The COVID-19 pandemic has increased rates of psychological distress and burnout in healthcare staff. How can we understand our experiences of the pandemic? We reflect on the experiences of psychiatry trainees in two north London mental health trusts. From a psychoanalytic understanding, states of extreme anxiety can lead to a manic defence and functioning in the paranoid–schizoid position. This position is derived from object relations theory and is characterised by binary thinking, splitting, projection, defensiveness and ‘knee-jerk’ decision-making. This can affect our perceptions, responses to others, relationships and ability to function and, therefore, our clinical practice and well-being. We consider the importance of recognising these processes and of organisational containment and having space to reflect. This supports functioning in the depressive position, a state of mind where we can tolerate anxiety, address difficult realities and develop new ideas. We hope these understandings are helpful to our colleagues in all professions.

In the world of medical education, there is generally a lot of emphasis on following procedure and tradition, and a reluctance to challenge the norm. It takes insight and courage to question traditional approaches and paradigms: why are psychiatric training programs done the way that they are? Reverse engineering involves taking something apart and analysing its workings to figure out how it does what it does and how it can be improved. In education, reverse engineering implies one determines learning outcomes upfront and then works back from them. Applied to postgraduate psychiatric training, it requires us to determine the basic principles or core concepts resulting in the successful formation of a well-rounded psychiatrist. In times of crisis there usually is more leeway to challenge the status-quo – hence the saying “never waste a good crisis”. Indeed, if the COVID-19 crisis has taught us anything, it is that education should be meeting learners where their attention is at, and that any healthcare organisation can be transformed within weeks when given the right incentives. In this workshop, Dr. De Picker will reflect on how post-COVID European psychiatric training can reinvent itself to address long-standing concerns and unmet needs. Innovative approaches will be needed to start shaping the psychiatrists of the future.

Air traffic controller training is highly regulated but lacks prescribed common assessment criteria and methods to evaluate trainees at the level of basic training and consideration of how trainees in fluence flight efficiency. We investigated whether there is a correlation between two parameters, viz. the trainees’ assessment score and fuel consumption, obtained and calculated after real-time human-in-the-loop radar simulations within the ATCOSIMA project. Although basic training assessment standards emphasise safety indicators, it was expected that trainees with higher assessment scores would achieve better flight efficiency, i.e. less fuel consumption. However, the results showed that trainees’ assessment scores and fuel consumption did not correlate in the expected way, leading to several conclusions.

An overview of the existing European trainee organizations is not easy to give. The historical tendencies as described in the first part have currently brought about many initiatives. In the second part of this article, a description of the two main European trainee organizations is given.

Research suggests that there is a lack of focus on developing trainees’ intrapersonal skills or adequately fostering self-care. Mindfulness training may help address the gaps in training programmes. Quantitative and qualitative studies involving mindfulness training for postgraduate trainees were reviewed. There is a need to explore different designs of mindfulness training groups to ascertain what would be feasible and effective, given the trainees’ existing time constraints. Furthermore, the current understanding is limited due to the difficulties defining and operationalising mindfulness. Qualitative research would help to explore what mindfulness training means to trainees and how it impacts on their lives.

This article offers an introduction to key systemic ideas as seen through the eyes of first-year trainees in a postgraduate systemic therapy course. Our aim is to present these ideas in user-friendly, accessible language, with examples to illustrate their use. The article is organised around three main themes: how a family system gets organised; how systemic work helps to effect change in families; and how a systemic therapist creates a context for change. Ideas covered include circular patterns, processes and questions, feedback loops, the importance of context, the interdependence of meaning and action, taking a meta-perspective, systemic hypothesising, neutrality, curiosity, second-order change, use of language and the position of the therapist. The article may be of particular interest to those who are new to systemic ideas, as well as for those involved in providing training in systemic practice.

Clinical teaching is an integral part of emergency medical practice. With the growing number of medical students and residents in the emergency department there are increasing expectations for clinicians to teach. But there are many challenges and obstacles to overcome when teaching in a busy department. By incorporating diverse strategies and techniques, we can become more effective and efficient emergency medicine teachers.