Dr. Anikó Nagy began her studies at what was then the Medical University of Pécs in 1986 and graduated in 1992. She looks back on her university years with great affection, remembering the liberating sense of freedom, her insatiable thirst for knowledge, and the legendary teachers. She worked as a psychiatrist in the Hungarian healthcare system for fourteen years. At first, Sweden seemed like an adventure to her, but after being offered a position, she decided to seize the opportunity in 2006. She is now a senior consultant psychiatrist in Norrköping. Although she still experiences a strong sense of homesickness, she closely follows developments in Hungary and has also remained in touch with some of her former colleagues.
Written by Rita Schweier
- What memories do you have of your university years?
- The University was very hierarchical at the time, everything was much more regulated than it is today, from group assignments and lectures to examination schedules, yet we never experienced these as restrictions; we accepted them and adapted. Back then, we did not even think about it. Even so, university gave me far more freedom than I had experienced in secondary school, and it was a much less uncertain period of my life. For a few years I served as our group’s representative, which was a mainly administrative role and involved coordinating exam schedules. It was no easy task because everyone in the group took the exams on the same day, and any request to take an exam separately had to be thoroughly justified.
I loved being a university student, I genuinely enjoyed studying and looked forward to attending lectures. Some people may even have considered me a swot, but that never bothered me because I felt I was exactly where I belonged. I was fascinated by the knowledge, the new information, and the teachers who had already become legendary figures at the University. One of my most memorable experiences was attending a lecture by Professor György Romhányi, who was no longer actively teaching at the time, but he occasionally returned to give lectures. I still remember the large lecture hall packed with students, active and retired teachers, and even visitors from outside the university. It felt as though every seat was occupied by at least two people. The moment Professor Romhányi began to speak, an extraordinary sense of respect and admiration filled the entire room.
It was a transitional era, somewhere between the old, the classical, and the new, modern model of university education and atmosphere. The legends and the old system were still very much alive, yet new ideas, technologies, and professional networks were beginning to emerge alongside the political changes taking place throughout the country. We still had to take comprehensive examinations in political economy and Russian language, yet at the same time, we could already read English-language books about MRI.
It was one of the freest and happiest periods of my life, but also one of the most anxiety-provoking. The reason was a personal struggle, since I suffered from social anxiety, which I managed to conceal and compensate for on the outside, but which nevertheless caused me considerable difficulties. Because of this, I never succeeded in building enough close, lasting relationships with either my classmates or my teachers, even though I completed my examinations with excellent results and without any real difficulties. Unfortunately, I am still in touch with only a handful of my former classmates, and I no longer have contact with any of my former teachers.
This highly structured system, which nevertheless allowed considerable freedom, gave me my first real opportunity to learn to use my abilities, and I am very grateful for that.
- When did you realise that psychiatry was the field closest to your heart?
- From as early as kindergarten, I wanted to become a paediatrician, and I remained convinced that this was my calling until my fourth year at medical school. Then neuroscience entered the curriculum, and my interest gradually but steadily shifted in that direction. For a long time, I could not decide between neurology and psychiatry, until I began working at the neurology department in Ajka. As there was no psychiatric ward at the hospital, all emergency psychiatric patients were admitted to our department, and my conversations with those patients ultimately led me towards this field. Naturally, my own personal struggles also played an important role in my motivation, but I did not see them as an obstacle; I rather experienced them as a driving force. I have never regretted my choice, although I sometimes wonder whether psychology might have suited me even better.
- Where and how long did you work in Hungary before moving abroad?
- After spending fourteen months at the neurology department, I joined the Department of Psychiatry in Szekszárd in January 1994, where I worked until obtaining my specialist qualification in 1997. Those four years were the most difficult period of both my professional and personal life. For the first time, I truly had to find my own way in a department that was not functioning particularly well and offered few opportunities for professional development. At the same time, I was fortunate to be surrounded by exceptionally kind and supportive people. My colleagues and the entire ward staff did everything they could for both the patients and one another, creating a positive atmosphere despite the many difficulties. To this day, I remain deeply grateful for the encouragement and support I received there. I am still in touch with a few of my former colleagues.
My professional ambitions eventually made me move on. After completing my specialist training, I was offered a position at the then Medical University of Pécs Department of Psychiatry, where I learned a lot and gained access to knowledge and professional networks that had previously been beyond my reach. I spent four years there, then I worked at the Psychiatry and Mental Health Outpatient Clinic. Those four years became the most rewarding period of my professional career in Hungary. One of the reasons for this is that I once again found myself working in an outstanding team, and the other is that I began my training as a psychotherapist. The programme was led by Dr. András Stark, one of the iconic figures of psychiatry in Pécs. It is still difficult for me to speak about him in the past tense, and I truly believe he is impossible to surpass. I should also mention Professor Károly Ozsváth, Dr. Mária Koltai, and my wonderful mentor and personal therapy trainer, Dr. Mária Horti. They were the people who inspired me and shaped my way of thinking, providing knowledge that continues to form the foundation of my professional identity as a psychiatrist. Once again, I was fortunate to join an excellent team. The colleagues who trained alongside me were remarkable people, and I still keep in touch with one of them. Those four years were both productive and intensive, since during that time, I also worked on call at the psychiatric ward in Szigetvár, while opening a private practice in Mohács, which operated successfully for two years, until my move to Sweden, which I am very proud of.
- How did you end up in Sweden?
- First of all, I should say that I never believed it would be possible to do this job at a high professional level in another language and within a different cultural context. In the spring of 2005, I received an invitation from the Hungarian Medical Chamber to attend an interview organised by the Department of Psychiatry in Jönköping. To be honest, I was quite surprised that the Hungarian Medical Chamber was outsourcing physicians abroad, so I simply threw the invitation away. My sibling, who was living abroad at the time, persuaded me to attend the interview—if for no other reason than curiosity’s sake. So I went, but as far as I was concerned, that was the end of the matter. A few days later, I received a phone call informing me that, together with ten other colleagues, I had been selected to take part in a three-day visit to Jönköping, during which we toured the department and met the staff. Their plan was to offer permanent positions to five of us afterwards. Before leaving Hungary, I regarded it simply as an opportunity for a free trip to Sweden and a chance to see how the healthcare system worked there, but I did not take it particularly seriously. After those three days, however, my perspective changed completely and I found myself thinking that, if I were among those selected, perhaps it would be worth giving it a try. In early September 2005, I received the news that I had indeed been offered a position. As the language course was due to begin in early October, I had to wind up my life in Hungary in a matter of weeks. Looking back, I think that was actually a good thing because it left me no time to become frightened or overthink my decision. From October 2005 until January 2006, we attended an intensive Swedish language course at a boarding school near Budapest. Then, on 15 February 2006, we officially began our new life in Sweden. The entire recruitment process—from the language course and the recognition of our medical degree and specialist qualification to opening a bank account and registering with the immigration authorities—was remarkably systematic, well-organised and thorough, they even booked us appartements. During our first year in Sweden, we continued studying the language while working in junior medical positions. After passing the C1 language examination in the autumn of 2006, I received my permanent employment contract. When I was asked which department I would most like to work in, I chose psychiatry once again. I started at the outpatient psychiatric clinic in Huskvarna in January 2007. Once again, I found myself in an excellent team and being surrounded by kind, supportive colleagues during the adjustment period meant a great deal to me. I made many friends there who helped me learn how the Swedish healthcare system worked.
I lived and worked in Jönköping for ten years. Then, following changes in my personal life, I moved to Norrköping in 2016. Leaving the clinic in Jönköping was difficult because I had truly enjoyed working there. In Norrköping, I initially joined a private outpatient psychiatric practice, and since 2021 I have been employed by the regional healthcare authority. I continue to work as a senior consultant physician in community mental health care. Once again, life was kind to me because I was welcomed by another outstanding team here as well.
- How do the working conditions, patient population and the delivery of care differ from the Hungarian system?
- We work in close cooperation with a wide range of social and healthcare services. It is a complex network that allows us to consider our patients’ needs from a much broader perspective. One of the defining features of the Swedish system is the almost complete absence of hierarchy: a nursing assistant without formal qualifications is regarded just as much a full member of the team as the senior consultant physician. Decision-making and responsibility are shared, the downside of which is that decisions sometimes take longer to reach, but the advantage is that perspectives emerge which might never be considered within a traditional hierarchical system. Because psychiatry in Sweden operates within a much broader multidisciplinary framework, this kind of information and opinion sharing is essential. Personally, I feel much more comfortable working in this system than I ever did in a conventional hierarchy.
The major disadvantage is the administrative burden because the system is highly bureaucratic and requires extensive documentation, which can sometimes overshadow the professional work. This is a challenge throughout Swedish society as a whole. For me the greatest drawback is that it takes a lot of time away from my patients.
Unfortunately, we also see an extraordinarily high number of patients struggling with addiction, as well as many neuropsychiatric conditions. I must admit that this came as quite a shock when I started working in Sweden. It required a complete shift in my professional mindset and a tremendous amount of learning.
- Do you have any professional collaboration with your psychiatrist colleagues in Hungary?
- Since leaving Jönköping, I have very few contacts, partly because of changes in my personal life. The relationships that have remained are rather friendly than professional. I still meet these colleagues whenever I return to Hungary, usually two or three times a year.
- I assume you have never regretted taking your chance abroad.
- No, I have not—and it has now been twenty-one years. Moving to Sweden has brought positive changes to every aspect of my life: professionally, personally and financially as well. My homesickness has never disappeared, and in fact, it grows stronger every year, but I would make the same choices again. I intend to remain in Sweden until I retire. After that, I would like to spend at least part of my time living in Hungary again.
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Dr Anikó Nagy