Postgraduate Psychiatric Training Research Articles

Are we training psychiatrists to develop skills in intellectual disability psychiatry? Current European context and future directions.

The majority of people with intellectual disabilities (ID) and psychiatric disorders access mainstream mental health services across Europe. However, only 56% of countries provide postgraduate psychiatric training in ID according to a survey across 42 European countries. We explore the challenges of ID training and make recommendations for education and health policymakers.

Training in psychiatry: making person-centred care a reality

The RCPsych curriculum for core trainees is currently undergoing review and revision. The Person-Centred Training and Curriculum Scoping Group, which fed into the revision, reported in 2018. This paper shares key findings from the report and offers suggestions on implementing person-centred care in postgraduate psychiatric training and assessment. The scoping group recommended that training and the curriculum should be explicitly person-centred. Among its other recommendations was that skills relating to person-centred practice should be assessed, and the planning, development and delivery of local MRCPsych courses should be co-produced alongside people with lived experience of mental health conditions.Declaration of interestAll authors contributed to the development and writing of College Report CR215.

Supervision: 'a random bag of arrangements'? Perspectives from psychiatrists on how to improve clinical teaching.

The aim of this study was to explore psychiatrists' perspectives on how clinical teaching and supervision can be improved in postgraduate psychiatric training. All New Zealand members of the Royal Australian and New Zealand College of Psychiatrists (fellows: n=367; affiliates: n=167) were invited to participate in an online survey that collected responses to two open-ended questions. The responses were then analysed qualitatively. A total of 27% psychiatrists responded. Two major themes emerged: supervisor competencies and the workplace educational environment, with subthemes of supervisor training, feedback and culture change. Suggestions to improve clinical teaching and supervision included defining supervisor teaching competencies, instituting evidence-based faculty development, a feedback structure and strengthening leadership support for workplace-based education.

TYOT: Tripadvisor for psychiatry trainees?

BackgroundAlthough guidelines to ensure the quality of postgraduate psychiatric training in Europe are provided both by the statements of the European Federation of Psychiatric Trainees (EFPT) and the UEMS Psychiatry Section's European Training Requirements, actual training conditions in different European countries have been documented to vary widely. Furthermore, most trainees are unaware of the existence of such guidelines.ObjectiveThe test your own training (TYOT) project set out to create an easy-to-use online tool that allows trainees to assess how their own training compares in relation to the European standards, thereby empowering trainees all over Europe.MethodsAn EFPT Focus Group consisting of psychiatric trainees or early career psychiatrists from eleven European countries created a core survey of key aspects of psychiatry training, such as the duration of the training program, the availability of clinical and educational supervision, access to international professional literature, the use of a national logbook, based on the UEMS European Training Requirements and the EFPT statements. Additional subsets of questions were designed for specific domains such as theoretical training in psychiatry, psychotherapy training and the role of supervisors and training institutions. Next, the questions were transferred to a suitable online hosting platform, which allows to automatically provide feedback in an algorithmic fashion about how the trainee’s experience compares to the European standards.ResultsThe TYOT platform will be launched in January 2017 and the first results will be presented at the European Congress of Psychiatry 2017. For more information about the TYOT tool please visit http://efpt.eu/training/tyot/.Disclosure of interestThe author has not supplied his declaration of competing interest.

Psychiatric training in perinatal mental health across European countries

IntroductionThe aim of postgraduate psychiatric training is to prepare psychiatrists to practice independently. The quality of care provided will depend on the training they received. Pregnancy and childbirth (usually called the perinatal period) are a high-risk period for many women with psychiatric problems. An illness episode at that time can have a devastating effect on women and the whole family, including the child's development.ObjectivesTo understand how perinatal mental health training is organized within Europe and how it fits in the training curricula.MethodsThe European Federation of Psychiatric Trainees conducts an annual survey of all member country organizations. We have asked respondents if they received training in perinatal psychiatry, whether that was optional or mandatory and what was its duration. Where training in perinatal psychiatry was not available we asked if they felt it should be.ResultsData will be presented from the 35 countries that responded in the 2016 survey. Six countries reported that training in perinatal mental health is available. But it is mandatory in only one, with the others offering a mix of theoretical and practical optional training. Of the 29 countries that do not offer perinatal psychiatry training, the majority reported it should be offered and mandatory.ConclusionThere is a gap in the expectations of psychiatrists treating women in pregnancy and after birth, and a widespread lack of training for them to be able to do so effectively.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Collaborative Role Education in Post Graduate Psychiatric Training: A Narrative Review

1.1 Objective: To review the literature and trusted scientific websites on studies about Collaborative role education and its application in postgraduate psychiatric training. 1.2 Methods: Medline literature and scientific websites were searched. The data selected were those discussing collaboration care efficacy, collaborative role competency and the application of adult education theory principles through Interprofessional education (IPE). The results reported are those obtained using appropriate techniques and published in reputable journals or on trusted scientific websites. Information relevant to mental health and postgraduate psychiatric training was selected for inclusion. 1.3 Results: Collaborative role is one of the seven core roles (CanMEDS) that define essential physician competencies. Collaborative care and IPE were efficacious in improving cost efficiency, patient safety, health professionals’ satisfaction and patient outcomes in different populations. According to a 2005 survey, the majority of mental health professionals in Canada support but do not presently offer formal pre-licensure, post-licensure, or continuing IPE involving collaborative mental health care. 1.4 Conclusion: Despite some challenges, IPE is a very worthy way to build collaborative role competency in postgraduate psychiatry trainees.

The Benefits of a Physician Assistant and/or Nurse Practitioner Psychiatric Postgraduate Training Program

In 2008, Regions Hospital in Saint Paul, Minnesota, began an advanced practice psychiatric provider fellowship program. Our mental health department offers a 1-year postgraduate psychiatric training program for physician assistants (PAs) and nurse practitioners (NPs) interested in obtaining further expertise in psychiatry. This is one of three current programs in the USA that offers postgraduate training for PAs and was the first postgraduate program for NPs in the field of psychiatry. The students participate in a 12month program where the primary areas of focus are adult inpatient, crisis, and outpatient mental health services. Additionally, the fellows receive training in the management of substance abuse disorders as well as comorbid acute and chronic medical conditions. The motivation for developing this program was to increase access and expertise in treating psychiatric illness in the community, on inpatient psychiatric units, and outpatient clinics. The mission is to graduate PAs and NPs who demonstrate clinical expertise, ethical behavior, leadership skills, cultural awareness, professionalism, and ongoing commitment to learning.

Perceived Quality of the Postgraduate Psychiatric Training in a Romanian Sample

Introduction The quality and opportunities of the postgraduate training are factors that influence the residents’ future career. Objectives To assess the perceived quality of the Romanian psychiatric training system. Aims To identify factors that may be improved in the psychiatric training. Methods Residents in psychiatry were asked to fulfill an anonymous questionnaire regarding satisfaction with their training and preferences for future practice. The questionnaire contained open and closed-ended questions about clinical and research training: the quality of lectures, case presentations, rotations between attending physicians, hospital practice, and access to conferences, to PhD enrollment, to randomized controlled trials (RCTs), and to psychotherapy training. Results The study included 45 residents in psychiatry from different years of training at Timisoara Neuroscience Department. 71.11% of the residents considered psychiatric emergencies to be the most useful training. All residents are satisfied with case presentations. Over 70% are satisfied and very satisfied with the lectures held by coordinators and supervision of the attending doctors. Still, the level of satisfaction with lectures and supervision decreases with the increasing of the years of training. More than 80% of residents are satisfied with participation to conferences, but very few have access to PhD, RCTs, or psychotherapy training. Most residents display a medium level of satisfaction with hospital activity. 40% prefer a mix of academic and medical career. Conclusions Although residents rate their overall training as satisfying, they have little access to research and psychotherapy opportunities. The study doesn’t intend to generalize the results for all the country.

Postgraduate training in psychiatry in India with focus on mumbai.

The present article traces the formation of the Indian Psychiatric Society and the progress of post-graduate training in psychiatry in India in general and Mumbai in particular. It covers the standard of psychiatric education, the goals and recommendations for improvisation of residency programmes, and the future of post-graduate psychiatric training.

European Psychiatric Association (EPA) Guidance on Post-graduate Psychiatric Training in Europe

The European Union Free Movement Directive gives professionals the opportunity to work and live within the European Union, but does not give specific requirements regarding how the specialists in medicine have to be trained, with the exception of a required minimum of 4years of education. Efforts have been undertaken to harmonize post-graduate training in psychiatry in Europe since the Treaty of Rome 1957, with the founding of the European Union of Medical Specialists (UEMS) and establishment of a charter outlining how psychiatrists should be trained. However, the different curricula for post-graduate training were only compared by surveys, never through a systematic review of the official national requirements. The published survey data still shows great differences between European countries and unlike other UEMS Boards, the Board of Psychiatry did not introduce a certification for specialists willing to practice in a foreign country within Europe. Such a European certification could help to keep a high qualification level for post-graduate training in psychiatry all over Europe. Moreover, it would make it easier for employers to assess the educational level of European psychiatrists applying for a job in their field.

EPA-1752 – European psychiatric association (EPA) guidance on post-graduate psychiatric training in Europe

The European Union Free Movement Directive gives professionals the opportunity to work and live within the European Union, but does not give specific requirements regarding how the specialists in medicine have to be trained, with the exception of a required minimum of 4 years of education. Efforts have been undertaken to harmonize post-graduate training in psychiatry in Europe since the Treaty of Rome 1957, with the founding of the UEMS (European Union of Medical Specialists) and establishment of a charter outlining how psychiatrists should be trained. However, the different curricula for post-graduate training were only compared by surveys, never through a systematic review of the official national requirements. The published survey data still show great differences between European countries and unlike other UEMS Boards, the Board of Psychiatry did not introduce a certification for specialists willing to practice in a foreign country within Europe. Such a European certification could help to keep a high qualification level for post-graduate training in psychiatry all over Europe. Moreover, it would make it easier for employers to assess the educational level of European psychiatrists applying for a job in their field.

Suicide Attempts in Malaysia from the Year 1969 to 2011

The aim of this paper is to review the literature on suicide attempts in Malaysia. PsycINFO, PubMed, and Medline databases from 1845 to 2012 and detailed manual search of local official reports from the Ministry of Health and the Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training were included in the current review. A total of 38 studies on suicide attempts in Malaysia were found and reviewed. Twenty-seven (76%) of the studies on suicide attempts were descriptive studies looking at sociodemographic data, psychiatric illnesses, and methods and reasons for suicide attempts. No study has been conducted on treatment and interventions for suicide attempts and the impact of culture was rarely considered. The review showed that in order for researchers, clinicians, and public health policy makers to obtain a better understanding of suicide attempts in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.

Supervision in psychiatry

Supervision is accepted as a part of postgraduate psychiatric training programmes (at least in the western world). However, despite its ubiquity, it is little researched. The purpose of this review was to synthesize research on supervision in psychiatry in the last 3 years (2009-2011). Given the dearth of such research, the boundary was extended to include general medicine and other mental health professions. The lack of research into supervision in psychiatry was confirmed by a comprehensive search of literature. The few articles published specific to psychiatry did, however, reflect the position of psychiatry, bridging medicine and the psychotherapies. Thus, they span from the impact of workplace-based assessments and reframing the theories of learning applicable to psychiatric training, through to the learning of psychotherapy by psychiatric trainees.The literature on supervision in general medicine is dominated by the impact of competency-based training, with its associated methods of assessment, and issues around the decision to entrust trainees with various professional activities.The psychotherapy supervision literature has been notable for two disparate themes: the centenary of psychotherapeutic supervision in 2009 prompted a number of scholars to write reflective pieces capturing advances and areas for further research; whereas the development of evidence-based clinical supervision has given rise to a considerable body of work. Research into supervision in psychiatry remains largely a terra incognita. If supervision is to continue to occupy a role as a key component of psychiatric training, research to justify that is needed urgently.

Psychiatry training in Europe: Views from the trenches

Background: In the majority of European countries, postgraduate psychiatry training schemes are developed and evaluated by national bodies in accordance with national legislation. In order to harmonise training in psychiatry across Europe, the European Union of Medical Specialists (UEMS) issued a number of recommendations for effective implementation of training programs in psychiatry.Aims: To describe the structure and quality assurance mechanisms of postgraduate psychiatric training in Europe.Method: The European Federation of Psychiatry Trainees (EFPT) conducted a survey, which was completed by the representatives of 29 member national psychiatric associations.Results: In most countries (N = 19), the duration of the training programme is 5 years or more. Twenty-six countries have adapted a basic training programme that includes the ‘common trunk’ (according to UEMS definition) or a modified version of it. In 25 countries, trainees are evaluated several times during their training with a final exam at the end. In 25 countries, official quality assurance mechanisms exist. However, results demonstrate great variations in their implementation.Conclusions: Overall, psychiatric training programmes and assessment methods are largely compatible with one another across Europe. Quality assurance mechanisms, however, vary significantly. These should receive adequate attention by national and international educational policy makers.

Beliefs and Attitudes of French Family Practitioners toward Depression: The Impact of Training in Mental Health

To study, in a sample of French Family Practitioners (FPs), beliefs and attitudes toward depression and how they vary according to training received in mental health. The Depression Attitude Questionnaire (DAQ) was completed by 468 FPs from all regions of France, recruited by pharmaceutical company representatives to attend focus groups on the management of depression in general practice. A three-factor model was derived from the DAQ, accounting for 37.7% of the total variance. The correlations between individual items of each component varied from 0.4 to 0.65, with an overall internal consistency of 0.47 (Cronbach's alpha). FPs had an overall neutral position on component 1, professional ease, a positive view on the origins of depression and its amenability to change (component 2), and a belief in the necessity of medication and the benefit of antidepressant therapy (component 3). Training in mental health, specifically through continuing medical education and postgraduate psychiatric hospital training, was significantly and positively associated with both professional ease and a medication approach to treating depression. This study is the first description of the beliefs and attitudes of French FPs toward depression using a standardized measure, the DAQ, despite the instrument's limited psychometric properties. It shows the positive effect of training in mental health on attitudes toward depression.

Psychiatric training in Europe

Aims and methodThis study aimed to establish the variations in the pre-defined aspects of postgraduate psychiatric training within the member countries of the European Federation of Psychiatric Trainees and illustrate the diversity of training experiences within Europe. Participants were required to complete a structured questionnaire.ResultsThere are wide variations in the length, content and structure of postgraduate psychiatric training across Europe. There are differing requirements for, and access to, psychotherapy training. Some countries have no examinations or formal assessments.Clinical implicationsAn understanding of the postgraduate training systems across Europe is essential not only for making informed choices about the development of trainees recruited from the European Economic Area but also for enhancing postgraduate training and patient care in all European countries.

Mental Health Reforms in Europe: Challenges of Postgraduate Psychiatric Training in Europe: A Trainee Perspective

Mental Health Reforms in Europe: Challenges of Postgraduate Psychiatric Training in Europe: A Trainee Perspective

Mental Health Reforms in Europe: Challenges of Postgraduate Psychiatric Training in Europe: A Trainee Perspective

The European Federation of Psychiatric Trainees (EFPT) is an umbrella organization for trainee associations in 31 countries. A survey asked member countries about the three most important issues facing postgraduate training. Qualitative analysis grouped responses in five categories: implementation of new postgraduate curricula, poor working conditions, low recruitment of psychiatric trainees, insufficient training opportunities, and inadequate psychotherapy training. Disparities between countries lead to trainee migration, which worsens conditions in their home countries. The EFPT is in a unique position to obtain feedback and work with partner organizations to improve the standards of psychiatric training for European trainees.

Educational Supervision Appropriate for Psychiatry Trainee's Needs

The authors studied the regularity and content of supervision sessions in one of the U.K. postgraduate psychiatric training schemes (Mid-Trent). A questionnaire sent to psychiatry trainees assessed the timing and duration of supervision, content and protection of supervision time, and overall quality of supervision. The authors examined the views of respondents based on their most recent experience of supervision. Almost all psychiatry trainees received regular, time-tabled supervision, and a majority went into supervision sessions with a preset agenda. Clinical case discussion was found to be the mainstay of the supervision session as reported by 94.7% of the respondents. One-third of the trainees used the supervision sessions to seek guidance regarding teaching medical students. They also sought advice on preparation for academic presentations in addition to developing administrative and management skills. A majority of trainees received personal and careers guidance and regular feedback on their performance. The average score for the overall quality of supervision was 7.88 out of 10. Supervision remains a unique learning experience for the psychiatry trainees. This study indicates that trainee psychiatrists want regular supervision sessions for discussion about various training issues. Educational supervision should be seen as an essential element in psychiatry training and assessed as part of the quality assurance monitoring of psychiatry training schemes.

Postgraduate training in psychiatry in India.

This review traces the evolution of modern medical education in India on the one hand and the formation of the Indian Psychiatric Society and the progress of postgraduate psychiatric education on the other hand, all in the context of Indian psychiatry. The topic is covered under the headings standard of psychiatric education, the goals, competencies required, impact of psychiatric disorders, relation of medicine to psychiatry, and the directions for the future of postgraduate psychiatric training.