Welcome to the Breakfast Club: Building academic psychiatry capacity in Queensland

Introduction

Six years ago, an editorial piece warned that academic psychiatry was endangered (Henderson et al., 2015), and another called for the next generation of academic psychiatrists to step forward (Kisely, 2015). In response, two trainees and two early career psychiatrists (ECPs) with interest in research started a club in Brisbane with the goal of ‘setting traps’ for discovery and building a platform for ongoing discovery (McGrath, 2014) for the next generation of academic psychiatrists.

Establishment

The idea was simple. We would have a breakfast meeting inviting any ECP or trainee interested in academic psychiatry. We would also invite one established academic psychiatrist. The guest of honour (Pancake Prince or Pancake Princess) would talk to us about how research has shaped their career. We chose a café in East Brisbane as our venue. We decided to call the club the ‘Breakfast Club’ because we were meeting up for breakfast. We wanted to say something clever about the similarities between the founders of the Club and the characters from the eponymous 1980s classic, but like most people, we had not seen John Hughes’ film since the 1990s.

We employed snowball sampling for recruitment. We thought of trainees or ECPs in Brisbane interested in research and started composing a list of names. We picked our inaugural guest of honour and decided on a time (8 a.m. on Friday). We invited the people on the list, and about six people came for the first meeting. After that, we chose the next Pancake Princess, added a few more names to our email list and met up again a couple of months later. From there, it went on like that for the next 5 years. The process of organising each meeting remained simple. We would choose the next guest of honour after each meeting. We would ask them to ‘tell us how research helped you to get to where you are today’ and give them a handful of Friday morning options. After they responded, we would book the date and send a group email to invite all the members. The setting was always casual. We sat around a wooden table at the same cafe, sipped on coffee and tea, and listened to the guest of honour. There was no PowerPoint presentation, no pre-lesson reading, no evaluation questionnaire. Just the sharing of wisdom as words were passed on from one generation to another.

Evolution

Initially, we anticipated that the Club would become something akin to steak and beer meetings common in the business world. We predicted sharing of hidden histories and insiders’ insights, creation of new collaborations, and heated debates and discussions. We would pitch new ideas to the academic influencers. We would write papers and win grants together. We would have a couple of idealistic schisms like Freud and Jung, make friends, enemies and frenemies. But that is not how it went down. Over the 5 years, we invited 20 Pancake Princes and Princesses. We started off by inviting ‘hard-core’ academic psychiatrists – professors with University groups and multi-million-dollar grants. After a while, we started inviting psychiatrists who were trying to implement and evaluate new ways of improving patient care in everyday practice. We had several clinical directors from different hospital networks, as well as psychiatrists from the private sector, a chief psychiatrist and a College President elect. Their messages were varied and heterogeneous. Some emphasised the importance of academic collaboration and clinical-research synergy, while others stressed the reality of bureaucratic challenges and burdensome paperwork. Although nobody questioned the importance of the patient-first approach (we do what we do to improve the lives of people living with mental disorders), a couple of guests openly questioned the value of doing a PhD as psychiatrists (there may be more effective ways of making a difference).

As of 2021, we have exactly 60 people on the Breakfast Club email list. This number is misleading. Each meeting was attended by around two to eight members only. We never changed the venue or the timing of the meeting over the 5 years. Although two Breakfast Club dinners (held on Saturday night at more central restaurants) were better attended than any breakfast meeting, we opted not to change the venue and time because the simplicity of the Club organisation was more important than meeting members’ short-term needs in ensuring the sustainability of the Club long-term. This stubbornness to stick to the same routine also meant that the attendees were often hamstrung by the requirement of the rotations they were doing or work commitments they had. Most only attended one or two meetings, and many on the list never made it to any meeting. The prerequisite to be on the Club email list was never properly articulated. If someone vaguely expressed interest in academic psychiatry, their name might be passed on to the Club organisers. Some people heard about the Club from other members or previous Pancake Princes/Princesses and approached the organisers to be added to the email list. Regardless, despite never formally advertising for membership, the Club membership grew.

Achievements

If we were writing a progress report to justify our existence, we would write something like this. From our humble beginning, the Breakfast Club managed to increase the number of its membership 15-fold, triggering the Queensland Dominance in Australasian Academic Psychiatry among ECPs. Our members have been recognised with multiple research awards from the RANZCP Foundation, including two Royal Australian and New Zealand College of Psychiatrists (RANZCP) Early Career Psychiatrist Awards, two Beverly Raphael New Investigator Grants, three RANZCP Foundation Early Career Research Grants and one Lived Experience Australia Award. Our research has been highlighted through numerous local, national and international media outlets. We have run two Congress symposia, showcasing the wide range of research our members conduct. In other words, the Breakfast Club has inspired the new generation of psychiatrists to step forward and brought the academic psychiatry back to life in Brisbane.

The truth is less exciting. Although individual members of the Club have published over 100 peer-reviewed articles collectively, we have only managed to publish one paper as a Club (Ng et al., 2019) over the past 5 years. Although we wanted to ‘set traps’ for discovery, we have not found any major breakthroughs in psychiatry. Alas, we are content with subtler achievements of the Club. It has become less uncool to inspire to be an academic psychiatrist in Brisbane. People no longer laugh at you if you tell them that you want to do a PhD during your training. Confidence breeds competence. As an increasing number of Breakfast Club members publish papers, complete their PhDs and are awarded with scholarships and grants, other trainees and ECPs in Brisbane can see that it is possible to be an effective academic psychiatrist while facing the same bureaucratic barriers and work–life imbalance they face.

Conclusion

The Breakfast Club created an environment where trainees and ECPs are given opportunities to meet and mingle with senior psychiatrists. We hope that the simplicity of this approach will inspire other similar groups to share and describe different approaches to enhance academic psychiatry in both Australia and New Zealand.