Exchange Programme Keeps Flourishing. But What is It?

Opened in 2011, the EFPT exchange programme has just selected participants for it’s 15th exchange placement period. Since the inception of the exchange programme, more than 200 have gone on exchange. In the 15th period, 70 trainees applied to go on exchange in 16 countries that were proposed by their colleagues. As usual, the English-speaking countries were the most popular, but interest in other countries keeps growing as well. EFPT Exchange working group, with support from the EFPT, also offers one bursary per application period for participants from lower income countries. Selection for it is based on merit. More info about the exchange can be found here…

Key points:

  • Selection periods: 2 times per year (next – April)
  • Observership period: 2-6 weeks. February – July and August – December
  • Who can apply: all psychiatry trainees across the Europe
  • Price: free of charge
  • Selection criteria: letter of motivation, CV, language proficiency, seniority in training
  • One bursary per selection period is offered
  • More than 90% of trainees were very satisfied with the experience.

But who can present the benefit of experience than the trainees themselves? Let‘s travel to Bristol with Zsófia Nemes from Hungary, who went on the EFPT Exchange Programme to Bristol Severn April 2018 and won the EFPT bursary as well.


Testimonial of Zsófia Nemes

In April 2018 I had the chance to spend a delightful time in Bristol, U.K. I stayed for four weeks at the home of an eating disorder specialist colleague, and I have to point out that he and his family were the most perfect hosts. I strongly recommend staying with them. Also, I have a lot to thank to the exchange programme organizer in Bristol, Dr. Stuart. He helped me with everything, so I could join various kinds of wards and outpatient care teams. He even suggested great free time activities according to my interests.

I found my observership really useful. Mostly I chose outpatient carer teams, since in Hungary the after-care hasn’t got that complexity yet. I was also interested in forensics. For my goals I had to visit different hospitals/outpatient centers almost every week, but travelling in Bristol was pretty simple (nearly everything is available on foot/by bike).

First, I experienced how a Liaison Team works. During that week I was involved in the in-patient examinations, the out-patient follow-up meetings, helping with the documentation and risk assessment, too. I participated in a Bálint group as well. Interestingly, though Mihály Bálint was Hungarian, it was the first occasion for me. During the group, I had the strange feeling that Hungarian and British psychiatrists share the same problems and feelings, despite the very different circumstances given.

My next stop was the Intensive Crisis Support Unit, which we don’t have in Hungary (and we can’t go to visit patients at home neither). In my opinion, it is a quite well-functioning system, as I found the clients really engaging with the follow-up, medication, and if needed, with hospitalization, too. The colleagues explained how the referral system works, also the role of the Mental Health Act. It was great to see how every level of professionals work together. I dare say I saw the most exciting cases here, visiting and supporting partially decompensated patients (and family) in their own environment.

With the Early Intervention team (which is in progress in our capital) I observed once again how engaged patients and family can be with treatment with the right help. They regard the engagement as the very first point of therapy, then follows the triage and the assessment. They use a sophisticated method to categorize first-episode psychotic patients: CAARMS (Comprehensive Assessment of At-Risk Mental States). Then the team establishes the support plan, which can vary from GP liaison therapy to group therapy, individual therapy or review in some weeks, etc.

I have to admit, one of my favorite days was the HM Prison visit. I visited a category B men’s prison, where there is a 24-hour listeners scheme for prisoners who may be at risk from suicide or self-harm. They have a dedicated Integrated Drug Treatment Service, too. It was exciting to see not only the examination of these seriously ill patients, and the differential diagnosis in progress, but the careful planning of the emission, too. Very hard work, but it can be uplifting.

For clearly mentally ill people there are high, medium and low-level security hospitals. I participated in a Forensic Ward round at Blackberry Hill Hospital. They have an amazing 20-person psychotherapy department for women, mostly living with personality disorders. It is incredibly well constructed: besides the usual elements, it has a metal workshop, a music room with different instruments, a gym and a garden with a lot of group exercises, for instance.  Patients and carers work together as a strong, very cohesive community.

I have spent a very short time at the Intensive Care Ward, which is an entirely different world from my home country. They provide an extreme number of psychiatric nurses to care for the patients. In this system they don’t use any form of restraint, which is sometimes more dangerous than the obsolete methods – according to a doctor there. Still, patients don’t get into humiliating situations, so their short- and long-term engagement with the therapy is easier to gain, therefore prognosis becomes better. Despite the intensive care nature of the ward, patients have the possibility to participate in art, drama or occupational therapy, for instance. I found it very confusing, challenging forward thinking at the same time, that improving patients can go to escorted, then later unescorted leaves, moreover they are provided with a supported, shared apartment if needed. It requires great trust and open-mindedness to run an acute-open ward.

Mother-Baby Unit was one of my main goals to see, unfortunately they cancelled the visit due to a shortage in human resources. Maybe, other trainees will have more luck.


In summary, this traineeship in Bristol gave me much insight and many great experiences about a different culture and its health care system. I really appreciated the time and thoughtfulness given to me during my whole stay.  I believe I have learned skills that will help me to be more productive, creative, and foresighted as well in my everyday job. Nevertheless, the settings I have observed gave me ideas that in the future I hope we can realize in my home country. I am truly thankful to everybody who attended me through this challenge. Also, getting to know Bristol was a gift: I won’t forget the lovely people and that very artistic, modern, youthful atmosphere it has.


I definitely will visit Bristol again – and won’t miss the Balloon Fiesta next time!



EFPT Exchange working group is always looking for new placements, so if you think that your department would be willing to accept a trainee from another exchange country – do not hesitate to contact us!


TL-DR: prepare your documents and apply for the adventure of your training!


Aiste Lengvenyte

Chair of the Exchange Working Group

General Manager for Exchange