Grenoble, January – February 2015
by Lucy Stirland
I have been a Francophile since being inspired by two eccentric French teachers at school, and was therefore instantly enthused when I first heard about the EFPT Exchange Programme. Thanks to the support of my home Deanery, supervisors and colleagues, I embarked on a three-week trip to Grenoble, nestled in the French Alps, from January to February 2015. I hoped that experiencing French psychiatry first-hand would give me the chance to practise my medical French and find out if I could see myself working in a francophone country in future.
I spent most of my placement at the Centre Hospitalier Alpes-Isère just outside Grenoble which, like my own hospital, is over 200 years old and is in the process of being modernised. I visited an acute admission and assessment ward and a longer-stay general adult ward, as well as seeing emergency consultations in the general hospital’s Emergency Department, sitting in at an outpatient clinic and joining a mobile géronto-psychiatrie team. The French state health system seemed to me rather more complicated at the point of delivery than the UK’s National Health Service (NHS), but does provide a high standard of care for people with mental health problems including long-term follow-up and medication at no cost to the patient.
There was plenty of opportunity to compare and contrast the practice of Psychiatry in the UK and France, but the most obvious difference for me was the variation in the medication used. Around a third of the drugs I saw prescribed are not used in the UK, and patients seem to stay on certain medications (particularly sedatives) much longer than they would in the UK. The way the French structure and record patient histories and mental state examinations also differs from British methods, but this made me reflect that perhaps the way we are taught is not the only right way.
France and the UK share similar problems in terms of recruitment and retention of trainees to Psychiatry, and the hospital in Grenoble particularly struggles to attract doctors. Their inventive methods of encouraging people to work and stay there include offering trainees quality accommodation at subsidised rates and two free delicious canteen meals each per day.
The local trainees’ hospitality was extremely warm and generous, and they hosted various traditional alpine meals for me, mostly revolving around melted cheese, meat and wine. I was kindly put up by one trainee for most of my stay and he took particular care to help me improve my French and include me in social activities. In return I shared my experiences of life as a trainee in Scotland, both clinical and cultural.
I had an extremely rich and worthwhile experience and would strongly encourage other trainees to join the EFPT Exchange Programme and forge links across Europe.
Lunch in the canteen (free!)
Centre Hospitalier Alpes-Isère main entrance
All photos taken by me