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Baessler F, Zafar A, Gargot T, da Costa MP, Biskup EM, De Picker L, Koelkebeck K, Riese F, Ryland H, Kazakova O, Birkle S, Kanellopoulos T, Grassl R, Braicu A, Schultz JH, Casanova Dias M. Psychiatry training in 42 European countries: A comparative analysis. Eur Neuropsychopharmacol 2021; 46:68-82. [PMID: 33678470 DOI: 10.1016/j.euroneuro.2021.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/15/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
Psychiatry qualifications are automatically recognized among European Union (EU) countries despite differences in national training programs. A widening gap between the number of psychiatrists, their competencies and the growing burden of mental illnesses in Europe has renewed calls for international standardization of training. Comprehensive information about training programs is missing, which limits thorough comparisons and undermines development of an actionable strategy to improve and harmonize psychiatry training. This study describes and compares the existing postgraduate psychiatry programs in 42 countries in the European region. Representatives of national psychiatry associations completed a semi-structured, 58-item questionnaire. Training structure and working conditions of each country were compared with population needs calculated by the World Health Organization to determine the European mean and contrasted among pre-2004 and post-2004 EU members and countries with unrecognized qualifications. Differences were tested with nonparametric (Wilcoxon) and parametric (Anova) tests. Median training duration was 60 months, significantly shorter in countries with unrecognized qualifications (48 months, χ²16.5, p < 0.001). In 80% of the countries, placement in a non-psychiatric specialty such as neurology or internal medicine was mandatory. Only 17 countries (40%) stipulated a one-month rotation in substance abuse and 11 (26%) in old-age psychiatry. The overall deficit of training versus population need was 22% for substance abuse and 15% for old-age psychiatry. Salaries were significantly higher in pre-2004 EU members (χ²22.9, p < 0.001) with the highest in Switzerland (€5,000). Significant variations in curricula, training structure and salaries exist in Europe. Harmonization of training standards could offer significant benefits for improving mental healthcare.
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Affiliation(s)
- Franziska Baessler
- Center for Psychosocial Medicine, Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
| | - Ali Zafar
- Center for Psychosocial Medicine, Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Thomas Gargot
- Psychiatrie de l'Enfant et de l'Adolescent, Pitié Salpêtriére - Charles Foix, Assistance Publique Hôpitaux de Paris, 47/83 boulevard de l'Hôpital, 75013, Paris, France; ISIR, Sorbonne Université, 4 Place Jussieu, 75005, Paris, France; CHART Laboratory - EA 4004, TIM, Paris 8 University, 93526, Saint Denis, France
| | - Mariana Pinto da Costa
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom; Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal; Hospital de Magalhães Lemos, Porto, Portugal
| | - Ewelina Maria Biskup
- Shanghai University of Medicine and Health Sciences Basic Medical College, Shanghai, China; Division of Internal Medicine, University of Basel, Basel, Switzerland
| | - Livia De Picker
- Collaborative Antwerp Psychiatric Research Institute, University of Antwerp, Antwerp, Belgium; University Psychiatric Department Campus Duffel, Duffel, Belgium
| | - Katja Koelkebeck
- LVR-Hospital Essen, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - Florian Riese
- University Hospital of Psychiatry Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland
| | - Howard Ryland
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Olga Kazakova
- Psychiatric Department, Psychiatric Clinic of Minsk City, Minsk, Belarus
| | - Sarah Birkle
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tuebingen, Germany
| | - Thanos Kanellopoulos
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children`s Hospital, Athens, Greece
| | - Roland Grassl
- University Clinic for Child and Adolescent Psychiatry and Psychotherapy, Vienna, Austria
| | - Alina Braicu
- National Centre for Mental Health, BSMHFT, Birmingham, UK
| | - Jobst-Hendrik Schultz
- Center for Psychosocial Medicine, Department of General Internal and Psychosomatic Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Marisa Casanova Dias
- Department of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK; Section of Women's Mental Health, Institute of Psychiatry, Psychology, and Neurosciences, King's College London, London, UK
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Gargot T, Arnaoutoglou NA, Costa T, Sidorova O, Liu-Thwaites N, Moorey S, Hanon C. Can we really teach cognitive behavioral therapy with a massive open online course? Eur Psychiatry 2020; 63:e38. [PMID: 32151289 PMCID: PMC7358632 DOI: 10.1192/j.eurpsy.2020.29] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
A better training in psychotherapy is needed for psychiatry trainees. Online Cognitive Behavioural Therapies (CBT) could be a good solution. Free and wide audience course like Massive Open Online course (MOOCs) increase dissemination and accessibility of the training. However, the engagement needs to be improved. A hybrid approach seems relevant with the MOOC as an incentive. Beyond the promotion of the topic, a MOOC can be a promotion tool for the provider. The economic model of the MOOC needed to be taken into account to allow sustainability. To explore these elements, we take into account a survey taken during the 1st European Psychiatric Association MOOC about CBT.
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Affiliation(s)
- Thomas Gargot
- CHART Laboratory-EA 4004, THIM, Paris 8 University, Paris Lumière University, Saint Denis, France.,Psychiatrie de l'Enfant et de l'Adolescent, Hôpitaux Universitaires, Pitié Salpêtrière-Charles Foix, Paris, France.,ISIR, Sorbonne Université, Paris, France.,European Federation of Psychiatric Trainees Psychotherapy Working Group, Bruxelles, Belgium.,European Psychiatric Association Psychotherapy Section, Strasbourg, France
| | - Nikitas A Arnaoutoglou
- European Federation of Psychiatric Trainees Psychotherapy Working Group, Bruxelles, Belgium.,European Psychiatric Association Psychotherapy Section, Strasbourg, France.,Windsor Research Unit, Cambridgeshire, Peterborough NHS FT, Cambridge, United Kingdom.,Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.,Memory and Cognitive Functions Clinic, 1st Department of Psychiatry, "Papageorgiou" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Tiago Costa
- Cumbria, Northumberland, Tyne and Wear, NHS Foundation Trust, Northumberland, United Kingdom.,Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Olga Sidorova
- European Federation of Psychiatric Trainees Psychotherapy Working Group, Bruxelles, Belgium.,European Psychiatric Association Psychotherapy Section, Strasbourg, France.,Riga East University Hospital, Riga, Latvia
| | | | - Stirling Moorey
- South London and Maudsley NHS Trust, Beckenham, United Kingdom.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Cécile Hanon
- Regional Resource Center of Old Age Psychiatry West-Paris University Hospital, Corentin Celton Hospital, APHP, Paris-Descartes University, Paris, France
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