In China, Vietnam, and Laos have undergone major social, economic, and cultural changes. Traditional values are being questioned or are disappearing, and new social values and structures have not yet been established. Despite significant increases in the wealth of the population, particularly in the cities, there have been simultaneous increases in uncertainty and in stressful living situations for a large majority of the population. As a result of these social upheavals, psychological and psychosomatic disorders and problems are on the rise (World Health Organization (WHO). The World Health report 2001; Patel and Kleinman 2003; Lopez et al. 2006; Prince et al. 2007; Saxena et al. 2007).

In Southeast Asia, 11 % of disability-adjusted life years and 27 % of years lived with disabilities are the results of neuropsychiatric disease (Lopez et al. 2006). Depression is the largest contributor to this disease burden (World Health Report 2001). The majority of the patients, who suffer from common mental disorders (CMDs), such as depressive and anxiety disorders, seek help in primary care. The point prevalence of CMDs in South Asian primary care practices varies between 20 and 45 %. A review of eight epidemiological studies of CMDs in South Asia showed that their point prevalence in primary care was 26.3 % (95 % CI, 25.3–27.4 %). Less than one-third of clinically significant CMDs are recognized (Ustun and Von Korff 1995; Xiao et al. 1997; Patel 1999; Yu et al. 2004). The resulting chronicity causes severe burdens on the affected families and on the health system.

In contrast, East Asia , particularly China, has a health system that is based on high-tech Western medicine. But there are only about 20,000 registered psychiatrists in China. Moreover, most of them used to focus on psychosis diagnosis and treatment.

Basic care is lacking for common mental and psychosomatic disorders and problems, and this care is not adequately addressed by traditional medicine. In the current medical education systems in China and Vietnam, psychosomatic or psychological content is only marginally taught (Tao 1994; Schirmer and Ninh 2002; Montegut et al. 2004; Liu 2005; Schirmer et al. 2005). More psychiatric education is available; however, it is taught mostly, if not always, in a biological manner, and there is a strong emphasis on psychotropic drugs and custodial care. Psychiatric resources are also lacking, which often allows the treatment of only severe cases, such as psychosis. In Vietnam, there is one psychiatrist for every 300,000 inhabitants. Only half of the eight medical schools have first-degree specialty training programs in psychiatry. Psychologists administer psychological tests and sometimes perform consultations, primarily in schools and industry (Schirmer and Ninh 2002; Montegut et al. 2004; Schirmer et al. 2005). Furthermore, education about consultation-liaison psychiatry and psychosomatics in daily clinical practice is nonexistent (Zhao et al. 1998; Yu et al. 2004). The situation in Laos is even worse: For the entire country, there are only two trained psychiatrists in the capital, Vientiane .

It is apparent that the current medical education systems in China, Vietnam, and Laos need support in different ways to develop efficient educational institutions and care structures.

From 2005 to 2008, a European–Asian cooperative project funded by the European Union was coordinated by Freiburg University (Department of Psychosomatic Medicine and Psychotherapy). The objective of the project was to support the development of Psychosomatic Medicine in China (Tongji University), Vietnam (Universities of Ho Chi Minh City and Hue), and Laos (University of Vientiane). In this project, a basic psychosomatic care curriculum for postgraduate medical doctors was applied.

During the first year, a team of prospective teachers was recruited for each center. The didactic elements of the new curriculum were taught to the future teachers. This was a mutual process that involved the German team teaching the teachers and adapting, modifying, and redesigning the lessons within the context of the partners. Teaching the teachers served as an experimental curriculum while supporting the future independence of the partners from the assistance of the European experts. The experimental lessons followed the contents of the intended curriculum. Teaching the teachers, therefore, focused on three target areas:

At the end of this activity, the future teachers were able to manage the pilot curriculum with the assistance of their European partners during the second year.

During the third year, the Asian partners were encouraged to organize and implement the new curriculum on their own. The results of the evaluations and the partners’ accumulated competence helped to fit the curriculum elements to the needs of the partners. The European staff provided supervision but limited their participation in teaching the curriculum (except for roles as guest lecturers on special topics). Supervisors supported the teachers’ needs in managing the courses and becoming competent trainers of biopsychosocial skills.