Training of medical specialists is mostly set at a national, sometimes regional level across Europe. Those concerned with the organization and improvement of training of medical specialists across the EU can avoid inventing the wheel all over again by finding inspiration and guidance in international cooperation [5]. The rich variety in how we train and educate future child and adolescent psychiatrists has been subject of research with the aim to contribute to the question what works best for whom and where. A special edition of European Child and Adolescent Psychiatry (January 2020) contributed to this venture with editorials and articles describing current systems of training across the continents of the world [2,3,4,5,6,7,8,9,10, 12].

One of the specific instruments that may help trainers put the insights from these studies into practice is the setting of an international curriculum framework, such as those developed by the European Union Medical Specialists association (UEMS). Recently, the CAP section of the UEMS updated its curriculum framework together with a large group of international CAP trainers from across Europe and with wider consultation from consumer and family organizations. This curriculum framework for postgraduate training in child and adolescent psychiatry constitutes a major part of the European Training Requirements, covering the content of training in the first five chapters of this document [13]. The other chapters provide guidance on the organization of training, the implementation of national curricula, the quality management within training institutions and the structure of coordination of training.

Functions of a curriculum framework

A curriculum framework serves as a roadmap for constructing training programs. It provides guidance and maps out training goals for trainees. It helps them to get an overview of where to go and at what stage they are in their training process. For training program directors, trainers and for all those concerned with training, the framework can help to provide focus and ensure all relevant parts of training are included in the program.

On an individual as well as a group level, it helps to identify which learning goals have already been achieved. This allows a shift in focus for their education, providing time for new goals. It can allow for fast tracking some trainees and build in extra depth or new areas of learning (e.g. research, teaching, leadership, advocacy, psychotherapy). If a trainee is struggling, it can alert them and their trainer to offer remedial support or rarely, to halt their training.

The revision processes

The revision process of the 2014 version of the curriculum framework was started at the UEMS-CAP annual section meeting in Ljubljana in October 2019. The section established a working group that conducted an iterative process involving editing and commenting on an online platform. Several rounds were conducted presenting consecutive drafts to members of the working group and a broader group of UEMS-CAP delegates. The revised curriculum framework draft was presented to a variety of stakeholders in the member countries (national CAP associations, junior CAP doctors' organizations and patient-carer groups in the fields of child mental health). Respondents were asked to provide feedback via an online consultation platform from November 2020 to June 2021. The feedback was analyzed and presented at a virtual roundtable meeting in September 2021. Changes were incorporated into the final version that was adopted at the UEMS-CAP Virtual Annual Meeting October 2nd 2021. After this internal validation, the curriculum framework is ready for inclusion in the official UEMS procedure for revision of European Training Requirements, which will be prepared in 2022.

Reading guide

As a trainee, you can read through the document to get an overview of what is (internationally) thought to be of importance in your training program. As a trainer, you can gain an overview of where your trainees are going and search through the learning goals to get a better idea of your own core competencies and knowledge, and what trainees can learn best from you. Also, it may help trainers to reflect on where they might need additional training or development to better undertake the trainer role. Training program directors or national associations can use this framework to compare or adjust their own national curriculums.

The revised Curriculum Framework consists of several sections covering essentials of child and adolescent psychiatry, theoretical knowledge, clinical practice (skills, conditions and settings) and professionalism in child and adolescent psychiatry. The order of the chapters and the numerical assignments within the chapters do not imply importance/hierarchy but are derived from logical sequences in clinical work or organization of knowledge, skills and professional behaviors.

Those who want to scrutinize the document and compare it to its previous version will find it now contains an essentials section covering everyday clinical practice as well as what can be expected from CAP in their roles in the improvement and organization of care, teaching and personal development. The changes in the knowledge section include a refinement of the appreciation of principles of brain imaging and electrophysiological techniques and research methodology as well as principles from (epi-)genetics encompassing gene-environment interactions, environmental effects on development and their application to child and adolescent psychiatry. The clinical skills and attitudes sections put a bit more stress on the application of (classical psychotherapeutic) skills in communication with system members, teams and networks of care around developing children. The scope in terms of clinical conditions is defined according to ICD-11 and the scope in terms of clinical settings gives a broader view of CAP practice. A number of items on digital lives, technology, telepsychiatry as well as transcultural and gender issues have been amended/extended. Throughout the document, the lifelong learning perspective is more present, including knowledge on adult learning and the skills and attitudes that are required to constantly adjust and adapt to changes in the field of CAP and society and maintain good medical practice.

The document is available at the UEMS-CAP website ready [14] to guide the development and refinement of national curricula in child and adolescent psychiatry. For those who long for more and an even broader international perspective, we can recommend similar initiatives in the US from the Accreditation Council for Graduate Medical Education (ACGME Milestones [1]) and in Australia from the Royal Australian & New Zealand College of Psychiatrists (RANZCP Training Program [11]). Putting the curriculum framework into practice, national bodies will adapt the specific content to their own context and the format to the structure chosen in their national postgraduate training regulations. The UEMS-CAP section respects cultural and context differences across Europe and realizes that the application and use of the framework should take these into account. Nonetheless, this curriculum framework summarizes the essentials of CAP training. It provides a range of knowledge, skills and competencies and a standard for proficiency that we think families across Europe are entitled to expect.