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Table 4 Characteristics of selected full-papers: expert opinion and narrative reviews

From: Training of adult psychiatrists and child and adolescent psychiatrists in europe: a systematic review of training characteristics and transition from child/adolescent to adult mental health services

Study Aim Methods Results (aggregated data) and authors’ conclusion Quality Score (/36)
Hansen & Thomsen, 2000 [34] To describe the structures of the Denmark and UK psychiatry training Expert opinion The UK postgraduate system puts greater emphasis on structuring the academic and clinical aspects of training. NA
The Danish system leaves the trainee in a more individualistic position.
Formalized training and supervision are sparse in Denmark compared with the UK. Some steps taken to harmonize the postgraduate psychiatric training of doctors in Europe. Still a very long way to go before trainees can move freely between EU countries with full recognition of their training.
Furedi et al., 2006 [35] To review the current status of psychiatry in selected countries of Central and Eastern Europe: Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, Russia, Slovakia and Slovenia. Narrative review.
A group of psychiatrists from the region evaluated the status of psychiatry at the end of 2004 based on data from their countries and information available on WHO homepages
The systems of psychiatric training vary across the region but there is an effort to standardize national systems according to the WPA and UEMS requirements. Psychiatric training, pre-, postgraduate and continuous medical education are gradually being transformed. NA
Zisook et al., 2007 [36] To compare and contrast psychiatry residency training in the USA, in Canada and selected countries in South America (Chile, Brazil), Europe (UK, Sweden, Czech Republic), and Asia (India, Korea and China). Expert opinion
9 individuals intimately familiar with psychiatry residency training in the USA, with prominent positions, and trained in other countries, describe their past training programs and make a comparison with USA training
Worldwide, psychiatry training varies considerably in different regions in terms of the duration of training, structure of clinical experiences, autonomy of trainee, didactic structure, level of supervision and rigor of evaluation. In some countries, training is much less structured than in the USA (e.g. Sweden). In others, it is somewhat more structured (e.g., Korea). Differences appear to be lessening. NA
Naber & Hohangen, 2008 [37] To describe training in psychiatry and psychotherapy in Germany Expert opinion: Editorial Since 1992, specialization in Germany is no longer in ‘psychiatry’ but in ‘psychiatry and psychotherapy’. NA
- Principal aim of training in Germany: to achieve a multidimensional approach to the diagnosis and treatment of psychiatric disorders.
- Special challenge: to offer psychotherapy training and to introduce psychotherapy into the classical spectrum of pharmaco and sociotherapeutic tools.
- Existing solution to face scarce funding for psychotherapy training: several hospitals providing a joint training programme for several psychiatry departments.
Garret-Cloanec, 2010 [38] Point of view about the current modifications of the Continuing Medical Education (CME) in France Expert opinion: Editorial The new system of CME in France is established by the law, based on the analysis of professional practice and the acquisition of knowledge or skills. Each professional must achieve his/her annual obligation by participating in one collective program. The organization is very complex, with the implications of many official organisms with various objectives. The lack of funding resources, with the possible intervention of pharmaceutical industries is also a problem. NA
Javed et al., 2010 [39] To describe the training and examination requirements of the new system in place in 2007 in the Psychiatric training in UK Expert opinion - The establishment of Postgraduate Medical Education and Training Board, Modernizing Medical Careers, new recruitment processes and changes in the curriculum and examination structure are all having a major impact on the future training and teaching programs in psychiatry in the UK.
- Entry into psychiatry is becoming increasingly competitive and progression in career is now competency based in addition to the examination requirements subject to an annual review and regular appraisal.
- A structured portfolio is also vital in order to present evidence of competencies and ensure smooth progression through the training grades.
Bobes et al., 2012 [40] To describe the current state of the Mental HealthCare Services in Spain Narrative review
A literature search performed using MEDLINE, Spanish journals, reference lists, national databases, and European and Spanish official documents
Specialist training programme in psychiatry was updated in 2008. NA
The new programme in psychiatry lasts four years.
Child and adolescent psychiatry is not recognized as a speciality.
Heterogeneous training of the specialists in charge of child and adolescent units is emphasized.
Palha & Marques-Teixeira, 2012 [41] To describe the panorama of psychiatry in Portugal, including training of professionals Expert opinion The rationale of the training is focused on the specificity of psychiatry on mental pathology, in the consequences of medical and chirurgical pathologies on the psychic system and in the always-considerable importance of the psychic system on the processes of human illness. NA
CAP is organized as an autonomous speciality (since 1959) with its specific training programme, rules and guidelines, as well as practice domain.
Van Schijndel et al., 2012 [42] To describe the state of psychiatry in the Netherlands Expert opinion Current programme developed and disseminated as from 1 January 2011. NA
- Backbone of the system: only one specialty with in-practice emphasis in three domains: CAP, AP or old age psychiatry, after a common trunk of general psychiatry.
- All the knowledge and the skills that should be achieved are described as competencies that are comprehensively assessed.
- Trainees have an increased liberty to fill in their own preferences and tailor a training scheme based on their personal interests.
Crommen, 2013 [43] To present CAP in Belgium and the Flemish association for CAP Expert opinion The CAP training program consists of integrated theoretical, clinical and research components. NA
- Residents must complete at least 1 year of training in AP and at least 3 years of training in CAP during the 5-year program.
- Residents can also complete 1 year of pediatrics or neurology.
- Both the biological and the psychodynamic aspects of CAP are covered in the curriculum, and basic psychotherapy courses are provided.
Training program currently being revised for standardization with the UEMS.
No recognition of “child and adolescent psychiatry” as a medical specialty by the government in Belgium.
Skokauskas, 2013 [44] To review the current system of post-graduate training in psychiatry in Ireland Comment on the National programme provided by the College of Psychiatry of Ireland The current post-graduate training system aims to be in line with best European and International standards.
- Length of post-graduate training: at least 7 years
- Curriculum in two phases: Basic and Higher Specialist Training.
- Programme content and structure well defined.
- College of Psychiatry of Ireland: responsible for the training of specialists in psychiatry.
Van Effenterre, 2013b [45] To describe CAP training in France Expert opinion - One and only pathway for CAP and AP, leading to a generalist title of psychiatrist. NA
- 2 mandatory semesters in CAP for all trainees.
- Training program is not national but depending on universities and regions.
Fegert et al., 2014 [46] To describe CAP in Germany Expert opinion: ESCAP Communication In Germany, CAP first became an independent medical specialty in 1969. NA
The requirements for specialist training are currently under review by the authorities. Continuity of training is provided for and controlled by the “Continuous Medical Education System” (CME), according to which all child and adolescent psychiatrists must fulfill defined criteria for continuous field-related training within a 5-year period.
Mayer et al., 2014 [47] To compare the different curricula of post-graduate training in psychiatry in Europe Narrative review of available publications on post-graduate training in psychiatry in Europe (Medline) + systematic overview for published postgraduate training curricula in Spanish, French, English and German (Goggle search) + e-mails sent to representatives of different professional medical societies Medline search: 6 papers. NA
Google and personal contacts to representatives of professional medical societies: access and translation of original post-graduate curricula.
Substantial differences between post-graduate training in the 6 European countries described (Germany, the Netherlands, Sweden, Belgium, France and UK): e.g. varying length, compulsory subjects, exam during training or final exam.
Christodolou & Kasiakogia, 2015 [48] To inform Greek psychiatrists and psychiatric trainees aspiring to emigrate in the UK. To describe the structure of the UK psychiatric training system and to compare it with the equivalent system in Greece Expert opinion Psychiatric training in the UK differs substantially to Greece in both structure and process: NA
- Pure psychiatric training in the UK Versus neurological and medical modules in Greece.
- In-training exams in the UK Versus only an exit exam in Greece
- 3-year higher training in UK.
Karwautz et al., 2015 [49] To describe CAP in Austria Expert opinion: ESCAP Communication CAP specialty was established in 2007. From 2015, the training requirements are changing by law for all specialty fields. NA
In next curriculum: a 4-year phase of basic CAP training followed by three six-month modules focusing on specific topics like adolescent psychiatry, developmental psychiatry, addiction treatment or pediatric/psychosomatic medicine.
Drobnic, 2016 [50] A brief report about the state of CAP in Slovenia Expert opinion: ESCAP Communication In 2002, Slovenia started the first formal training in CAP.
The training lasts 5 years, including 3 years of AP, 1.5 years of CAP, and 6 months of paediatrics and developmental neurology.
  1. NA non available, UEMS CAP Union Européenne des Médecins Spécialistes section of Child and Adolescents Psychiatry, EFPT European Federation of Psychiatry Trainees, WHO World Health Organization, WPA World Psychiatric Association, EBP European Board of Psychiatry, ECPC Early Career Psychiatrists Committee, CAP Child and Adolescent Psychiatry, AP Adult Psychiatry, ESCAP European Society of Child and Adolescents Psychiatry, GAP General and Adult Psychiatry