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The objective of the present study was to conduct a systematic inquiry into the frequency and impact of patients’ suicide on psychiatric trainees, and the availability and usefulness of training courses. Data were collected from 114 psychiatric trainees of the Dutch-speaking part of Belgium, representing a 70% response rate. A self-report questionnaire developed in the UK was adapted to the Flemish situation. A Dutch version of the Impact of Event Scale (IES) inquiring about post-traumatic stress symptoms was also used. The frequency of suicide experience was considerably higher in the present study than in similar studies in the USA and the UK. Thirty percent of first year trainees had been confronted with patient suicide. Personal and professional impact of patient suicide, as well as post-traumatic stress scores were considerably lower in Flemish psychiatric trainees. They considered informal support to be of more value than formal support to come to terms with the event. Finally, postgraduate training in post-suicide management was found to be largely insufficient. The results of the present study show that psychiatric trainees in the Dutch-speaking part of Belgium are at a high risk of experiencing patient suicide, whereas the impact of this experience appears to be relatively low. Only a small minority of trainees has received adequate training on procedures to follow after patient suicide.
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.
Methods:
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.
Results:
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%).
Conclusions:
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.
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