Message from an EFPT exchange participant

Dr Owen P O’Sullivan, St. John of God Hospital, Stillorgan, Co. Dublin, Ireland.

I am an Irish psychiatric trainee based in Dublin. I have a strong interest in neuropsychiatry and the history and philosophy of psychiatry.

I was selected to participate in the EFPT exchange program in the spring of 2015. During my stay, I undertook a four-week Clinical Observership based in the STOCAD (Brain Stimulation) Unit at the Pitié-Salpêtrière Hospital in Paris, one of the largest and most celebrated hospitals in Europe.exchange2015owen

I applied in the hope of getting fresh perspectives on a different healthcare system and some hands-on exposure to another culture from the viewpoint of my trainee counterparts abroad. The “total immersion” nature of the Paris placement with regard to the language was a critical factor for me. I have always loved learning French and owing to its illustrious role in the history of psychiatry, the Pitié-Salpêtrière was an easy first choice.

I submitted my application toward the end of my basic specialist training scheme and was very fortunate as my consultants in Dublin at the time (Drs Paul Moran & David McNamara) were fully supportive of both my application and, ultimately, in facilitating my leave from work.

STOCAD is a small, but highly-specialised tertiary referral centre which delivers rTMS, DBS and virtual reality therapy for treatment-resistant OCD, ADS and recurrent depressive disorder and several other disorders that have not responded to conventional treatment. My time was spent observing initial assessments on admission, taking histories from patients, sitting in on routine ward reviews by internes and participating in the weekly ward round and teaching sessions. I also got the opportunity to observe the entire rTMS process from start to finish and sit in on several virtual reality therapy sessions for patients with recurrent fails. TMS and virtual reality therapy are not currently accessible in Ireland and it was great for me, as it was an observership, to be afforded the time and space to discuss the more practical aspects of it with patients and nursing staff.

Innumerable discussions and debates were held on ward rounds – and later even over a glass of wine – on the current state of psychiatry, differing practices between countries and the indeed the changing roles of psychopharmacology, ECT and psychotherapy in the context of the advent of newer modalities such as, rTMS and virtual reality therapy.

I owe a special thank you to all of the doctors, internes, externes and nursing staff that were so welcoming and obliging in assisting me throughout, as well as the local coordinator of EFPT Exchange Programme Clara Feteanu. On a practical note, as French is the language of the exchange, at the very least intermediate level would be required. For would-be applicants, I would recommend they have an assessment at their local Alliance Française to gauge their level with regard to the Common European Framework of Reference for Languages. I relished my time in Paris and would strongly recommend any interested trainees to apply for this exchange program.