EFPT Exchange Programme – the experience of being a young psychiatrist abroad

During the autumn of 2013, I have spent the last 3 weeks of September in the Adolescent Psychiatry Department of KBC (University Hospital Center) Rijeka in Croatia through the EFPT Exchange Programme. Rijeka is the main port city of Croatia and the third largest in the country, being situated on the northern part of the Adriatic coast.

The person who received me in the clinic was Dr. Mirjana Graovac, head of Adolescent Psychiatry Department of KBC Rijeka. Although her programme is very busy, she made sure everyday that I got the best of my experience in their clinic.

The Adolescent Psychiatry Department provides both in-patient – with a number of 6 beds, and out-patient services. In the clinic there work three specialist doctors, the head nurse, a psychologist, nurses and a variable number of residents. What I most enjoyed was their focus on psychotherapy, with regular and very well organized programmes of both individual but mostly group psychotherapy. I was able to attend the daily adolescent groups and even some of them were held in English, by the kindness and participation of their young patients.

Every morning the head nurse, the psychologist or one of the residents held the adolescent group sessions. For two days a week – Tuesday and Thursday – also outpatients came to the clinic and took part in this routine. Once a week there are held Counseling Groups for patient families because the clinic has its main focus on the development of healthy families.

Another great thing that is quite different in Romania is that all the staff of the clinic had some form of therapy training and they were all involved in different psychotherapeutic activities. For example there were days when the head nurse, Liliana, held the „Social education groups”, also in the afternoons and before dinner the nurse on duty had occupational or art therapy groups with the kids. This is definitely a model worth copying!

The reality of Croatian psychiatry gave me the greatest lesson one can learn trough this kind of experience: we might have an international system of classification but the social impact on mental health makes psychiatry very different from country to country. As a practitioner abroad you are confronted with a multitude of pathology that might seem as foreign to you as a language you never heard.

In the Rijekian clinic a large number of adolescents were victims of the post-war socio-economic difficulties, even though the war had ended for 18 years now. Almost all of their parents were, direct or indirect victims of the war, suffering themselves from PTSD, depression or other medical and mental health problems. This context lead to attachment pathology in the young generation, frequently associating addictions, school ditching or drop-out, behavioral problems and so on. Nevertheless the majority of these kids had great personalities, were very smart and articulated. All of them needed a great deal of love and support and were very quick in forming friendships. Language was never a barrier as they spoke excellent English.

It is believed that post-war generations are the most resilient as they have a great need to stride and heal both their country and themselves. All I hope is for these young people to get the strength they need to stop the “trans-generational transfer of trauma”, because they already have the chance of very good trained and eager mental health professionals who work every day to make possible an incredibly well organized and functional system of support and care.

To sum up, I recommend the EFPT Exchange Program to all my fellow residents as one of the most useful experiences any young psychiatrist can have. In this Era of Globalization you never know to which part of the world your professional steps might take you.

Special thanks to Dr. Marina Fistonić for all her kindness and helpfulness!

Dr Cristina Petrescu-Ghenea
Child and Adolescent Psychiatry Department,
“Prof. Dr. Al. Obregia” Clinical Psychiatry Hospital, Bucharest


Host, Dr Marina Fistonić (left) with Dr Cristina Petrescu-Ghenea