Combining clinical and academic roles during psychiatric training can be challenging but equally enriching. However, the Covid-19 pandemic has complicated many aspects of psychiatric training, including changes of service provision, clinical duties, training activities and academic opportunities. In this interactive Workshop session, tips and strategies for balancing academic and clinical responsibilities during psychiatric training will be discussed based on real-life experiences and literature recommendations. The impact of the pandemic and what skills could be useful to flexibly tackle the challenges that come with an ongoing public health crisis while working to satisfy academic and clinical requirements in a set period of time will also be considered. The speaker will also include additional resources to improve such soft skills for participants.

The ongoing pandemic has brought many changes to the lives of almost all people around the world. Medical professionals have also experienced significant changes at their workplace, with many of them engaged in treating COVID-19 patients instead of working in a field of medicine they have trained to work in. Trainees of all medical specialities have often been the first ones to join the effort in combating the pandemic and psychiatric trainees were no exception. The pandemic has brought their training to a halt and the majority of psychiatric educational activities have initially been postponed or canceled, with clinical rotations between different institutions almost non-existent. In a search for more space to treat COVID-19 patients, psychiatric wards were often the first ones to be repurposed. Epidemiological measures have lowered the number of patients a trainee could see each day and have also made clinical supervision less available. However, the introduction of online communication platforms as a new standard of interaction has helped mitigate many of the issues and enabled resuming most of the educational activities. Since trainees were usually more experienced in online communication than senior doctors, their skills were very valuable in establishing telepsychiatric services. Even though the pandemic has created many obstacles in psychiatric training, it has also proved that training is very much about learning and implementing new skills, as well as adapting to new circumstances.

Globally, mental health legislation has been changing and evolving throughout time. Compulsory admission is when patients with mental disorders are admitted to a psychiatric unit against their own will to receive treatment. In Europe, as public attitudes and practices shifted, compulsory admission procedures were reformed to ensure patient rights and safety. Differences however exist for compulsory admission procedures between countries. In 2018, a survey was created and disseminated by the European Psychiatric Association Ethics Committee to National Psychiatric Associations within 40 European countries to learn more about the legislation, key actors involved, and reasons for admission. Results showed that approximately half of the responding countries required an independent medical expert, typically a psychiatrist, to be involved in the procedure. Most countries by law required the involvement of a court-appointed judge in making the decision about compulsory admission and to review the case after a certain period of time. All but one country have time limits on legal decisions for compulsory admission. Further, patients have the right to obtain legal counsel to assist them through the process of appeal or the decision in most countries. The primary reasons for admission were the patient being a danger to themselves or others. Despite continued efforts, stigma still surrounds mental health disorders. Public awareness and increased knowledge are needed to improve the perception of compulsory admissions. Moving forward, it is necessary to create educational courses, as well as written guidelines for key actors, to stimulate good practice and promote voluntary treatment (Wasserman et al. 2020; https://doi.org/10.1192/j.eurpsy.2020.79).

Most psychiatric disorders (between 50% and 90%) remain untreated although effective treatments exist (Kohn et al., 2004). Stigma is frequent toward patients and mental health professionals (Rüsch et al., 2005). It impairs access to care especially during the early signs, amplifying the treatment gap, mainly due to a shortage of resources. How the brain makes prior internal models of the world could explain why we all stigmatize. The Bayesian brain hypothesis describes the optimal combination of priors, coming from our evolution, our memory and our perceptions, to make decisions (Parr et al., 2018). This can be intuitively understood by visual illusions, but also medical categorical diagnostic reasoning (Medow, 2011). These priors allow to simplify the world and categorize people (Sherman et al., 1998). Beyond cognitive modelling, Computational approaches also led to the development of several electronic devices, from apps to social robots, (Gargot et al., 2021). Patients reported that it was easier to self-disclose toward an avatar, that cannot judge, than toward a therapist (Hang and Gratch, 2010). These technologies could improve early, scalable as well as efficient access to care (Andersson et al., 2019). Empathy is the best strategy to tackle stigma. What is it exactly? Good therapist-patient synchronization of brains (Czeszumski et al., 2020) and bodies (Ramseyer et Tschacher, 2011) could foster better communication and thus empathy. There is an urgent need to promote research in empathy (Belzung, 2017), non-specific factors in psychotherapy mechanisms (Miller et Moyers, 2021) and psychotherapy online training resources (Gargot et al., 2020).

Women consistently fare worse than men in different professional metrics in terms of salary, promotions, grant money, and scholarly publishing. In clinical and management leadership roles, a similar trend of underrepresentation for women exists. It has been shown in academic publishing that women progressed to senior author positions at a slower pace, resulting in their ongoing underrepresentation as senior writers. Previous literature has shown that one of the most effective strategies for promoting women to leadership positions is the collaboration with men to identify attitudinal and institutional barriers, since gender equality is not only a “women’s concern.” To address this, a cross-sectional, multinational survey was disseminated in English (SurveyMonkey) to psychiatric trainees and psychiatrists across Europe. This study aims to explore the perspectives of female and male psychiatrists on the obstacles they face in their careers. The survey covered items on self-promotion, current institutional environment, and networking along with contextual information- age, gender, professional degree, current field, and years of professional experience in the current field. We hope that the presentation of these findings will serve as a springboard for future educational activities to address concerns connected to the gender gap. The speaker will present the comparison of female and male psychiatrists’ barriers and challenges they face during their professional development. This talk is hoped to elicit discussion in preparation for future action and inform a roadmap for addressing issues related to the gender gap with subsequent educational events.

What not to do to thrive in your career The presentation will examine options that are usually available to psychiatrists during their training and early in their career and propose criteria which should be used to select or discard them. Among the criteria proposed – in addition to personal interest - should be the amount of time that engaging in a particular pursuit might take, the potential gain of the engagement later on in one’s career, the likelihood of expanding the circle of friends and acquaintances and several others.

Covid-19 pandemic has affected early career psychiatrists (ECP) and psychiatric trainees significantly. Child and Adolescent Psychiatry (CAP) specialists and trainees have a particular position in the pandemic as redeployments to adult units are possibly more disorientating for these psychiatrists normally working in paediatric settings. Redeployments and abrupt but potentially permanent changes to the delivery of service and training are explored via the Covid-19 and Early Career Psychiatrists survey which was prepared and disseminated by the EPA ECP Committee and the European Federation of Psychiatric Trainees (EFPT). The CAP related data from the survey will be discussed in this presentation and the implications on the future of CAP will be considered with particular emphasis on training.

The first engagement in research in your career This presentation will argue that in addition to considering the scientific interest of a topic presented for research it is important to consider other criteria before engaging in a study. These include the place of the study, the team which will be engaged in the work, the ownership of the data which will be produced, the duration of the study and other matters. The presentation will also discuss the amount of time that should be given to scientific research early in one’s career and the nature of the gain that engagement in research can offer for one’s development and career.

Academic research and publications can serve as important drivers of career development for early-career psychiatrists. However, the current focus on clinical teaching during the postgraduate program leaves much less room for scholastic training for young professionals. Combined with a lack of standardized European curricula despite automatically recognized qualifications in European Union countries, early-career psychiatrists encounter challenging job prospects across Europe, often faced with the hard choice of pursuing careers in clinical practice or opt for academia. In recent years, academia has attracted more and more young psychiatrists eager to contribute as researchers, teachers and/or administrators within academic and higher education institutions. What are the challenges they face and how they can overcome them to combine clinical work, teaching and research? The component of teaching and research varies widely in European psychiatry training and mostly early-career psychiatrists are unaware about the importance of publications, formal qualifications, stipends, international experiences, participating in studies, writing grant applications, etc, for their academic career. Often, they are not clearly informed about the advantages/disadvantages of pursuing an academic career and learn at a later stage about the important steps towards a successful career combining clinical work, research and teaching. In this session, we will share a brief insight into the challenges of academia and the possible ways forward with some real-life experiences of the speaker, who is leading several interdisciplinary research projects at the Heidelberg University Hospital along with handling patients and family at the same time. An interactive discussion and exchange of knowledge is desired.

The functioning of the central nervous system (CNS) is the result of the integration of bidirectional messages between the brain and peripheral organs. Despite the anatomical separation, gut microbiota, i.e., the microorganisms colonising the gastrointestinal tract, is related to the CNS through the so-called “gut–brain axis” that is also involved in immune processes. The recent literature indicates that the gut microbiota may affect brain functions through endocrine and metabolic pathways, antibody production and the enteric network, while supporting its possible role in the onset and maintenance of several neuropsychiatric and neurodevelopmental disorders, such as autism spectrum disorders (ASDs). The term ASDs includes autistic disorder, Asperger’s syndrome, childhood disintegrative and pervasive developmental disorders not otherwise specified different. All these conditions are characterised by persistent deficits in social communication and social interaction, as well as limited and repetitive behaviours, interests or activities. In the last two decades, an impressive number of cross-sectional studies reported significant differences in microbiota composition between children with an ASD and controls, thus strengthening the hypothesis of a possible link between GI dysbiosis and ASD. The amount of studies documenting the possible involvement of microbiota in ASD pathogenesis led to considering whether treatments acting on gut flora could ameliorate ASD symptoms. The available findings, although preliminary, would indicate data gut microbiota might represent an interesting field of research for a better understanding of the pathophysiology of ASD (of also of other neuropsychiatric disorders), and possibly a target for the development of innovative treatments just labelled as “psychobiotics”.

Autism spectrum disorder (ASD) is characterized by a triad of difficulties including altered communication, impairements in social internactions, as well as restricted interests and repetitive behaviours. It used to be known as a predominantly male disorder, but recent research has shown that the male/female ratio is trending downward and that the actual estimate is about 3:1. Until now, diagnostic criteria have been developed based on research conducted primarily in male populations. However, in recent years, female autism has attracted scientific interest, revealing some unique features in the presentation of this disorder in girls and women. This presentation will focus on gender differences and characteristics of ASD in females, including personal descriptions and experiences of women diagnosed with ASD.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by difficulties in social interaction and communication, and by restricted and repetitive behaviors. A meta-analysis describes motor difficulties in ASD (Downey and Rapport, 2012) in 85% to 90% of cases (Liu et al. 2010). Electronic devices will help to better characterize these movement impairments (Gargot et al., in press). Another meta-analysis shows difficulties in sensorial integration in ASD, with a prevalence ranging from 45 to 95% (Ben Sasson, 2009). Sensorimotor contigencies are learned interactively (Jacquey et al., 2020), in a perception-action loop, an early milestone in development (Piaget, 1937). A cascade model (Bonnet-Brilhault, 2017) hypothesizes that social difficulties stem in sensorimotor difficulties (Cook, 2016; Neal, 2011; Dziuk et al. 2007; Kojovic, 2019), themselves atypically developed due to a peculiar neurobiological background. This model predicts that early sensorimotor reeducation could prevent the development of social difficulties, whereas the rehabilitation of social skills would improve only part of the impairment, that is driven by sensorimotor processes. How to target these issues? Grandin, 1992 and Edelson et al., 1999 validated the efficacy of deep pressure therapy in ASD. It is important to improve attractivity and decrease the stigmatization of this method. Oto is a compressive armchair with inflatable cushions controlled electronically. It records level of pressure and its duration, chosen by the user. A systematic review showed the efficacy of virtual reality in ASD (Mesa-Gresa et al, 2018). A CAVE device could habituate children to ecological audio-visual stimulations.