Global Mental Health as a Component of Psychiatric Residency Training

Abstract

This study seeks to assess the educational value of an international psychiatry elective using a cross section of psychiatric residents. In 2010, a 10-item semi-structured questionnaire was administered to Mount Sinai psychiatric residents who have participated in the Global Health Residency Track of the Mount Sinai School of Medicine. Authors reviewed the qualitative data and arrived at a consensus regarding trends and deviations regarding residents' experiences of their international field work. Six residents participated in this study. Common themes included exposure to sicker, treatment-naïve patients in resource scarce conditions, enhancement of cross-cultural communications skills, renewed appreciation for psychiatry, empowerment as teachers, and greater awareness of health-care systems. Knowing that an international elective existed would be a significant factor in their choice of residency. Respondents had concerns for the sustainability. Participants felt that the elective was a place to consolidate skills already learned during residency and resulted in increased professional confidence although it did not necessarily alter career paths. International electives can enrich psychiatric residency training in terms of understanding of mental health care systems, cross cultural psychiatry, sharpening diagnostic skills, building professional confidence and communication skills, and reaffirming motivation to practice psychiatry.

Global Health Training in US Graduate Psychiatric Education

“…These included, for example, the Mayo International Health Program (30), the Mount Sinai Global Health Residency Track (31), and the University of California at San Francisco Global Health Clinical Scholars Program (32). For many programs, funding was also offered through a centralized institutional body (such as a center for global health) and made available to residents from across different clinical specialties.…”

An Ethical Framework for Global Psychiatry

“…Despite increasing ethical recommendations for research and health care delivery in low-income and international settings, no ethical framework for global psychiatry currently exists. 18,19 Without sophisticated guidance on how to identify and grapple with these issues, global psychiatrists run the risk of causing more harm than good, and potentially jeopardizing future service work in this emerging field. 2 The ethical framework we envision fits in the wider context of a robust curriculum in the ethics of global health outreach.…”

“…6 Still in its early years, global psychiatry is uniquely positioned in the field of medicine as being exposed to distinct, and often intensified, ethical predicaments. 7 Because the field is still young, there is a great opportunity to fill an unmet need for an ethical framework for global psychiatry. In this review, we examine what sets psychiatry apart from other disciplines when it comes to ethical considerations while practicing abroad, and as a result of our findings we propose an ethical framework to assist the practicing global psychiatrist and students of psychiatry to recognize and resolve ethical dilemmas as they arise prior to, during, and after working in the field of global mental health.…”

Expanding the Pipeline: The New York University School of Medicine–University of Ghana School of Medicine and Dentistry Psychiatric Education Initiative

“…As global mental health as a clinical and scholarly endeavor has become more prominent, interest has also surged among psychiatry residency training programs [5, 8, 9]. A number of adult residency programs offer international experiences in the provision of clinical care, teaching, and research [8, 10–12].…”

“…A number of adult residency programs offer international experiences in the provision of clinical care, teaching, and research [8, 10–12]. In response to the growing popularity of global health opportunities, a discussion about the ethics of sending residents for short-term clinical rotations and research particularly in differently resourced settings has raised concerns about continuity of care, the need for quality supervision, and institutional reciprocity [10, 13, 14].…”