In Poland, the therapeutic modality of Electroconvulsive Therapy (ECT) boasts a history spanning over seven decades. Despite its documented therapeutic efficacy and safety profile, its integration into clinical practice remains suboptimal. Recent data elucidates a marked paucity in the utilization rate of ECT in Poland. Therefore, it is imperative to discern the barriers impeding its broader adoption of this potentially life-saving treatment.

The aim of this study is to investigate the attitude of early career psychiatrists towards ECT and its place in clinical practice in Poland.

A web-based, anonymous survey was conducted, targeting early career psychiatrists in Poland. The questionnaire, part of an international study, consisted of 36 multiple-choice and Likert scale questions.

The majority of respondents emphasised the importance of further educational opportunities related to ECT, seeing it as a safe, effective, and possibly lifesaving procedure. Most of them benefited from ECT training during their residency, however less than a half had the opportunity to administer ECT themselves. They exhibited an interest to introduce ECT into their therapeutic repertoire, depending on the provision of requisite financial and infrastructural support.

There is a palpable eagerness among early career psychiatrists in Poland to enhance their proficiency in ECT. A robust curriculum, encompassing both theoretical discourse and hands-on ECT training, is paramount for all psychiatry trainees. Concurrently, there is a pressing need to formulate national ECT guidelines within Poland, which could potentially ameliorate apprehensions surrounding this procedure.

None Declared

Electroconvulsive therapy (ECT) is a psychiatric intervention that has proven effectiveness and safety in various psychiatric conditions, such as major depressive disorder, prolonged or severe manic episodes and catatonia. Despite positive scientific evidence, ECT was always seen as controversial by patients, caregivers, and even some psychiatrists, which lead to a decrease in its use over the years.

To investigate the way young psychiatrists view the place of ECT in modern psychiatry by assessing their knowledge, attitude and access to training opportunities in ECT.

An anonymous survey was disseminated online among early career psychiatrists and psychiatric trainees. The questionnaire consisted of 36 multiple-choice and Likert scale questions.

Most of our respondents consider ECT both an effective and a safe treatment option and would recommend ECT to their patients when indicated. Early career psychiatrists who had access to ECT training are more knowledgeable about the indications, precautions and side effects of this method, but more than half of the participants mentioned ECT training was unavailable during their residency programme. Almost all respondents stated that they are interested in enhancing their theoretical and practical competencies in ECT.

Early career psychiatrists have a positive attitude towards ECT but express the need of targeted education aimed at improving levels of knowledge about ECT.

None Declared

The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.

The sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.

About 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.

The finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.

Psychiatry training programs vary in the degree to which they offer trainees with an opportunity to get involved in research. Exposure to research during the training period is critical, as this is usually when trainees start their own scientific research projects and gain their first experiences in academic publishing.

We present the European Journal of Psychiatric Trainees (EJPT) (ejpt.scholasticahq.com), the official journal of the European Federation of Psychiatric Trainees (EFPT), including its scope, mission and vision and practical considerations.

Reflecting on the foundation and operation of the European Journal of Psychiatric Trainees.

The European Journal of Psychiatric Trainees is an Open Access, double blind peer-reviewed journal which aims to publish original and innovative research as well as clinical, theory, perspective and policy articles, and reviews in the field of psychiatric training, psychiatry and mental health. Its mission is to encourage research on psychiatric training and inspire scientific engagement by psychiatric trainees. Work conducted by psychiatric trainees and studies of training in psychiatry are prioritized. The journal is open to submissions, and while articles from psychiatric trainees are prioritized, submissions within scope from others are also encouraged. The article processing fee is very low and waivable. It is planned to publish two issues yearly.

The first article was published in July 2022, titled “Fluoxetine misuse by snorting in a teenager: a case report” and it received 218 views as of 17 October 2022, which confirms the journal’s potential for visibility.

The European Journal of Psychiatric Trainees is a non-profit initiative designed to offer psychiatric trainees a platform to publish and gain experience in publishing. Thanks to its robust double blind peer reviewing system, it has the potential to contribute to scientific excellence.

None Declared

Migration of mental health professionals is an important phenomenon influencing mental health services of host and donor countries. Data on medical migration in Europe is very limited, particularly in the field of young doctors and psychiatry. To research this hot topic, the European Federation of Psychiatric Trainees (EFPT) conducted the EFPT Brain Drain Survey.

To identify the impact of previous short-term mobility on international migration and to understand characteristics, patterns and reasons of migration.

In this cross-sectional European multicentre study, data were collected from 2281 psychiatric trainees across 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on migration.

Two-thirds of the trainees had not had a short-mobility experience in their lifetime, but those that went abroad were satisfied with their experiences, reporting that these influenced their attitude towards migration positively. However, the majority of the trainees had not had a migratory experience of more than 1 year. Flows showed that Switzerland and United Kingdom have the greatest number of immigrant trainees, whereas Germany and Greece have the greatest number of trainees leaving. ‘'Pull factors'’ were mostly academic and personal reasons, whereas ‘'push factors'’ were mainly: academic and financial reasons. Trainees that wanted to leave the country were significantly more dissatisfied with their income.

The majority of the trainees has considered leaving the country they currently lived in, but a lower percentage has taken steps towards migration.

This is the first European psychiatric exchange programme and it aims to promote an intercultural professional exchange and cooperation among psychiatric trainees across Europe, with a focus on individual experience.

To provide trainees with the opportunities to:

• promote awareness of intercultural aspects of psychiatry

• engage in clinical, and/or research, and/or teaching activities

• become acquainted with different mental health systems

• gain experience of different illness manifestations and treatment options

• experience a different training programme

• socialise with peer group, promote networking and discuss coping strategies regarding work life balance

The programme was developed by the exchange working group of the EFPT in 2011 and it offers 2-6 weeks in observational placements across Europe in diverse areas.

Feedback from pilot phase (January-July 2012) has shown excellent overall satisfaction of participants in the project. In the 2nd phase (August-December 2012) the programme has expanded offering more observational placements in 8 countries such as: Croatia, Denmark, France, Italy, Portugal, Slovenia, Spain and UK. In the 3rd phase (January-July 2013) it expanded further to include Ireland, Netherlands and Romania in a total of 11 hosting countries. Placements are offered in many subspecialties such as: psychotherapy, emergency psychiatry, child and adolescent psychiatry, eating disorders, family therapy, liaison psychiatry and psychosomatics, drug addictions, learning disabilities, forensic psychiatry and old age psychiatry.

We hope that the diversity of placements offered by this innovative programme will constitute a new approach to the improvement of psychiatric training and practice across Europe.

Although psychoactive substance use disorders (PSUD) belong to the domain of mental health, their management varies greatly among European countries. Furthermore, both the role of psychiatrists and trainees in the treatment of PSUD is not the same for each European country.

Among the context of the European Federation of Psychiatric Trainees (EFPT), the PSUD Working Group has developed a survey that has been spread out between the 15th of august 2015 and 15th of October 2016, at the aim of gathering information about the training in PSUD in Europe, both from Child and Adolescent, and General Adult Psychiatric (CAP and GAP) trainees.

The survey investigated, at European level, the organisation of the PSUD training, trainees satisfaction, attitudes towards people who use psychoactive substances, management of pharmacologic and involvement in common clinical situations.

A 70-items questionnaire regarding the aforementioned objectives was developed, and shared trough an online data-collecting system among European CAP and GAP trainees, with 40 trainees per country filling the survey in at least 25 countries. One national coordinator per country facilitated the delivering of the survey.

A total of 1250 surveys were filled from more than 25 European countries.

Data from the survey will be promptly analysed.

The survey will be the first to explore European psychiatric trainees attitudes and practices about PSUD. Findings from this independent survey may serve in understanding the needs of trainees in the field of substance misuse psychiatry.

The authors have not supplied their declaration of competing interest.

Global trends in the nature of working conditions pose significant threats to the training of medical professionals, as a result of cuts in educational grants and the salaries of professionals in training. Psychiatric trainees are not exempt from these changes.

To determine the current working conditions of psychiatric trainees and how they impact on their experience of training.

A semi-structured survey was distributed to all members of the European forum of psychiatric trainees. Responses were collected online from 34 participating countries. The respondents were representatives of national trainee associations. Data collection was completed between May and July 2016.

Respondents reported that the most important issues affecting postgraduate training were firstly working conditions, then salary, psychotherapy training and supervision, respectively. The average official mandatory working hours for a trainee, including on call duty was reported to be on average 40.16 (± 10.14 hours per week). In reality, the time that trainees report working is more than 20% higher than official working hours (on average 49.08 ± 15 per week). There is an officially recognized minimum vacation period of 20 days in almost all countries, ranging up to a maximum of 40 days (mean: 26.93 ± 4.97, per year). Salaries demonstrate an even greater variation, ranging from 100 Euros (as in the case of Moldova), up to over 5000 Euros (as in the case of Germany or Switzerland) per month.

Psychiatric trainees often work longer than the officially recognized hours and their income varies considerably between countries, which have been identified as the two biggest challenges trainees face.

The authors have not supplied their declaration of competing interest.

The aim of postgraduate psychiatric training is to prepare psychiatrists to practice independently. The quality of care provided will depend on the training they received. Pregnancy and childbirth (usually called the perinatal period) are a high-risk period for many women with psychiatric problems. An illness episode at that time can have a devastating effect on women and the whole family, including the child's development.

To understand how perinatal mental health training is organized within Europe and how it fits in the training curricula.

The European Federation of Psychiatric Trainees conducts an annual survey of all member country organizations. We have asked respondents if they received training in perinatal psychiatry, whether that was optional or mandatory and what was its duration. Where training in perinatal psychiatry was not available we asked if they felt it should be.

Data will be presented from the 35 countries that responded in the 2016 survey. Six countries reported that training in perinatal mental health is available. But it is mandatory in only one, with the others offering a mix of theoretical and practical optional training. Of the 29 countries that do not offer perinatal psychiatry training, the majority reported it should be offered and mandatory.

There is a gap in the expectations of psychiatrists treating women in pregnancy and after birth, and a widespread lack of training for them to be able to do so effectively.

The authors have not supplied their declaration of competing interest.

There is a shortage of psychiatrists worldwide. Within Europe, psychiatric trainees can move between countries, which increases the problem in some countries and alleviates it in others. However, little is known about the reasons psychiatric trainees move to another country.

Survey of psychiatric trainees in 33 European countries, exploring how frequently psychiatric trainees have migrated or want to migrate, their reasons to stay and leave the country, and the countries where they come from and where they move to. A 61-item self-report questionnaire was developed, covering questions about their demographics, experiences of short-term mobility (from 3 months up to 1 year), experiences of long-term migration (of more than 1 year) and their attitudes towards migration.

A total of 2281 psychiatric trainees in Europe participated in the survey, of which 72.0% have ‘ever’ considered to move to a different country in their future, 53.5% were considering it ‘now’, at the time of the survey, and 13.3% had already moved country. For these immigrant trainees, academic was the main reason they gave to move from their country of origin. For all trainees, the overall main reason for which they would leave was financial (34.4%), especially in those with lower (<500€) incomes (58.1%), whereas in those with higher (>2500€) incomes, personal reasons were paramount (44.5%).

A high number of psychiatric trainees considered moving to another country, and their motivation largely reflects the substantial salary differences. These findings suggest tackling financial conditions and academic opportunities.

Recruitment in to psychiatry is a long-standing concern in many countries, with low proportions of medical graduates choosing it as a specialty and ongoing stigma from within the medical profession. In other countries, the reverse problem is the case, with too many doctors wishing to enter psychiatry and insufficient training places available.

To understand the current situation within Europe with regards to recruitment in to psychiatry and to identify existing initiatives designed to boost recruitment.

The European Federation of Psychiatric Trainees conducts an annual survey of all member organizations. This is purposive sampling via an online, semi-structured survey, which is completed by country representatives. The survey asks respondents to identify if their country has a problem with recruitment and if so whether there were too many or too few applicants for training places. Those countries identifying recruitment initiatives were asked to provide further details.

Data will be presented from the past three years (2014–2016). Around half of all countries have stated that recruitment is a concern in the EFPT country survey. Many report that the number of new psychiatrists is too low and vacancies are not being filled. A small number reported that the number of new psychiatrists is too high and there are not enough vacancies. Of those countries reporting problems with recruitment around half describe initiatives to improve recruitment, which include financial incentives, careers fairs, mentoring schemes and a whole host of other projects.

Recruitment in to psychiatry remains a serious problem in many European countries, but there are a wide range of initiatives, which aim to combat this shortfall.

The authors have not supplied their declaration of competing interest.

Workforce migration of mental health professionals seems to have a significant impact on mental health services, both in the donor and host countries. Nevertheless, information on migration in junior doctors within Europe is very limited. Therefore, the European Federation of Psychiatric Trainees (EFPT) has conducted the Brain Drain Survey.

To identify, in junior doctors training in psychiatry, the impact of international short-term mobility experiences, towards a future workforce migration across countries, exploring its patterns and reasons.

In this cross-sectional international study, data were collected from 2281 psychiatric trainees in 33 countries. All participants answered to the EFPT Brain Drain Survey reporting their attitudes and experiences on mobility and migration.

Only one-third of the trainees had a short-mobility experience in their lifetime, being education the main purpose for these experiences. Interestingly, the main predictors for future migratory tendency were not only the having a income and being dissatisfied with this income, but having a short-mobility experience. In fact, people that had short-mobility experiences were two times more likely to express a migratory tendency. Trainees that went abroad were predominantly satisfied with their experiences, reporting that these influenced their attitudes towards migration, positively.

These findings show that short-term mobility has a positive impact into future long-term migration, increasing its probability.

The authors have not supplied their declaration of competing interest.

It is a well known fact that qualified health professionals generally migrate to high-income, developed regions. Nevertheless, the perceptions of this immigrant skilled health workforce on access to opportunities or feeling discriminated in their host countries, have not yet been explored or adequately addressed.

This work has focused on the perceptions of immigrant psychiatry trainees in several European countries about their views on having equal access to opportunities as natives or feeling discriminated.

A semi-structured 61-item questionnaire was circulated by National Coordinators in each country and was completed by 2281 psychiatric trainees from 33 European countries between year 2013 and 2014. Data has been analysed using the Software Package for Social Sciences for Windows v. 22.0 (SPSS Inc. Chicago, IL).

In these findings, more than one in ten psychiatry trainees across Europe were immigrants, with top host countries being Switzerland, Sweden and UK. Satisfaction with migration and the perception of having equal opportunities as the native trainees varied depending on the host country they migrated to. More than one-third of the trainees felt discriminated, not having the same opportunities as the local colleagues, especially concerning the work opportunities and the academic conditions. Still, nearly two-thirds considered having the same opportunities than natives.

A high number of immigrant psychiatry trainees subjectively feels they do not have the same opportunities as local trainees. Further research about factual and perceived discrimination by immigrant workforce should be done.

The authors have not supplied their declaration of competing interest.

Migration of medical professionals has a global impact on healthcare and services, including on mental health. Exploring the reasons for migration and why psychiatric trainees consider to migrate to certain countries is therefore crucial to understand the decision-making process related to migration of psychiatric trainees as well as of future specialists.

The aims of this Brain Drain Survey, was to research which countries most trainees in Europe migrate to (host countries) and for which reasons trainees choose to migrate to these countries (“pull factors”).

In a multicenter, cross-sectional study, data was collected in 33 countries. As part of the survey, all participants responded to a questionnaire exploring trainees’ experiences and attitudes towards migration.

Our results showed that Sweden, Switzerland and the UK were all significant net hosts. The percentage of immigrants varied between these countries. One of the main contributors as a “pull” factor was unsurprisingly, salary. It is notable that all three-host countries were within the highest wage brackets within our survey.

Psychiatric trainees tend to migrate to countries with higher income.

The authors have not supplied their declaration of competing interest.

The brain drain of mental health professionals is an important issue especially for developing countries with inadequate recruitment rates. The European Federation of Psychiatric Trainees (EFPT) investigated the extent of migration among trainees across Europe by Brain Drain research project. Results from a non-EU country, with the lowest number of mental health professionals per 100 000 population across OECD countries might provide important clues.

To identify attitudes towards and behaviors towards international migration among psychiatry trainees from Turkey.

An online survey was conducted among psychiatry trainees from Turkey in 2013, as part of the EFPT Brain Drain Research Project.

Of 107 trainees surveyed, 74% considered living abroad. However, the rate of having even short mobility experience was just 13%, and these were mainly educational visits. More than half of those who visited a foreign country reported to have a satisfactory experience, which might explain the positive influence of these visits on attitudes towards migration. Responders perceived academic conditions as the most important aspect of training that needs to be improved, in line with the fact that inadequate training programs were important reasons for migrating.

Overall, psychiatry trainees in Turkey tend to remain in their country of origin, which may protect healthcare system against the detriment of workforce loss. The relatively low rate of migration may also reflect the legislative barriers (e.g. being o non-EU country) impeding migrating. Our findings also suggest that the unmet educational needs of trainees require immediate attention.

The authors have not supplied their declaration of competing interest.

Recruitment of medical students and junior doctors in to psychiatry is a long-standing concern in many countries, with low proportions of medical graduates choosing it as a specialty and ongoing stigma from within the medical profession. In some countries the reverse problem is the case, with too many doctors wishing to enter psychiatry, and insufficient training places available.

To understand the current situation within Europe with regards to recruitment in to psychiatry and to identify existing recruitment initiatives.

The European Federation of Psychiatric Trainees conducts an annual survey of all member organisations. A delegate of each national association of psychiatric trainees is asked to identify if their country has a problem with recruitment and if so, whether there were too many or too few applicants for training places. Delegates from countries with recruitment initiatives were contacted to provide further details.

In 2014, a total of 31 countries completed the survey, with 17 stating that too few medical practitioners choose psychiatry. In total 8 countries with recruitment problems reported that initiatives exist to encourage doctors to enter psychiatric training. Of these, 7 responded to describe the initiatives, which included national recruitment strategies, financial incentives, careers fairs, mentoring schemes and a whole host of other projects.

Recruitment in to psychiatry remains a serious problem in a significant proportion of European countries, but a wide range of initiatives exist which aim to combat this shortfall. It will be important over the coming years to establish which initiatives are most effective at increasing recruitment.

The authors have not supplied their declaration of competing interest.

The authors have not supplied their declaration of competing interest.

Approaching and offering treatment to a patient in perinatal period might be complicated. Often, it is regarded as one of the most difficult aspects in psychiatry. Given the increasing trends in the number of female patients of childbearing age consulting to psychiatric services, it has become an issue that specialists of today and tomorrow need to be well aware of.

To better understand the impact of perinatal mental health training on psychiatric trainees from different countries in Europe who receive such training.

The European Federation of Psychiatric Trainees conducts annual surveys, directing questions to national trainee representatives, to assess the situation of psychiatric training. EFPT representatives of the countries where perinatal mental health training was reported to be included in psychiatry and/or child and adolescent psychiatry training programmes, namely Germany, France, Malta, Finland and Ireland, were contacted. Qualitative interviews focusing on the confidence (or in confidence) trainees feel when a patient who is planning pregnancy, pregnant or breastfeeding consults to them and the impact of training in perinatal mental health on their attitudes as clinicians were explored.

Although theoretical training in perinatal mental health is considered as an important aspect of psychiatry training in general, practical training or rotations are not found as essential. However, being able to benefit to more than one generation was perceived as a source of motivation.

Perinatal mental health is appreciated as a critical part of theoretical education by trainees and in countries where a clinical rotation is available, it enhances making more use of resources and consultation possibilities.

The authors have not supplied their declaration of competing interest.

The aim of this study was to explore female community health agents’ views about the value of recording qualitative information on contextual health issues they observe during home visits, data that are not officially required to be documented for the Brazilian System of Primary Healthcare Information.

The study was conducted in community primary healthcare centres located in the cities of Araçatuba and Coroados (state of São Paulo) and Rio de Janeiro (state of Rio de Janeiro), Brazil.

The design was a qualitative, exploratory study. The purposeful sampling criteria were being female, with a minimum of three years of continuous service in the same location. Data collection with 62 participants was conducted via 11 focus groups (in 2007 and 2008). Audio files were transcribed and submitted to the method of thematic analysis. Four themes guided the analysis: working with qualitative information and undocumented observation; reflecting on qualitative information; integrating/analysing quantitative and qualitative information; and information-sharing with agents and family health teams. In 2010, 25 community health agents verified the final interpretation of the findings.

Participants valued the recording of qualitative, contextual information to expand understanding of primary healthcare issues and as an indicator of clients’ improved health behaviour and health literacy. While participants initiated the recording of additional health information, they generally did not inform the family health team about these findings. They perceived that team members devalued this type of information by considering it a reflection of the clientele’s social conditions or problems beyond the scope of medical concerns. Documentation of qualitative evidence can account for the effectiveness of health education in two ways: by improving preventative care, and by amplifying the voices of underprivileged clients who live in poverty to ensure the most appropriate and best quality primary healthcare for them.