Two thirds of Europe’s psychiatric trainees are looking to migrate

Authors: Matthew Limb 

Publication date:  04 Oct 2017

Researchers have identified a large “willingness to migrate” among psychiatric trainees in Europe, that could leave some countries at high risk of “brain drain.”[1]

Albania, Bulgaria, Cyprus, Romania, and Ukraine were among the countries most likely to lose trainees and face shortages because they might not be replaced, according to a study of 2013-14 survey data recently published.

In the survey of 2281 psychiatry trainees in 33 countries, two thirds were eager to migrate elsewhere at some point in their careers and half were considering leaving “now.” The authors said that this is the largest ever study of psychiatric trainees in Europe.

More than a quarter of trainees had already taken practical steps towards migrating, with salary differences given as the biggest reason for moving.

In 2013-14, the UK had the third highest percentage of immigrant trainees (27.7%), behind Sweden (28.4%) and Switzerland (74.9%), with very few thinking of returning to their country of origin.

These were also the countries with the highest incomes for trainees, according to the analysis published in the European Psychiatry Journal.

Mariana Pinto da Costa, who led the study, said it was possible the data captured the “high point of migration” on the continent at a time of financial “crisis.”

But further research would be needed to see if the expressed intentions were carried through, and if they were affected by more recent political, social, or economic changes.

She told The BMJ, “This was a pre-Brexit situation. Next year we will start a follow-up study to see if trainees, not only in the UK but across several other countries, still feel the same.”

The researchers sought to explore how often trainees have migrated or wanted to migrate, their reasons to stay or leave their countries, and where they move to.

They examined experiences of short term mobility, defined as three months to one year; experiences of long term migration, defined as more than a year; and attitudes towards migration.

They identified two migration types. “Typical” migrants were those dissatisfied with low salaries, mostly in eastern and southern Europe, wanting better paid posts, and moving to northern and western Europe.

“Atypical” migrants were those broadly satisfied with their salaries but eyeing potential moves for personal or academic reasons, often choosing countries outside of Europe.

The researchers said there could be around 20 000 psychiatric trainees in Europe although there are no exact official numbers for many countries.

The survey showed 13.3% of trainees in Europe were immigrants already—having a different nationality to the country they were training in.

Among all trainees, financial or salary reasons were cited most (34.4%) as a reason for leaving the country, with personal or family reasons coming second (33.6%), and academic reasons third (25.8%).

Trainees with low incomes reported finances as their main reason to leave (58.1%). Whereas in Finland, Germany, the Netherlands, Sweden, and Switzerland personal reasons were foremost.

In the UK, 5% of trainees responded (166 out of 3244) and of these 44% said they were considering leaving to go to countries in Europe and elsewhere.

Pinto da Costa, who is Portuguese, has herself moved to London and works at the Unit for Social and Community Psychiatry at Queen Mary University of London. She said that the findings could help decision makers to implement strategies to protect their medical workforce, including raising incomes, improving training and work conditions, and developing recruitment and retention campaigns.


  1. Pinto da Costa M, Giurgiuca A, Holmes K, et al. To which countries do European psychiatric trainees want to move to and why?Eur Psychiatry  2017;45:174-81. [Link] . [Link]   [Link] .

Matthew Limb London

Cite this as BMJ Careers ; doi: