to all. We would also welcome input and improvisation for future applicability. The upcoming project titled Diversity in Psychiatry with aim to provide awareness of what a career in Psychiatry has to offer. One of the quotes from the interviewee that stood out is “ Psychiatry is the final frontier of Medicine”. On reflection, I could not agree more.
As part of EFPT in general, my fellow RPIP comrades and I would like to extend our invitation and welcome to the Bristol Forum in July with aim of shaping the future of psychiatry. The trajectory of Psychiatry is one to be observed and proudly be part of. There is reward in this journey. Let’s make it together.
In Autumn 2017, Matilda Salta undertook an exchange in Umeå, Sweden
Being raised and education in a southern European country, Portugal, when I saw the option to undertake an internship so far north in Europe, it immediately became my first choice for an EFPT Exchange Program application. Personally, the choice was also influenced by my wish to experience living in a Scandinavian country, and the possibility of seeing an Aurora Borealis (the Northern Lights). Professionally, I heard great things about the work performed by Scandinavian Psychiatrists, and was curious to see how certain cultural factors may influence the presentation of patients with psychiatric illnesses. My greatest interests in Psychiatry are psychopathology and somatic treatments. The inspiration to go to a country where I don’t understand the language had to do with my readings about the psychiatric practice of some “classic” psychiatrists, that had travelled around Europe to get to know and observe patients in different countries and asylums. The language was not barrier because my purpose was to observe that patients’ behaviour, attitudes, and the various avenues of nonverbal communication. I wanted to work in an acute patient setting in a neuropsychiatric ward, and that was what happened – I had, for two weeks, the possibility to join the work done in Ward 2 in Umeå Psychiatry Department, which admits psychotic patients with several different illnesses.
It all went great, from the beginning to the end of the stay: the Local Coordinator, Dr. Matilda Naesström, was of amazing availability to host me and mycolleagues, having planned our internship and social activities in a very creative way. And, what at first sounded strange “what could you possibly learn in a ward with patients whom you cannot understand?” turned out great. My supervisor, Dr. Peter Asellus got the idea. “So, you’re interested inphenomenology?”. Exactly!
Umeå is a beautiful city, the city of birches. One of my personal life dreams came true when we had the luck to watch an Aurora Borealis (weather and activity were matching for two nights during my time there). I met great colleagues from Sweden, one from Portugal, from France and from Turkey, all very nice and fun to be around. Saw some beautiful landscapes in the area called HighCoast, two hours driving far from Umeå.Went to nice restaurants and the best cocktail bar I’ve ever been. And finally got to work with a very competent team in the ward. I discussed some interesting perspectives on psychopathology, psychiatric nosology and treatment approaches. My main goal was achieved: I definitely consider myself more experienced in psychopathology learning, especially because I ascertain the patients’ symptoms, which I obviously couldn’t verbally obtain, integrate them into syndromes and discuss the differential. I was amazed (but not that surprised) on how much objective clinical information one can obtain just by watching the patients behaviour. Also I got to learn how the Department is organized, and how psychiatric learning and practice works in Sweden.
In conclusion, I couldn’t stop recommending this place to all my colleagues in Setúbal Hospital Centres’ Psychiatry Department, where I work. And even got the desire to return, and even possibly emigrate to Sweden!
Best regards to all the EFPT Team and thank you for your important work!
About the EPA
The European Psychiatric Association (EPA) was founded in 1983. With active individual members in as many as 88 countries and 42 National Psychiatric Association Members who represent over 80.000 European psychiatrists, the EPA is the main association representing psychiatry in Europe. The EPA deals with psychiatry and its related disciplines and it focuses on the improvement of care for the mentally ill as well as on the development of professional excellence, through activities addressing the interests of psychiatrists in academia, research and practice throughout all stages of career development.
EPA’s support to the Early Career Psychiatrists
To face the challenges of a rapidly changing disciplines, the EPA aims to give young professionals a voice in the development of training, research and practice standards, helping them shape their professional identity and move forward in their career with confidence. As the main association representing psychiatry in Europe, the EPA strives to offer stimulating and inspiring opportunities for young psychiatrists through educational and training activities across Europe, as well as during the annual European Congress of Psychiatry.
How to get involved?
The EPA has been developing a variety of activities such as a scientific track and networking opportunities during the EPA annual congress specifically for Early Career Psychiatrists (ECPs). During the 27th European Congress of Psychiatry in Warsaw, Poland (6-9 April 2019) the programme will once again focus on popular topics for young psychiatrists. Be sure to check our website for upcoming information on the programme here.
In addition to our dedicated congress programme, several other EPA activities are of high interest for ECPs, such as the upcoming EPA MOOC (Massive Open Online Course): an “Introduction to Cognitive Behavioural Therapy”. With this free online course, ECPs will be able to understand the varieties of CBT, their evolution, the application of CBT to various disorders, its key clinical features and the place of this important therapy in psychiatry today. More information on this exciting course, composed of mini-lecture videos, demonstrative role-plays and interviews with international experts in the field, is available at www.europsy.net/onlinelearning.
Every year, the EPA also organises an annual Summer School, a programme tailored for 25 selected young psychiatrists from all over Europe, who come together for a three-day intensive programme led a renowned faculty. This year, the topic will be the “ABCs of Psychotherapy”, and the event will be held in Strasbourg, France, on 6-9 September 2018. Be sure to visit our website for more information!
The EPA Early Career Psychiatrists Committee
These events are planned with the full involvement of the EPA ECP Committee which aims to give ECPs a voice in the evolution of clinical training, research and practice standards to enable them to take influence on their own career. The Committee itself consists of five members and more than thirty ECPs are actively involved in its four Task Forces focused on Research, Publications, Meetings & Associations, and Professional Development.
The conference focused on the topic “belonging to” and this motto was found in many of the Congress’s events. The bi-annual scientific Congress is the largest child and adolescent psychiatry and psychotherapy event in the German-speaking world. The congress offers an important opportunity for further professional development and the presentation of the latest scientific results, as well as the possibility for a regular reunion of colleagues and to get to know new participants and exchange experiences.
“Belonging to” is a theme that is relevant to all children and young people from early childhood. Being part of a family, friends, school, sports clubs etc.
“Belonging to” has many facets in our society. It shows, on the one hand, the discussion about the inclusion of children with difficulties in regular school teaching. In addition, children who are particularly burdened also need better participation opportunities in our society. At the moment, the refugee crisis and the fate of the unaccompanied underage refugees make it clear every day how important acceptance and opportunities are for a successful treatment of trauma. Therefore, during the UNICEF day on Saturday, 25 March, the focus was on the participation and integration of mostly young refugees as well as on the topic of international work.
This year, it was a great honor that the EFPT could be represented by a symposium on the subject during the UNICEF day.
“Intercultural understanding within the framework of specialist training –
The example of the European Federation of Psychiatric Trainees –
Chances and opportunities”
The contribution demonstrated the opportunities for intercultural understanding and perspective which arise through the EFPT.
During the symposium, the importance of intercultural understanding for child and adolescent psychiatrists was discussed. The work of the CAP working group was presented. In addition, the exchange program was outlined, allowing young clinicians in psychiatry to gain experience in other European countries, representing an opportunity for intercultural understanding for curious trainees. In addition, opportunities for young researchers in Europe were presented.
The 90-minute symposium was organized by representatives of EFPT: Teresa Gómez Alemany (Barcelona, Spain); Franziska Bässler (Heidelberg, Germany); Roland Grassl (Vienna, Austria) and Sarah Maria Birkle (Hamm, Germany). There was a total of four lectures which were assessed by the participants as a very positive experience.
This symposium was a clear example of the determined strength and persistent enthusiasm shown by EFPT members.
This example demonstrates that EFPT gives us the opportunity to develop intercultural understanding towards our profession and our patients, to obtain different perspectives during our training program, and enables an international approach to our thoughts and ideas enriching both our common and individual goals.
At this point we would also like to give our thanks to the DGKJP for the opportunity to participate in the congress.
Teresa Gómez Alemany (Chair of the EFPT- CAP Working Group and EFPT Board Member)
Sarah Maria Birkle (EFPT CAP and – Exchange Working Group member, CAP representative EFPT, Germany)
Franziska Bässler (Former EFPT Board Member and – EFPT secretary)
Roland Grassl (Former EFPT Board Member and – EFPT treasurer)
For the first half of the EFPT year, MENTA has been working hard to fulfill the goals set in Istanbul, in accordance with our new statement:
“EFPT strongly believes that the coordination of trainees’ interests and efforts is key to promoting high quality psychiatric training. It is therefore essential that all psychiatric trainees are represented by national trainee organisations in their countries. These associations are the core of the Federation, keeping it international, strong and continuously active in the improvement of psychiatric training around Europe and the world. EFPT should serve as a model, guide and framework to maintaining the existing national trainees associations and establishing new ones in Europe and beyond, serving for the best interests of trainees from all over the globe”.
To that end we have been maintaining regular online communication amongst the members of our WG, which includes 10 trainees from 8 countries.
Our first and most important objective is to help trainees from all the National Training Associations (NTAs) to maintain strong and active associations within their countries. We are in close contact with the EFPT Board and the General Manager of NTAs in order to give the necessary assistance, mainly to those countries which find it difficult to actively maintain their associations and fully participate in the Federation. We invite any trainee who may be having difficulties in the development of their NTA to contact us.
Secondly, our most visible work is to promote the establishment of new NTAs and their full integration with EFPT. We hope that Kosovo and Moldova will join us as full members in Bristol 2018, following their fruitful participation in the previous annual fora. We have also contacted two motivated trainees from Bulgaria (Kaloyan Martin and Kristina Semdakova) thanks to their participation in the Young Psychiatrist’s Network, and are providing guidance to establish an association and begin their active participating in EFPT. We are also reaching out to colleagues from Iceland.
This year MENTA has made the significant step of expanding the EFPT model beyond Europe. Our Iranian colleagues, leaded by Elham Shandiz, have recently established their NTA, and sent us a picture of its Board (pictured); they are eager to collaborate with EFPT and promote new national associations in Asia. On the other hand, Samadhi Salguedo, from Bolivia, is struggling hard to establish their national association. Starting from that country, and with colleagues from Argentina, Guatemala and Panama, we think that a big movement of trainees may rapidly spread in Latin America. Our hope is that in the near future, trainees from around the globe will be more and more united: perhaps a World Federation of Psychiatric Trainees?
We are happy to keep working for the federation, and are quite open to more trainees who wish to participate in our group. Do not hesitate to contact us!
Beck Institute for Cognitive Behavior Therapy is a leading international source fortraining, therapy, and resources in CBT. Our mission is to improve lives worldwide through excellence in Cognitive Behavior Therapy.
Cognitive Behavior Therapy (CBT), was pioneered by Dr. Aaron T. Beck in the 1960s. Unlike traditional psychotherapy, he developed a treatment that was short-term and focused on problem-solving and teaching clients skills to make long lasting change in their thinking, behavior, and mood.
In the years since its introduction, CBT has been studied and demonstrated to be one of the most effective treatments for a wide variety of disorders. Thousands of studies have demonstrated its efficacy for psychiatric disorders, psychological problems, and medical issues with a psychological component.
Beck Institute for Cognitive Behavior Therapy was founded in 1994 by Dr. Aaron Beck and his daughter, Dr. Judith Beck, a preeminent psychologist in her own right, as a new setting for state-of-the-art psychotherapy and professional training opportunities. Through their vision, Beck Institute has carried out the mission of teaching CBT to health and mental health professionals, enhancing the lives of people worldwide. Over the last 23 years, Beck Institute has grown into an unparalleled hub for CBT excellence.
Beck Institute runs unmatched training workshops both for individual professionals and for organizations, offers online resources to consumers and professionals alike, and provides therapy to clients at our Philadelphia headquarters. In addition to professional and client services, Beck Institute remains an international authority and resource for CBT information and research.
Today, Beck Institute continues the work of Dr. Aaron Beck by educating health and mental health professionals, students, and organizations in CBT through our interactive and experiential training, both in person and online. Offering a full range of training opportunities for professionals, educators, and students, training with Beck Institute faculty prepares clinicians for excellence in the field.
Beck Institute has an alumni network of nearly 5,500 individuals who have participated in in-person workshops since 2008, and over 6,000 individuals from 99 countries who have participated in online courses since the courses began in 2016. Each year, Beck Institute also trains thousands of clinicians through training in workplaces and at professional conferences throughout the world. According to 2016 survey results, 98% of workshop trainees would recommend Beck Institute workshops to their colleagues.
We believe that teaching CBT will improve the lives of both therapists and their clients, and fill the world with healthier, happier people.
Learn more about:
During and after the most recent EFPT Forum in Istanbul, where I officially stepped down from the EFPT board after 4 years of service, many have asked me what life brings after EFPT. Each time, I have found it difficult to answer that question while wondering if there is really such a thing as “after EFPT”. Perhaps it is just my stubborn reluctance to the notion of being “retired” and embracing the “alumnus” status, yet I still feel part of EFPT – a feeling I expect will linger on long after I will have finished my training (which is scheduled by 1.5 years from the time I am writing this piece). Stepping down from certain tasks and responsibilities of a formal EFPT role has certainly created some much-needed free space in my agenda, mailbox and mind, from which other projects in my professional and personal life can benefit. Yet I know that whenever I choose to step out into the world of European psychiatry once more, be it at a congress, exchange, EFPT Forum or simply in some new (digital) venture, I will meet all of my friends again!
I want to seize this opportunity to talk a bit about the decisions that lead me to take on a formal role in EFPT, first as member of the board and later as President-Elect. I am reiterating this story as some of you may find you can relate to this. In both cases, I owe so much to the people who encouraged and mentored me into taking my engagement with EFPT to the next level. I owe them for pushing me outside of my comfort zone and making me do something I would certainly not have been ambitious or confident enough to do on my own. Because of these EFPT friends who believed in me from the start and who helped me along the way, we were finally able to bring to life two ideas which were the motor for my commitment in EFPT, i.e. the reform of Forum fees to make them more democratic and fair for trainees from lower income countries, and the project that eventually became #TYOT. Back then as much as today, I was eager to extend the rewards that EFPT brought to me personally to other trainees and I am therefore very proud of these collaborative achievements. Likewise, I am exceedingly proud of my fellow LOC members who did the unthinkable and moved heaven and earth to organize a successful Antwerp Forum seemingly against all odds! Even today, I am at a loss to understand how we managed to do what we did – thank you so much, dear friends!
I am confident that EFPT by itself is responsible for preventing me from burnout or dropping out of my training throughout these past years. Whenever I found myself frustrated or lacking in motivation in my workplace at times, EFPT offered the necessary inspiration, companionship and support through which I could both channel and fuel my ambition and passion to make a positive impact. I therefore feel extremely grateful to EFPT for giving me these opportunities, for allowing me to learn and grow in a safe yet challenging peer-supported environment. Each of the different EFPT boards I was a member of provided keen and distinct examples of leadership and teamwork which helped me to grow both in terms of skill and confidence – and to feel supported in finding my own personal style. I can recommend this experience to each and every psychiatry trainee. Whatever role you take on, EFPT will not let you down!
In summary, to cite the wise words of our current EFPT president which were sung at a certain International Night in a certain Flemish city: “EFPT – nothing compares to you!”
Livia De Picker
EFPT President 2015-2016