Psychiatric specialty training in Greece: Comparative analysis of educational programs (2000 vs 2014)

Abstract

Modern educational programs for specialization in psychiatry should follow the developments in psychiatric science, both in the part of acquired knowledge about mental disorders and their treatment, as well as in the part of clinical practice in the diverse spectrum of modern psychiatric services. In Greece, the institutional framework for psychiatric training during specialization has yet to modernize and conform to European standards. For the moment, it is covered by a 1994 Presidential Decree, which briefly describes the time of specialization in psychiatry and the duration of clinical practice in the relevant educational subjects. This study presents a comparative analysis of training in the specialty of Psychiatry in two distinct periods (2000 vs 2014). Already by the year 2000, psychiatric training showed many structural weaknesses. The areas of clinical experience, theoretical and psychotherapeutic training have shown wide divergences among training centers, and limited potential for convergence with European standards under the existing framework. Important exceptions were certain university clinics, with the bulk of future psychiatrists in the country falling short of educational benefits. Fifteen years later and under the burden of the consequences of the economic crisis, the institutional framework has not yet changed, and the overall situation seems to have deteriorated dramatically. The number of training centers offering full specialization and the number of psychiatrists who receive training increased in reverse proportion to the number of specialized psychiatrists employed in hospitals, which has been drastically reduced due to restrictive measures on staff recruitment. Almost all training indicators show deterioration, but mainly the area of theoretical training shows the most dramatic degradation. Nevertheless, it is noteworthy that nowadays several psychiatric clinics endeavor to develop training programs in conjunction with psychiatric services not under their own administration, a practice not provided for in the current legislative framework. At the same time, there is an increase in the number of training centers that adopt some statutory procedures to monitor and evaluate trainees during the training process. The long-term restrictions recorded however, reveal the difficulty hospitals and psychiatric clinics have in developing training programs responding to the full range of modern clinical and theoretical training in psychiatry independently and autonomously. The recent economic crisis in the country and the attempts for much needed administrational reforms, create now more than ever the appropriate conditions for a reform of the educational framework for specialization in psychiatry, taking into account national resources and future expectations for the mental health system of our country.