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.

Education is growing to a European level with the development of student exchanges. The EFPT Exchange Programme is the first psychiatric exchange programme to be developed in Europe. It was launched in 2011 by the EFPT Exchange Programme Working Group.

To provide European psychiatric trainees with the possibility of intercultural professional experience with a simplified exchange procedure.

To promote acquaintance of different health systems and psychiatric practices as well as cooperation among trainees, with a focus on individual experience.

The programme is run by trainees, for trainees, and provides observatory internships of 2-6 weeks in psychiatric units accredited for education. We collected systematic online feedback on participant satisfaction, as well as data on countries of residence, countries of exchange and number of applicants per phase.

Since 2011, the program has extended to 11 countries and offers 50 placements in diverse clinical psychiatry units accredited for education. Six phases of exchange have been conducted, with a total of 85 exchanges. We observed an average of 34 applications per phase with 70% of applicants originating from: Turkey, UK, Portugal, Ireland, Romania, France, Croatia. 46% of applicants were accepted for exchange. The large number of trainees underlines the richness of professional exchange and the positive effect on personal development.

The succes of this programme among trainees should encourage the promotion of mobility in psychiatric training.

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.