M. Pinto da Costa

473 – Collaborative trainee-led research in psychiatry in Europe

Introduction Research is one of the most appealing fields for trainees in psychiatry and is an essential competency within curricula. Skills gained through research impact on clinical care and can be developed throughout the training of young psychiatrists. Since mobility is growing at different levels within psychiatry, giving rise to new challenges while requiring the exchange of visions and know-how , international collaborative research becomes crucial and should be promoted since the training. Objectives To share the experience of joint work and collaborative research done through joining professional associations, such as the European Federation of Psychiatric Trainees (EFPT) that provide opportunities for participating in research activities and establishing networks with others. Aims The interest for academic background and investigational activities are essential in psychiatry, being therefore crucial to share and promote discussion on the international research projects done in an international meeting point like this. Methods Assess the research projects done through time by the EFPT research group with special focus on the most recent ones. Results Since 2008 the EFPT started a research group with the aim of facilitating trainee-led collaborative studies. Over the years, several international research projects on training-related areas have been conducted and published in international peer-reviewed journals. Conclusions The research projects done will be briefly presented, showing that trainees can have the possibility to participate in all the phases of the projects as national coordinators and share with other colleagues their research competencies, having the possibility at times to rely on supervision by internationally renowned experts.

Psychiatric trainees’ view on a European curriculum of psychiatry

The European Federation of Psychiatric Trainees (EFPT) represents the consensus of psychiatry trainees associations across more than 30 European countries, advocating for the improvement and harmonization of psychiatry training across Europe. This federation has as priority to get direct feedback from psychiatry trainees, analyzing the concerns related to psychiatry and training in Europe, collaborating with other national and international partners to translate trainees’ views into action, while offering trainees several opportunities. Surveys of psychiatry trainees show that the main concerns around Europe revolve around differences of duration of training in the different countries, the discrepancies between the European training standards, the national programmes and the real experience of trainees. Likewise, levels of recruitment into psychiatry and inadequate working conditions also concern trainees, especially at the current times of economic challenge, where the choice to migrate abroad is quite frequent. Nevertheless, the involvement of psychiatry trainees in the development of national programmes and in the quality assurance of training varies significantly around Europe. This presentation will highlight the current differences observed in the structure, content and duration of psychiatry training programs in Europe, reporting trainees’ views on a European curriculum of psychiatry, and exploring mechanisms to evaluate and harmonize the postgraduate training in Europe.

Why Portugal is pushing towards migration

Background International professional mobility is a reality, people have skills they can put in the global marketplace. The increasing migration of health professionals to wealthy countries is a phenomenon known as “brain drain”. Objectives/Aims This work aims to present the push factors that pressure people to migrate from Portugal. Methods A cross-sectional survey was carried out with the psychiatric trainees in Portugal. A self-administered structured questionnaire was distributed to collect psychiatry trainees’ demographic and educational characteristics. Results In Portugal, the majority of trainees have a Portuguese citizenship. Almost 2/3 did not have a short-mobility experience, and the majority never migrated to another country. Less than half consider staying in Portugal in the next years, and nearly 4/5 have considered leaving the country. Working conditions ranked first as the priority condition to be improved in psychiatry in Portugal, followed by financial conditions. In fact, an attractive job for psychiatry trainees in Portugal must have as the most important feature a pleasant work environment. Conclusions An alarming percentage of psychiatry trainees from Portugal intend to migrate. Impact on future career, financial conditions of doctors, job opportunities and better working conditions were some of the motivating factors behind the migration.

Workforce Migration and Brain Drain in Psychiatry Trainees

Workforce migration of health professionals is influencing countries’ health services. In this new global context it is worthwhile to look for actual and future migration by recognizing the push factors that pressure people to leave the donor country, the pull factors that make the recipient country seem attractive, while confirming patterns and duration of migration. Despite the concern for migration has moved to the forefront agendas raising questions, there is lack of data of migration flows, as significant highly skilled migration has been within the European Union, and additionally, there is scarcity of data in psychiatry. As an attempt to explore migration among psychiatry trainees, the European Federation of Psychiatry Trainees (EFPT) has done a cross-sectional European multicentre study, collecting data from 2281 psychiatric trainees across 33 countries, assessing opinions and experiences of international migration. The results provided by this study bring an overview of migration among psychiatric trainees. This data analysis and discussion will permit further comparisons with other groups, such as physicians in general and psychiatry consultants worldwide. The possibility to endorse discussion in this symposium addressing the starting period of the training, having an outline of migration and the different cultural challenges faced on the way to a psychiatry career, may raise awareness on the current trends, help to elucidate the underlying issues and recommend possible systems of support. Migration within psychiatry will probably continue, being therefore essential to enhance support to those who migrate, and actually influence the mental health care provided internationally.

The Perspective of Trainees On the Psychiatry Training

The European Federation of Psychiatric Trainees (EFPT) represents the consensus of psychiatric trainees across more than 30 European countries, advocating for the improvement of the psychiatry training regardless of the country. The current challenges in the psychiatry training that trainees face at the European level will be presented; discussing the attitudes and opinions of the psychiatric trainees in the light of EFPT studies. Recently, the EFPT has developed a cross-sectional multicentre study, collecting data from trainees across 33 European countries, inquiring them on the conditions to be improved in their country regarding Psychiatry, such as: academic (training or educational opportunities), professional network (team work, cooperation), work (employment, conditions, workload) and financial (salaries); having been reported their attitudes and experiences of mobility and migration. Indeed the EFPT supports trainees going across borders through the EFPT Exchange Program. Moreover, being highly skilled brain migration a current trend, the EFPT has as well investigated deeply this topic. Likewise, the EFPT aims to research the aspects of postgraduate training in European countries in collaboration with Union Europeenne des Medecins Specialistes (UEMS) in an effort to find solutions to the lack of training standards. This future approach is expected to facilitate the harmonization of psychiatric training in Europe, so important nowadays, especially given the increase of mobility opportunities and marked migration trends of professionals across countries. Enhancing and harmonizing the training can afterwards take an effect towards improving the similarities of the mental healthcare internationally.

Teo-pc Pilot Study – Trainees' Experiences and Opinions Regarding the UEMS Psychiatric Competencies in Their National Training Programmes

Introduction Psychiatric training in the European Union is undergoing a process of harmonization of national curricula in order to establish a common postgraduate training framework. The Research Group of the European Federation of Psychiatric Trainees (EFPT) is conducting a multi-national study on psychiatry education of trainees among the European countries in regard to the Union Europeenne Des Medecins Specialistes (UEMS) 2009 competencies framework. Objectives The aims are to raise awareness on these competencies, compile data on trainees‘ experience of their training and assessment methods, opinions on level of confidence, and on relevance of these competencies. Methods This study surveyed trainees from 15 EFPT countries using a questionnaire developed specifically for this research. Results Psychiatric training in Europe differs significantly regarding length, with a training duration ranging from 4 to 8 years. Only 26,7% of the trainees were well acquainted with the UEMS competencies and trainees from only 8 countries declared to have a competency based national training curriculum. These results reveal that trainees have different experiences and opinions on competencies and assessment methods depending on their country of residence. Discussions A limitation of the results may be that our respondents are the EFPT representatives’ and probably have better knowledge on the educational issues. Conclusions The combined quantitative and qualitative outlook on national training programmes from the trainees point of view enhances our understanding and perspective of the dynamic processes of psychiatric education in Europe. Data obtained from this research study contributes to the efforts to unify psychiatric training curricula.

EPA-1466 – Migration and brain drain

Changes taking place nowadays, such as globalisation, increased mobility, population ageing, financial crisis and social networking force us to test the old views and adapt to the new realities. This consequently leads to interrogations that reflect current differences of perception created by the great velocity and intensity, followed by an unprecedented degree of interconnectivity and lowering of international barriers. Therefore, it is worthwhile to look for actual and future migration onto the new global context by recognizing the push factors that pressure people to leave the donor country, the pull factors that make the recipient country seem attractive, while confirming patterns and duration of migration. Despite the concern for migration has moved to the forefront agendas raising questions, nevertheless, there is lack of data of migration flows, as significant highly skilled migration has been within the European Union, and additionally, there is scarcity of data in psychiatry. For that reason, as an attempt to explore migration among psychiatry trainees, the European Federation of Psychiatry Trainees (EFPT) has been doing a survey to assess opinions and experiences of international migration. This data analysis and discussion will permit further comparisons with other groups, such as physicians in general and psychiatry consultants. The results provided by this study bring an overview of migration among psychiatric trainees and the different challenges faced in this pathway to a psychiatry career. Migration within psychiatry will probably continue, being therefore essential to enhance support to those who migrate, and actually influence the mental health care provided internationally.

897 – European federation of psychiatric trainees (efpt) exchange programme: building links across europe

Introduction 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. Objectives 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 Methods 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. Results 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. Conclusions 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.

P-974 - Complex post-traumatic stress disorder and co-morbidities: clinical case over 40 years after war

Post-traumatic stress disorder (PTSD) is a mental disorder that arises from the experience of life traumatic events. Research shows high-incidence of co-morbidities between PTSD: suicidal ideation, substance abuse, mood disorders and psychosis that complicate it, leading on occasion, when concerning stressful situations of an exceptional threat or catastrophic nature, to Enduring personality change after a catastrophic event. PTSD may precede this type of personality change, which may be seen as a chronic sequel of a stress disorder. The aim of this work is to present and discuss a clinical case: its assessment, diagnosis, differential diagnosis, treatment, evolution and outcomes, using it to illustrate the development of PTSD, and its relationship with other co-morbidities, consenting to promote the discussion of this nosological entity, providing recommendations for assessment and treatment of individuals with a trauma history, such as life-threatening events. It is reported a case of a 66 year old male patient, veteran of the war in Mozambique that was admitted at the Psychiatry Department in Portugal after a suicidal attempt. Patient presented traumatic reexperience, hyperarousal, avoidance and emotional numbing. Moreover, online search was done of the literature review, using Medline and Pubmed, exploring papers concerning PTSD. PTSD may be predisposed by affective, cognitive and environmental factors that occur in response to a traumatic event, but also to pre-existing psychological vulnerability. This patient is an example that recounts a response to the prolonged traumatic exposure which personality change has been enduring as maladaptive features leading to an impairment functioning.

P-852 - Access to information in psychiatric training (ATIIPT) among the delegates to the european federation of psychiatric trainees (EFPT) 2011 forum

Introduction In the last decades, psychiatric training has undergone a major transformation due to the contribution of recent scientific developments in psychiatry. Nowadays, the information acquired during the Psychiatric training seems considerably variable in content and quality between different countries. However, data concerning access to information and also about the educational resources available to the trainees in Europe is very limited. Objectives and aims The ATIIPT survey aimed to evaluate Psychiatric trainees’ access to published, online, seniors or industrys information in Europe. Methods A short paper questionnaire constituted of 7 questions (Appendix 1) was created by the members of the EFPT Research Working Group and passed to each delegate of the 32 countries represented at the 19th EFPT Forum in Prague, Czech Republic, on the 2nd of July 2011. Results According to the ATIIPT results, access to information among Psychiatric trainees in Europe is heterogeneous. The most available resources are books and websites, and the most preferable resource is journals. Most of the trainees find their resources sufficient, with the main obstacles being related to low availability of journals and books, lack of time and help from seniors. Conclusions Better access to information and more evidence in practice is warranted, since the introduction of novel approaches to access to information may create better psychiatrists in the future, encourage medical students to consider psychiatry as a potential career, and help reduce negative attitudes towards mental illness.