Abstract Background Postgraduate medical trainees experience high rates of burnout, but evidence regarding psychiatric trainees is missing. We aim to determine burnout rates among psychiatric ...trainees, and identify individual, educational and work-related factors associated with severe burnout. Methods In an online survey psychiatric trainees from 22 countries were asked to complete the Maslach Burnout Inventory (MBI-GS) and provide information on individual, educational and work-related parameters. Linear mixed models were used to predict the MBI-GS scores, and a generalized linear mixed model to predict severe burnout. Results This is the largest study on burnout and training conditions among psychiatric trainees to date. Complete data were obtained from 1980 out of 7625 approached trainees (26%; range 17.8–65.6%). Participants were 31.9 (SD 5.3) years old with 2.8 (SD 1.9) years of training. Severe burnout was found in 726 (36.7%) trainees. The risk was higher for trainees who were younger ( P < 0.001), without children ( P = 0.010), and had not opted for psychiatry as a first career choice ( P = 0.043). After adjustment for socio-demographic characteristics, years in training and country differences in burnout, severe burnout remained associated with long working hours ( P < 0.001), lack of supervision ( P < 0.001), and not having regular time to rest ( P = 0.001). Main findings were replicated in a sensitivity analysis with countries with response rate above 50%. Conclusions Besides previously described risk factors such as working hours and younger age, this is the first evidence of negative influence of lack of supervision and not opting for psychiatry as a first career choice on trainees’ burnout.
Abstract Number and procedures of involuntary hospital admissions vary in Europe according to the different socio-cultural contexts. The European Commission has funded the EUNOMIA study in 12 ...European countries in order to develop European recommendations for good clinical practice in involuntary hospital admissions. The recommendations have been developed with the direct and active involvement of national leaders and key professionals, who worked out national recommendations, subsequently summarized into a European document, through the use of specific categories. The need for standardizing the involuntary hospital admission has been highlighted by all centers. In the final recommendations, it has been stressed the need to: providing information to patients about the reasons for hospitalization and its presumable duration; protecting patients’ rights during hospitalization; encouraging the involvement of family members; improving the communication between community and hospital teams; organizing meetings, seminars and focus-groups with users; developing training courses for involved professionals on the management of aggressive behaviors, clinical aspects of major mental disorders, the legal and administrative aspects of involuntary hospital admissions, on communication skills. The results showed the huge variation of involuntary hospital admissions in Europe and the importance of developing guidelines on this procedure.
Today‘s generation relies on the Internet as their main source of information and uses it for a variety of purposes, including professional networking and education. With regard to the nature of a ...therapeutic relationship, it is necessary to establish certain professional boundaries between psychiatrists and their patients. These boundaries can be compromised by a patient‘s request to connect online via social networks. Moreover, disclosure of patient-identifiable information can undermine the assurance of doctor-patient confidentiality. Another potential drawback is the excessive and careless disclosure of private information by the psychiatrist. The use of emails for psychiatric clinical work can cause concerns on different levels. Firstly, confidentiality of email conversations can not always be garanteed. Secondly, patients and families trying to directly reach clinicians by finding their emails on the internet can disrupt the usual course of care. The use of smartphone apps and gathering of data through them also creates new ethical issues. The consequence of constantly monitoring citizens by state-sized private companies is a concern, like the use of private or medical data to promote products and influence behaviours, or to determine insurance policy rates. Due to these ethical challenges, many psychiatrists simply ignore social media and new information technologies. However, they miss valuable opportunities to engage in public health and policy discussions, establish national and international professional networks, and facilitate patients’ access to information about health and services. These questions and precautions should be inculcated as a part of the psychiatric training so that psychiatrists in the 21st century will be able to navigate themselves in the rapidly developing social media arena as cautious, yet active members.
Starting a private practice can be on one hand the most exciting step you will take in your career, on the other hand it can be at the same time the most intimidating one. First of all, take the time ...to really think through what you want your work schedule and surroundings to be like and then set up your office the way it will work best for you. You may not get every item on your wish list right away, but do not be afraid to try to set it up just the way you want. Build a healthy network of collaborative clinicians around your practice. Your colleagues can be a great source of referrals to your practice. And without refferals, it is difficult to maintain sufficient patient turnout. That is also why a big part of private practice is marketing. If you want to establish and develop a successful business, you must sell yourself and your practice. Beside your role as a clinician, you will also be running a business. If you seek out some private-practice coaching, you might save a lot of time. Private practice can be wonderful, it is not for everyone. Some therapists find being in a solo private practice very tiring and lonely. For some psychiatrists, the ideal is actually a group practice that has therapists, counsellors, social workers and psychologists so that supervision can be done from a multidisciplinary perspective.
Disclosure of interest
The author has not supplied his declaration of competing interest.
Ways of travelling and means of communication have exponentially developed, while their price has dropped. It is now relatively easy for a psychiatrist to travel in different countries in the early ...stages of his career. The development of European programs such as Erasmus has increased exchanges during medical school. After graduation, it is possible to travel abroad for a few weeks as an observer, months a researcher, but also for one’s entire life, as European legislation has made it possible for doctors to register and permanently work in many countries. The crisis in recruitment of psychiatrists that many countries face has put junior doctors in a position of finding a job almost wherever they want. On the one hand, this phenomenon tends to drain resources in less favoured countries, and psychiatrists travelling the world might become mercenaries, looking for the best opportunities and not being able to maintain consistency in service provision. This would ultimately lead to psychiatrists only becoming technicians, providing a service for a fixed period of time, and being replaced as leaders by managers in charge of running services. On the other hand, this constitutes a unique chance from a personal point of view, as a way to gain experience and discover other cultures. From a professional point of view, working in a different system is also a valuable experience, and the travelling doctor can bring his own culture and tend to naturally ‘think outside the box”, benefiting the service and the patients. In addition, a growing number of patients migrating themselves and coming from diverse backgrounds will benefit from a psychiatrist with a personal experience of migration.
Abstract Background Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the ...relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees. Methods One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire. Results The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean) = 0.92, SD = 1.44, range = 0–12) and most in Portugal (M = 19.06, SD = 17.44, range = 0–100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M = 3.30, SD = 1.26 vs. M = 2.39, SD = 1.06 on a 5-point Likert scale: 1 “completely disagree” to 5 “completely agree”). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio) = 1.21, 95%CI = 1.12–1.30 and OR = 1.18, 95%CI = 1.02–1.37). Conclusions There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.
Media are considered to be the public's primary source of information regarding mental illness. Evidence suggests that media representations of people with psychiatric disorders are frequently ...negative and contribute to their stigmatization. On the other hand, media can play an important role in reducing this stigmatisation by providing adequate information about this topic. An example of an use of a standardised and objective measurement of the stigma of mental illness in print media using clearly operationalized definitions will be shawn. The Picture of Mental Illness in newspapers (PICMIN) instrument is based on the principles of content analysis and used in an analysis of the coverage on mental health/illness issues in Czech, Croatian, and Slovak print media. Some of the most interesting findings based on the analysis include; a similarly high level of stigmatizing articles across countries, clearly exceeding the ones with destigmatizing statements; overrepresentation of schizophrenia and eating disorders and underrepresentation of anxiety disorders and dementia when comparing the correlation of their actual rate in the populations; the proportion of articles depicting mental disorders together with aggressive deeds being as high as onethird of all articles; homicide being most frequently mentioned in the context of psychotic disorders, while affective disorders being most frequently associated with completed suicides, etc. As the influences of the media and the stigma of psychiatric disorders are heterogeneous, activities that should tighten the mental health together with media professionals should be initiated in an ultimate effort to improve media coverage of mental illness issues.
Introduction Continuous advances in psychiatric research and increased service users’ expectations led to the need to develop a new international framework for psychiatric training. The assessment of ...early career psychiatrists’ (ECPs) views has been emphasized as an important step of this process. However, at the moment, only few national studies have investigated ECPs’ opinions on received training. Aims To assess: 1) ECPs’ satisfaction with training and self-confidence in different psychiatric domains; 2) availability of clinical supervision and educational opportunities during training. Methods The Early Career Psychiatrists Committee of the European Psychiatric Association - in collaboration with the European Federation of Psychiatric Trainees, conducted an online survey among European ECPs. The Psychiatric Training Questionnaire, a multiple choice-answer self-reported instrument developed for this occasion, was completed by 194 respondents from 34 European countries. Results Most respondents (73%) were completely or partially satisfied with the received training. Highest levels of self-confidence were reported in clinical psychiatry (93%), pharmacotherapy (68%) and emergency psychiatry (67%); the most problematic areas for ECPs were forensic psychiatry (68%), psychotherapy (63%) and child and adolescent psychiatry (57%). Thirty percent of ECPs were not assigned to a tutor for clinical activities, 67% did not receive any psychotherapeutic supervision and only 19% participated in exchange programs. Conclusions ECPs are globally satisfied with the training received; however, they report the need to enhance training in psychotherapy, forensic psychiatry and child and adolescent psychiatry, to ensure adequate supervision to all trainees and to improve the opportunities for international exchange programmes.
Research is one of the most attractive fields for young doctors training in psychiatry. The acquisition of research skills by all trainees has been recommended by recent consensus documents on ...standards of psychiatric training in Europe. However, not always trainees have adequate access to all the phases of a research project during their residencies. Joining professional associations provides opportunities for participating in research activities and establishing networks with other colleagues. In this respect, the European Federation of Psychiatric Trainees (EFPT) in 2008 started a research group with the aim of facilitating trainee-led collaborative studies. Over the years several international research projects on training-related areas have been conducted and published in international peer-reviewed journals. EFPT members can participate to all the phases of the projects as national coordinators and share with other colleagues their research competencies. Furthermore, many EFPT research projects have had the possibility to rely on supervision by internationally renowned experts. Currently, the topics of the main ongoing studies are: 1) Early career psychiatrists views on psychiatric training (in collaboration with European Psychiatric Association - Early Career Psychiatric Committee); 2) Relationship between trainees and pharmaceutical industries; 3) Child and Adolescent psychiatric training; 4) Trainees’ views on the future of psychiatry and psychiatric training; 5) Trainees’ access to information and use of information technologies during training. In this presentation, issues in research training will be discussed, the EFPT cooperative trainee-led research network will be described and an overview of the results of the ongoing studies will be provided.
Modern technology and globalization dramatically changed our perception of how research in psychiatry should be done. On one hand, research topics in modern psychiatry considerably broadened over the ...years, and opportunities for collaboration as well as dissemination of results dramatically increased. On the other hand, research in psychiatry has become highly demanding, requiring the use of the most modern methodologies, large numbers of participants and fast publications of the results in highly competitive journals. Inevitably, it has become very costly in terms of time, money and human resources. These changes brought more opportunities for research to the new generations of European early career psychiatrists. Nevertheless, they also increased the inequality in opportunities for research among them, due to relative centralization of the most “exclusive” psychiatric research sites. Indeed, the majority of European early career psychiatrists miss real opportunities to get involved in research due to a lack of mentorship, psychiatric research groups and research facilities in their countries. Within this scenario, choosing the right kind of research for early career psychiatrists might be confusing and somewhat discouraging. To support the involvement of young colleagues in research, the Early Career Psychiatrists Committee has formed the Task Force on Research. We will present several projects run by our task force, each relying on a different approach of research in psychiatry. We think that the proposed approaches would be useful for early career psychiatrists, since they take into account both the strengths and limitations inherent to the role/position of early career psychiatrists.
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