In this short paper, I will describe the place of Psychiatry within the European Union of Medical Specialists (UEMS) and the role that the UEMS Section of Psychiatry plays in setting standards for psychiatric training in Europe. An important part of the work has been the development of a competency framework for psychiatry that describes the learning outcomes for psychiatric postgraduate training in Europe.
The UEMS (Union Européenne des Médecins Spécialistes, or European Union of Medical Specialists) is a non-governmental organisation representing national associations of medical specialists at the European level. It has a membership of 40 national associations, and it operates through 43 Specialist Sections and their European Boards, 17 Multidisciplinary Joint Committees and 4 Thematic Federations. The UEMS is committed to promoting the free movement of medical specialists across Europe and ensuring that there is a professional consensus on the framework for the highest possible standard for their training.
The UEMS Section of Psychiatry is the UEMS Specialist Section that discharges the mission of UEMS with respect to the specialty of psychiatry. Since 2007, one of the Section’s main activities has been to develop, disseminate and review the European Framework for Competencies in Psychiatry (EFCP). The purpose of the EFCP is to support the harmonization and improve the standards of post-graduate training in psychiatry in Europe by providing a list of learning outcomes that national associations and other regulators of psychiatry training in Europe may refer to when constructing curricula for postgraduate training and systems for continuing professional development. The latest version of the EFCP can be found here.
In 2007 the Section of Psychiatry established a working group, including medical educationalists, senior psychiatrists with expertise in training and psychiatrists in training and gave it the task of writing the first edition of the EFCP. This was based on the Profile of a Psychiatrist (UEMS Section for Psychiatry, 2005) and the UEMS Charter on Training of Medical Specialists in the EU (UEMS Section for Psychiatry/European Board of Psychiatry, 2003).
The group chose to use the CanMEDS 2005 physician competency framework (Frank, 2005) as its guiding structure. It consulted the American Board of Psychiatry and Neurology’s Core Competencies for Psychiatric Practice (Scheiber et al, 2003), the Royal College of Physicians and Surgeons of Canada’s Objectives of training in psychiatry (RCPS, 2007) and the UK Royal College of Psychiatrists’ Curriculum for Psychiatry Specialty Training, (Royal College of Psychiatrists, 2006). The group then developed the framework through an iterative process that involved consulting national psychiatric associations, trainee organisations, patient and carer organizations, the European Psychiatric Association, and the World Psychiatric Association.
The Section gave the final approval to the first version of the European Framework for Competencies in Psychiatry (EFCP) in 2009.
The update of the EFPC began in 2018 and was finished in 2023. It continued to be based on The CanMEDS physician competency framework as amended in 2015 (Franke et al, 2015) and it drew on the revised version of The Profile of a Psychiatrist, which was approved by The Section of Psychiatry in April 2018 (UEMS Section of Psychiatry, 2018).
In addition, the update has incorporated learning outcomes that emanated from the UEMS Section of Psychiatry Position Paper on the Use of Coercive Practices in Mental Health Services (UEMS, Section of Psychiatry, 2022).
The learning outcomes in the European Framework for Competencies in Psychiatry are arranged under the seven physician roles or meta-competencies, derived from the CanMEDS 2005 physician competency framework (Frank et al,2005 & 2015) as adapted for the UEMS Profile of a Psychiatrist 2018). The seven physician roles consist of Psychiatric Expert/Clinical Decision-Maker, Communicator, Collaborator, Leader, Health Advocate, Scholar and Professional.
There is a description of how each physician role is applied in the specialty of psychiatry. Each physician role is broken down into key competencies, and this is followed by a list of each key competency’s underpinning supporting competencies. The supporting competencies are formulated in an operational way that will facilitate the delivery of learning and assessment, striking a balance between the need to provide meaningful guidance and the risk of being over prescriptive.
The Framework includes a grid of suggested methods that may be used to assess the acquisition of each supporting competency. The rationale for the selection of assessment methods is described in more detail in the glossary of terms at the end of the Framework. The Framework also includes a description of how Entrustable Professional Activities (ten Cate, 2000) may be included as part of an assessment system and there is a description of several suggested EPA’s.
The next step in our work to improve training in Europe is to develop an examination that will test achievement of the knowledge outcomes of the EFCP. So we are working with our partners in the European Psychiatric Association and the European Federation of Psychiatric Trainees to construct a syllabus and a collection bank that will be blueprinted to the EFCP. □
References by request
Frank, JR (Ed) (2005). The CanMEDS 2005 physician competency framework. Better standards. Better physicians. Better care. Ottowa: The Royal College of Physicians and Surgeons of Canada.
Frank JR, Snell L, Sherbino J, editors. CanMEDS 2015 physician competency framework. Ottawa: College of Physicians and Surgeons of Canada. https://www.royalcollege.ca/rcsite/canmeds/canmeds-framework-e.
Royal College of Physicians and Surgeons of Canada (2007) Objectives of training in Psychiatry. Ottowa: Royal College of Physicians and Surgeons of Canada.
Royal College of Psychiatrists (2006) Specialty Curriculum for Psychiatry Training. London: Royal College of Psychiatrists.
Scheiber SC, Kramer TAM & Adamowski SE (2003). A Report of the American Board of Psychiatry and Neurology Inc. Core Competencies for Psychiatric Practice: What Clinicans Need to Know. Washington: American Psychiatric Publishing.
ten Cate, O. (2014). What Entrustable Professional Activities add to a competency-based curriculum. Academic Psychiatry 89(4): 1.
UEMS Section of Psychiatry/European Board of Psychiatry (2003) Charter on Training of Medical Specialists in the EU (Chapter 6): Requirements for the Specialty of Psychiatry.
UEMS Section of Psychiatry (2005) The Profile of a Psychiatrist.
UEMS Section of Psychiatry (2018) The Profile of a Psychiatrist (Revised).
UEMS Section of Psychiatry (2022) Position Paper on the use of coercive practices in Psychiatry.
UEMS Section of Psychiatry documents are available from: www.uemspsychiatry.org.