A large number of our colleagues are currently facing a serious issue: the prolonged waiting times for the issuance of FMH specialist titles. Throughout the entire previous year it has been difficult to avoid media headlines highlighting the situation and emphasizing the urgency of resolving it. As representatives of psychiatry trainees in Switzerland, we have been closely following these developments for months, and we have previously reported on this issue in a previous post.
In order to inform our members about the current state of affairs and to provide a broader overview, we present a summary of the events that have led us to where we stand today.
Who is responsible for what?
Before we dive more deeply into the situation, we will first provide an explanation of the key organizations and their roles.
FMH is the umbrella professional organization that brings together all medical doctors in Switzerland and represents their interests.
The issuance and official recognition of medical specialist titles is delegated by the FMH to the SIWF/ISFM. This independent organ approves postgraduate specialist training programs, accredits training institutions, as well as manages and oversees the entire system of postgraduate and continued medical education in Switzerland.
vsao-asmac is the professional association and trade union of medical residents and senior hospital physicians (Oberärzte, Chefs de clinique) in Switzerland, which protects their labor, legal, and professional rights.
SGPP/SSPP (Swiss Society of Psychiatry and Psychotherapy) is the national professional medical society representing psychiatrists and psychotherapists in Switzerland. It is responsible for defining professional standards, contributing to postgraduate and continuing medical education, and representing the specialty at a national level.
And finally, our association SVPA-ASMAP-ASAP represents psychiatry trainees towards the above mentioned institutions and offers guidance about the psychiatry training to our members from all over Switzerland.
Now that the basic terms and institutions have been explained, it is time to take a deep dive into the entire situation.
How Did It All Begin?
2024 – The Year the Problem Escalated
Already in 2024, waiting times for the issuance of FMH specialist titles — even when complete documentation had been submitted to SIWF/ISFM — frequently exceeded six months, and in many cases stretched to an entire year. The SIWF/ISFM attributed those delays to the growing complexity of training programs as well as the part-time and foreign training periods, but it seems governance and organisational problems such as the lack of workforce led to the accumulation of delays.
In psychiatry, the situation was further complicated by unclear instructions regarding the entry of rotations into the e-Logbook, where even SIWF/ISFM itself could not provide the correct procedure, which consequently led to additional delays in the processing of applications.
The First Attempts to Solve the Problem
January – April 2025
During 2025, it became clear that the issue was no longer isolated or sporadic. In January 2025, vsao-asmac sent its first letter to SIWF/ISFM demanding immediate action calling for clearer and more transparent communication with physicians requesting implementation of previously announced measures with clear progress reporting. As no response followed, a second and more assertive letter was sent on April 16 emphasising the need for additional staff to process applications stating that the issue must be formally presented to the FMH Delegates’ Assembly calling for involvement of the FMH Medical Chamber. No answer was provided by the SIWF/ISFM.
Turning Points Within FMH
30 April and 5 June 2025
At the Delegates’ Assembly on April 30, vsao-asmac presented the seriousness of the consequences for physicians, requesting greater transparency from SIWF/ISFM, a structured progress report, and the presentation of proposed solutions at the next Assembly. The FMH delegates approved vsao-asmac’s motion. On June 5, the FMH Medical Chamber expressed strong support for shortening processing times and improving communication.
A Summer of Silence
June – August 2025
SIWF/ISFM provided no public information during this period.
Distrust and frustration grew steadily, as doctors awaiting their FMH title faced increasing impact on finances, working conditions and career stagnancy. Hospitals also started to protest, as they were unable to recruit the needed successors for “Kader/cadre” positions.
Unsatisfied with the answers from the associations, a group of residents formed an independent association to organise legal actions against the SIWF/ISFM: Relève Médicale Suisse.
During the SIWF/ISFM committee meeting in August, vsao-asmac stressed the need to expand staffing resources and to involve disciplinary societies in resolving systemic difficulties.
SIWF/ISFM Finally Responds — with Concerning News
3 October 2025
The president of ISFM/SWIF resigned in September, arguing that the needed reforms in the training system could not be addressed in the current structures…Dre Nathalie Koch was appointed as director Ad interim of the institution.
Quickly thereafter, the SIWF/ISFM announced that the current waiting time for specialist titles had reached twelve months. Although shocking, this declaration displayed a stride towards more transparency, as SIWF/ISFM acknowledged their delays, with over 2500 persons awaiting their title at the time.
On the same day, vsao-asmac issued an open letter to SIWF/ISFM and FMH requesting clear and regular communication, financial compensation for colleagues affected by income loss due to delays and complete cancellation of fees for all applicants waiting longer than 90 days.
At Last, Progress: FMH Support and Concrete Decisions
6 November and 20 November 2025
On 6 November, the FMH Medical Chamber announced several crucial decisions. The FMH formally expressed its support for SIWF/ISFM in resolving the crisis, committed to joint cooperation, and recommended a 50% reduction in fees for affected physicians. The institutions also issued a public apology for the situation and finally took responsibility for the delays.
On 20 November, SIWF/ISFM implemented this recommendation and introduced a 50% fee reduction with retroactive effect for all those having requested their title between 01.01.2025 and the end of 2026 and facing a delay over 6 months. An external audit has also been promised.
The Role of SVPA-ASMAP-ASAP and a Call for Accountability
One of our core missions is to provide guidance to psychiatry trainees during their postgraduate training. Through our online infographic and detailed explanations as well as regular logbook workshops, we continuously help trainees to avoid further delays during the process of their title issuance by ensuring that the complex psychiatry logbook is filled correctly. We are also in regular contact with the IT experts of the SIWF/ISFM and the psychiatry Title commission to identify common mistakes in the logbook and resolve them.
Our organisation has been actively involved throughout this entire crisis. As early as spring 2025, we contacted SIWF/ISFM and its director Jörg Göbli, raised concerns regarding inconsistencies in the psychiatric training programme, and regularly informed our members through newsletters. We were also in regular contact with the SGPP/SSPP and the vsao-asmac to exchange information about the state of the delays and possible action points.
As the SIWF/ISFM did not unveil their struggles (even publishing a very positive yearly report despite their unacceptable delays), residents were isolated with this issue. They awaited their title for up to a year, receiving no information or, in some cases, passively-aggressive responses. As shown in the chronological overview of the situation, it took many months until the medical community realised the urgency of the situation. The lack of rapid response gave the idea that the struggles of the residents, having already invested 5-8 years into their training and trying to build sustainable careers, were of secondary importance. With our labour union also unable to provide concrete support, this contributed to a growing dissatisfaction, as trainees had no-one to turn to for support during this difficult time in their careers.
We acknowledge that SIWF/ISFM is part of a complex system but the lack of accountability displayed by the relevant institutions throughout this crisis, SIWF/ISFM as well as FMH and vsao-asmac, raises serious doubts about the trust that can be given to the structures that decide upon the future of our careers.
Accountability of the various levels of a system that is struggling to execute its mission is essential. Without this, words might not lead to significant actions and positive developments will not be sustainable, as we have seen during most of 2025. Previously made arguments about the prolonged waiting times being caused by the increasing complexity of the very training programmes the institution has itself approved should not be raised, as they undermine trust and are likely to increase the experience of helplessness within medical staff. Overall, blaming medical trainees for systemic issues is not acceptable, and shows a resistance to growth and accountability that is concerning.
At the moment, while efforts are being stated, there is no clarity to our knowledge about the objectives and their time sensitivity. After the confusion and lack of communication witnessed in the last year, we believe that our medical trainees deserve to know which changes will happen, when, and how. While the complexity of medical training is – to say the least – not expected to decrease in the future, regular audits and close oversight by independent entities, along with adequate transparency about their outcomes to the public, seem not only warranted, but essential.
The last year has made it painfully clear that foresight is a key element of change, and while the past cannot be unmade, we hope that institutions will learn from it when considering future developments of medical training requirements. Transparent communication of SIWF/ISFM about their processing time, with regular (i.e. monthly) updates and more visibility during the issuance process (for example on the logbook website and in the confirmation mail sent after submission) would be essential to rebuild trust in our institutions.
As the training validation delays have led to substantial financial costs to trainees, to the benefit of their employers, we ask for more wide-spread accountability of hospitals throughout Switzerland. We therefore encourage fair, wide-spread and transparent compensation processes by clinics.
Furthermore, the forthcoming and anticipated results of the external audit—which has been promised to be published openly—are eagerly awaited and will be closely monitored by us as well.
SVPA-ASMAP-ASAP will continue to closely monitor the situation and provide updates on all new decisions and developments within SIWF/ISFM. We invite colleagues to share their experiences regarding the implementation of the measures in practice, both regarding SIWF/ISFM and support (i.e. compensations) by their employers. This can of course also be done anonymously. We would also like to take this opportunity to ask colleagues who have successfully obtained fee refunds to contact us and share their experiences (the process itself, how long it took, and any documentation that may have been required).
Even though the SVPA-ASMAP-ASAP cannot directly resolve issues, our platform remains a place to share impressions, which helps us maintain an overview of the situation specific to psychiatric trainees and to advocate on their behalf. Our organisation will, as it has done so far, remain committed to the principles of transparent and clear dissemination of information, so that our colleagues can be informed about all responsibilities and requirements on the path to obtaining the specialist title, as well as the rights and resources that are available to us.
What can you do ?
Prepare your record for the title issuance
- Read the training program carefully to ensure you are taking all the needed criteria into consideration while planning your rotations – you can attend our Logbook workshop at the next pre-congress or invite us to your clinic to learn our tips and tricks about the Logbook.
- You can contact us for any question and consult our comprehensive overview of the training program
- Fill your logbook and validate every training period with a certificate regularly (at least once a year)
- Before asking your title, make sure you complied with all the needed criterias!
Bridge the gap
- Financial compensation by employers: To our knowledge, negotiations between some local vsao-asmac branches and hospitals have led to compensations provided by the hospitals themselves for their employees. Trainees can contact their vsao-asmac section or – if feeling comfortable to do so – their employer to discuss how they can be compensated.
- You can request a “priority processing” at the ISFM-SIWF if you need to obtain your title quickly to enter a position or honor an already signed contract.
- If you have submitted your files to obtain your title between the 01.01.2025 and the end of 2026 and suffered a delay of >6 months, you can apply for a 50% reduction of the fees to the SIWF/ISFM.
Fight the fight
- You can inform us of any unresolved issue/problem or unanswered questions, that may help the next trainee in your position and help us advocate for adequate solutions to this crisis.
- Both speciality organisations like our own and the cantonal vsao-asmac sections are still actively fighting to have the crisis resolved. You can support them by becoming a member or joining their committees.
- The association Relève Médicale Suisse (ARMS) (ARMS SMN | LinkedIn) has organised independently of the vsao-asmac to support trainees waiting for their title. This group of around 150 young physicians accuses the ISFM of “unjustified delays” that endanger both the medical workforce and patients’ access to care. The ARMS have taken legal steps: formal warning letters have been sent to the ISFM and a complaint filed with the Federal Department of Home Affairs (FDHA), calling on the authorities to restore a “just, efficient and transparent” system and have filed an appeal with the Federal Administrative Court to have the existence of “unjustified delays” recognized and to obtain the establishment of binding deadlines.
SOURCES:
https://www.siwf.ch/fr/isfm-en-bref/information-bearbeitungsstand.cfm
https://siwf.ch/files/pdf32/20251120_news_gebuehrenreduktion_siwf_v2_fr.pdf
https://www.fmh.ch/files/pdf32/251106_cp-isfm-chambre-medicale_def-v1.pdf
https://vsao.ch/fr/formation-medicale-continue/situation-actuelle-a-lisfm-ce-que-fait-lasmac/
https://vsao.ch/wp-content/uploads/2025/10/20251003_brief_fr_final.pdf
https://svpa-asmap.ch/fr/information-on-the-current-isfm-siwf-delays/
https://www.tdg.ch/medecins-suisses-bloques-par-un-titre-qui-narrive-pas-657941611695
https://www.medinside.ch/fr/lisfm-sous-pression-la-releve-medicale-sorganise-20251016
