Hostname: page-component-7d684dbfc8-4nnqn Total loading time: 0 Render date: 2023-09-29T20:50:51.569Z Has data issue: false Feature Flags: { "corePageComponentGetUserInfoFromSharedSession": true, "coreDisableEcommerce": false, "coreDisableSocialShare": false, "coreDisableEcommerceForArticlePurchase": false, "coreDisableEcommerceForBookPurchase": false, "coreDisableEcommerceForElementPurchase": false, "coreUseNewShare": true, "useRatesEcommerce": true } hasContentIssue false

To which countries do European psychiatric trainees want to move to and why?

Published online by Cambridge University Press:  23 March 2020

M. Pinto da Costa*
Hospital de Magalhães Lemos, Porto, Portugal Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Services Development), Queen Mary University of London, London, United Kingdom
A. Giurgiuca
The Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
K. Holmes
Avon and Wiltshire Mental Health Partnership Trust, Bristol, United Kingdom
E. Biskup
University Hospital of Basel, Department of Internal Medicine, Basel, Switzerland Shanghai University of Medicine and Health Sciences Basic Medical College, Shanghai, China
T. Mogren
Allmänspykiatriska kliniken Falun/Säter, Säter, Sweden
S. Tomori
University Hospital Center Mother Teresa, Department of Pediatrics, Tirana, Albania
O. Kilic
Koc University Hospital, Department of Psychiatry, Istanbul, Turkey
V. Banjac
Clinic of psychiatry, University Clinical Center of the Republic of Srpska, Banjaluka, Bosnia and Herzegovina
R. Molina-Ruiz
CSM de Hospital Universitario Fundación Alcorcón, Psychiatry Department, Madrid, Spain
C. Palumbo
Hospital Papa Giovanni XXIII-Bergamo (BG), Department of Psychiatry, Bergamo, Italy
D. Frydecka
Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
J. Kaaja
Universiy of Tampere, Tampere, Finland
E. El-Higaya
School of Medicine, National University of Ireland, Galway, Ireland
A. Kanellopoulos
Mental Health Care Unit, Evgenidion Therapeftirion, National & Kapodistrian University of Athens, Greece
B.H. Amit
Tel Aviv University, Department of psychiatry, Geha Mental Health Center, Petach Tiqwa, Israel
D. Madissoon
South-Estonian Hospital, Psychiatry Clinic, Võru, Estonia
E. Andreou
Athalassa Mental Health Hospital, Mental Health Services, Nicosia, Cyprus
I. Uleviciute-Belena
Clinical hospital of Vilnius, Office of primary mental health care, Vilnius, Lithuania
I. Rakos
University Hospital Dubrava, Department of Psychiatry, Referral Center for the Stress-Related Disorders, Zagreb, Croatia
J. Dragasek
Pavol Jozef Šafárik University, Faculty of Medicine, 1st Department of Psychiatry, Košice, Slovakia
K. Feffer
Shalvata mental health center, Hod-Hasharon, Israel
M. Farrugia
Mount Carmel Hospital, Triq l-Imdina, Malta
M. Mitkovic-Voncina
Belgrade University School of Medicine, Institute of Mental Health, Belgrade, Serbia
T. Gargot
Service de psychiatrie de l‘enfant et de l‘adolescent, hôpital de la Pitié-Salpêtrière, Paris, France Equipe interaction, institut des systèmes intelligents et de la robotique, Paris, France
F. Baessler
Centre for psychosocial medicine and department of general internal medicine and psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
M. Pantovic-Stefanovic
Department for Affective Disorders, University Clinical Center of Serbia, Belgrade, Serbia
L. De Picker
Collaborative Antwerp Psychiatric Research Institute, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
*Corresponding author. Hospital de Magalhães Lemos, Rua Professor Álvaro Rodrigues, 4149-003 Porto, Portugal. E-mail (M. Pinto da Costa).
Get access



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.

Original article
Copyright © European Psychiatric Association 2017

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)


W.H.O., Nursing and midwifery services facing crisis, experts say; 2000.Google Scholar
Kevat, DParker, MGoldacre, MJMigration of doctors from developing countries to Australia: an estimate from surveys of doctors. The Lancet 2012;380:S5.CrossRefGoogle Scholar
Fazel, SEbmeier, KPSpecialty choice in UK junior doctors: is psychiatry the least popular specialty for UK and international medical graduates?. Bmc Med Educ 2009;9:77.CrossRefGoogle ScholarPubMed
Salsberg, ERockey, PHRivers, KLBrotherton, SEJackson, GRUS residency training before and after the 1997 Balanced Budget Act. JAMA 2008; 300: 11741180.CrossRefGoogle ScholarPubMed
Goldacre, MJDavidson, JMLambert, TWCountry of training and ethnic origin of UK doctors: database and survey studies. BMJ 2004;329:597.CrossRefGoogle ScholarPubMed
Eastwood, JBConroy, RENaicker, SWest, PATutt, RCPlange-Rhule, JLoss of health professionals from sub-Saharan Africa: the pivotal role of the UK. The Lancet 2005; 365: 18931900.CrossRefGoogle ScholarPubMed
Gureje, OHollins, SBotbol, MJaved, AJorge, MOkech, V, et al.Report of the WPA task force on brain drain. World Psychiatry 2009; 8: 115118.CrossRefGoogle ScholarPubMed
Jenkins, RKydd, RMullen, PThomson, KSculley, JKuper, S, et al.International migration of doctors, and its impact on availability of psychiatrists in low and middle income countries. PLoS One 2010;5:e9049.CrossRefGoogle ScholarPubMed
Willis-Shattuck, MBidwell, PThomas, SWyness, LBlaauw, DDitlopo, PMotivation and retention of health workers in developing countries: a systematic review. BMC Health Serv Res 2008;8:247.CrossRefGoogle ScholarPubMed
Gadit, AAInternational migration of doctors from developing countries: need to follow the Commonwealth Code. J Med Ethics 2008; 34: 6768.CrossRefGoogle ScholarPubMed
Kingma, MNursing migration: global treasure hunt or disaster-in-the-making?. Nurs Inq 2001; 8: 205212.CrossRefGoogle ScholarPubMed
Kangasniemi, MWinters, LACommander, SIs the medical brain drain beneficial? Evidence from overseas doctors in the UK. Soc Sci Med 2007; 65: 915923.CrossRefGoogle ScholarPubMed
United Nations, World Youth Report New York: United Nations; 2013 [Available from:].Google Scholar
Karabekiroglu, KDogangun, BHerguner, Svon Salis, TRothenberger, AChild and adolescent psychiatry training in Europe: differences and challenges in harmonization. Eur Child Adolesc Psychiatry 2006; 15: 467475.CrossRefGoogle ScholarPubMed
Jauhar, SGuloksuz, SAndlauer, OLydall, GMarques, JGMendonca, L, et al.Choice of antipsychotic treatment by European psychiatry trainees: are decisions based on evidence?. BMC Psychiatry 2012;12:27.CrossRefGoogle ScholarPubMed
Riese, FGuloksuz, SRoventa, CFair, JDHaravuori, HRolko, T, et al.Pharmaceutical industry interactions of psychiatric trainees from 20 European countries. Eur Psychiatry 2015; 30: 284290.CrossRefGoogle ScholarPubMed
Jovanovic, NPodlesek, AVolpe, UBarrett, EFerrari, SRojnic Kuzman, M, et al.Burnout syndrome among psychiatric trainees in 22 countries: risk increased by long working hours, lack of supervision, and psychiatry not being first career choice. Eur Psychiatry 2016; 32: 3441.CrossRefGoogle Scholar
Kuzman, MRGiacco, DSimmons, MWuyts, PBausch-Becker, NFavre, G, et al.Psychiatry training in Europe: views from the trenches. Med Teach 2012;34:e708e717.CrossRefGoogle ScholarPubMed
Pang, TBrain drain and health professionals. BMJ 2002; 324: 499500.CrossRefGoogle ScholarPubMed
Dieleman, MToonen, JToure, HMartineau, TThe match between motivation and performance management of health sector workers in Mali. Hum Resour Health 2006;4:2.CrossRefGoogle ScholarPubMed
de Silva, NLSamarasekara, KRodrigo, CSamarakoon, LFernando, SDRajapakse, SWhy do doctors emigrate from Sri Lanka? A survey of medical undergraduates and new graduates. BMC Res Notes 2014;7:918.CrossRefGoogle ScholarPubMed
Patel, VRecruiting doctors from poor countries: the great brain robbery?. BMJ 2003; 327(7420): 926928.CrossRefGoogle ScholarPubMed
Guilbert, JJThe World Health Report 2006: working together for health. Educ Health (Abingdon) 2006; 19: 385387.CrossRefGoogle Scholar
Europe, W Health worker migration in the european region: country case studies and policy implications; 2006.Google Scholar
Brittlebank, AHermans, MBhugra, DPinto da Costa, MRojnic-Kuzman, MFiorillo, A, et al.Training in psychiatry throughout Europe. Eur Arch Psychiatry Clin Neurosci 2016; 266: 155164.CrossRefGoogle ScholarPubMed
Ambrose, AJLin, SYChun, MBCultural competency training requirements in graduate medical education. J Grad Med Educ 2013; 5: 227231.CrossRefGoogle ScholarPubMed
Stilwell, BDiallo, KZurn, PDal Poz, MRAdams, OBuchan, JDeveloping evidence-based ethical policies on the migration of health workers: conceptual and practical challenges. Hum Resour Health 2003;1:8.CrossRefGoogle ScholarPubMed
Submit a response


No Comments have been published for this article.