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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.
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.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The in utero origins of breast cancer are an increasing focus of
research. However, the long time period between exposure and disease diagnosis,
and the lack of standardized perinatal data collection makes this research
challenging. We assessed perinatal factors, as proxies for in
utero exposures, and breast cancer risk using pooled,
population-based birth and cancer registry data. Birth registries provided
information on perinatal exposures. Cases were females born in Norway, Sweden or
Denmark who were subsequently diagnosed with primary, invasive breast cancer
(n = 1419). Ten controls for each case were selected from
the birth registries matched on country and birth year (n =
14,190). Relative risks (RRs) and 95% confidence intervals (CIs) were estimated
using unconditional regression models. Breast cancer risk rose 7% (95% CI
2–13%) with every 500 g (roughly 1 s.d.) increase in birth
weight and 7% for every 1 s.d. increase in birth length (95% CI
1–14%). The association with birth length was attenuated after adjustment
for birth weight, while the increase in risk with birth weight remained with
adjustment for birth length. Ponderal index and small- and
large-for-gestational-age status were not better predictors of risk than either
weight or length alone. Risk was not associated with maternal education or age,
gestational duration, delivery type or birth order, or with several pregnancy
complications, including preeclampsia. These data confirm the positive
association between birth weight and breast cancer risk. Other pregnancy
characteristics, including complications such as preeclampsia, do not appear to
be involved in later breast carcinogenesis in young women.
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