Drs Without Borders is seeking psychiatrists

[tr]

From MSF:

"We are URGENTLY recruiting a Psychiatrists for our projects in 70+ countries around the world. I am wondering if you could help share this opportunity with your professional networks and through your website, listserv, newsletter, social media, mailing list etc. in order to help us fill this urgent field need. This could be a great opportunity for anyone who has professional experience in mental health issues associated with HIV/AIDS, post-traumatic stress disorder (PTSD), sexual violence, trauma or tuberculosis (TB) and an interest in giving back to the global community.

I’ve attached a flyer and a graphic with some basic information about the job profile and requirements that you can share. Any applicants interested in applying should send their CV or resume to [email protected] with the subject line “Psychiatrists”. Please let me know if you have any questions. You can reach me by email with any inquiries about this fieldwork opportunity."

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[wolfvgang22]

As a board certified, fellowship trained psychiatrist with expertise in these very areas I find it ironic to see this, considering how uninterested MSF has been in the past when I've inquired. I guess times change. Perhaps COVID-19 has had an impact on recruitment?

 

[Sushirolls]

When I looked years ago, they had no interest in Psychiatry. Now that I have more knowledge of the world, I don't see the point.

Many foreign countries will have limited formularies of haldol, a TCA and maybe zoloft. The resources will be so constrained and ECT will likely be the biggest benefit for most people. The trauma and cultural issues at play will mostly need therapy - but the cultural limitations on how well a person can flourish will limit the therapy, and realistically a person will need a SW, but oh that resource doesn't really exist either. I see burn out, and frustration with limited resources and limited gains. A psychologist may be more suited considering resource limitations.

Ultimately if people want a limited resource practice experience, right around the corner is a local Community mental health center or FQHC.

 

[Stagg737]

but the cultural limitations on how well a person can flourish will limit the therapy, and realistically a person will need a SW, but oh that resource doesn't really exist either. I see burn out, and frustration with limited resources and limited gains. A psychologist may be more suited considering resource limitations.

This. I also think that the language and cultural barrier may preclude most psychiatrists from providing any truly meaningful care. I have had a fairly significant exposure to several Latin American cultures, and there are still times when I feel like I may be missing something or misunderstanding d/t cultural differences, especially if needing a translator. Before I landed on psych, I was very interested in international work. However, I feel like many fields, and especially psych more than any other, requires someone native to those countries or at the very least someone who has lived in these places for several years before rendering effective treatment.

 

[Psychresy]

This. I also think that the language and cultural barrier may preclude most psychiatrists from providing any truly meaningful care. I have had a fairly significant exposure to several Latin American cultures, and there are still times when I feel like I may be missing something or misunderstanding d/t cultural differences, especially if needing a translator. Before I landed on psych, I was very interested in international work. However, I feel like many fields, and especially psych more than any other, requires someone native to those countries or at the very least someone who has lived in these places for several years before rendering effective treatment.

What are your thoughts on potential impact of training local providers might have though? I always thought it would be amazing to be able to get into a war torn place and teach local therapists, psychologists how to do manualized trauma focused work, i.e. Cpt, etc.

I agree it would be near impossible for a psychiatrist to step in and do this without knowing the language and culture, but perhaps overseeing a program like this sort would be impactful.

 

[allantois]

I already find myself frustrated working with low SES patients here who have terrible insurance coverage, lack of housing/transportation, lack of access to good medical care/testing/etc. I can only imagine working at that agency

 

[Candidate2017]

Plot twist: MSF puts you on a bus, drops you off at your local CMHC or ED to work for free signing off on notes for midlevels doing 10-15 minute visits.

 

[Liquid8]

I also didn't think MSF ever had much interest in psychiatrists. I suspect that language and transcultural issues would be a limiting factor, but the more pressing problem is that psychiatrists on the whole don't earn enough and for cash only private practices taking 3 months off would be akin to abandoning their current patients. I suppose it might be attractive to early career psychiatrists.

 

[Stagg737]

What are your thoughts on potential impact of training local providers might have though? I always thought it would be amazing to be able to get into a war torn place and teach local therapists, psychologists how to do manualized trauma focused work, i.e. Cpt, etc.

I agree it would be near impossible for a psychiatrist to step in and do this without knowing the language and culture, but perhaps overseeing a program like this sort would be impactful.

I think that would probably be the most useful thing to do, and perhaps maybe the only effective way of helping. Plenty of studies regarding global medicine/aid have shown that the most effective ways of making an impact in these places is to either train people to do something that they previously couldn't (see Himalayan Cataract Project) or just by directly providing cash or raw materials to these locations and allowing local workers to be hired to make the improvements themselves.

This is probably the easiest to accomplish in areas with a high need of a certain procedure with few to no people who are able to perform it available. I could certainly see this working for some forms of therapy, but I could also see problems because the psychiatrist who is teaching other therapists doesn't understand local cultural or religious beliefs which could interfere with certain therapies.

 

[SmallBird]

Having worked in this kind of setting, emphatically, many of these responses are wrong-minded. You can make a dramatic impact, but its going to require applying your skills in a different way. You may get to train enthusiastic lay providers without burdensome regulations; you will get to see many many psychotic patients and start them on meds; you will get to treat the side-effects of badly chosen med regimens (anticholinergics are likely available in most settings); and given the reduced administrative requirements you will find you can see, diagnose, and start treatment for many more patients than you expect. I can't comment on how 'efficient' this is from a global health perspective but the idea that well-trained psychiatrists aren't useful in low-resource settings is just not true.

I once worked at a hospital in a low-resource country with probably 50 psych beds but no doctor. Just a nurse who was guessing which meds might work. It wasn't hard to make things better.

 

[Monocles]

I also didn't think MSF ever had much interest in psychiatrists. I suspect that language and transcultural issues would be a limiting factor, but the more pressing problem is that psychiatrists on the whole don't earn enough and for cash only private practices taking 3 months off would be akin to abandoning their current patients. I suppose it might be attractive to early career psychiatrists.

*Laughs in student debt*

 

[Liquid8]

*Laughs in student debt*

Sorry, forgot I went through a different system!

Here it only seems like ophthalmologists are the ones who can afford to take time off to do charitable work overseas as they're routinely charging in the thousands for 15 minute cataract operations.