Psychiatry and International Work

[surfguy84]

I'm nearly half way through M3 and need to start getting more serious about narrowing things down. At present, I'm stuck between EM and Psychiatry. Part of my indecision stems from my strong desire to perform international aid work. I've done more than my fair share of traveling before and during med school and it's definitely something I want to continue doing after finishing school/residency.

I've been following the Syrian conflict pretty closely over the last several years. Just this morning I was reading how so many people who have recently been freed from ISIS are going to be in serious need for psychological help given the atrocities they've witnessed. I think it'd be so amazing to go over there and work with this population. Of course, this is just one example, there are many areas around the world that have similar needs. But given language barriers, doing psychiatric aid work seems like it'd be almost impossible. Does anyone have any information about opportunities like this for psychiatrists?

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[NickNaylor]

One of our faculty members previously worked at the State Department for the overwhelming majority of his career and got to travel all over. He did a Grand Rounds talking about his experience which was quite interesting. So working at the State Department would be potential option. There are a lot of government employees abroad.

The CIA also hires psychiatrists, and though I believe most of the positions are state-side, they may have some international opportunities available, too.

I know next to nothing about working with, for example, service organizations and/or with local populations, but I’m going to assume that will require specialized skills in addition to issues with licensure that would likely be significant hurdles to jump in order to get that kind of situation set up.

 

[TexasPhysician]

Duke has an international option for PGY4 year.

 

[clausewitz2]

Duke has an international option for PGY4 year.

Notably it does delay graduation by several months, but that is because it is six-nine months long and not a meaningless 4 week elective/vacation.

 

[TexasPhysician]

Notably it does delay graduation by several months, but that is because it is six-nine months long and not a meaningless 4 week elective/vacation.

I would think that anyone interested in international work is fine with less income and efficiency. If not, volunteer work isn’t for you.

 

[nikeforlife]

I'm nearly half way through M3 and need to start getting more serious about narrowing things down. At present, I'm stuck between EM and Psychiatry. Part of my indecision stems from my strong desire to perform international aid work. I've done more than my fair share of traveling before and during med school and it's definitely something I want to continue doing after finishing school/residency.

I've been following the Syrian conflict pretty closely over the last several years. Just this morning I was reading how so many people who have recently been freed from ISIS are going to be in serious need for psychological help given the atrocities they've witnessed. I think it'd be so amazing to go over there and work with this population. Of course, this is just one example, there are many areas around the world that have similar needs. But given language barriers, doing psychiatric aid work seems like it'd be almost impossible. Does anyone have any information about opportunities like this for psychiatrists?

Check out UCSF's new global health psych fellowship

I'm nearly half way through M3 and need to start getting more serious about narrowing things down. At present, I'm stuck between EM and Psychiatry. Part of my indecision stems from my strong desire to perform international aid work. I've done more than my fair share of traveling before and during med school and it's definitely something I want to continue doing after finishing school/residency.

I've been following the Syrian conflict pretty closely over the last several years. Just this morning I was reading how so many people who have recently been freed from ISIS are going to be in serious need for psychological help given the atrocities they've witnessed. I think it'd be so amazing to go over there and work with this population. Of course, this is just one example, there are many areas around the world that have similar needs. But given language barriers, doing psychiatric aid work seems like it'd be almost impossible. Does anyone have any information about opportunities like this for psychiatrists?

Check out UCSF's new HEAL Initiative global health fellowship!

 

[clausewitz2]

I would think that anyone interested in international work is fine with less income and efficiency. If not, volunteer work isn’t for you.

Totally agreed. This opportunity was the main reason I even applied to Duke despite the other negatives of its reputation/call schedule.

 

[thefamousboat]

I highly doubt the CIA or State is going to substantively "help" improve the lives of anyone in other nations, much less their mental health. Sadly, though, that's where most of the $ probably will be.

 

[surfguy84]

One of our faculty members previously worked at the State Department for the overwhelming majority of his career and got to travel all over. He did a Grand Rounds talking about his experience which was quite interesting. So working at the State Department would be potential option. There are a lot of government employees abroad.

The CIA also hires psychiatrists, and though I believe most of the positions are state-side, they may have some international opportunities available, too.

I know next to nothing about working with, for example, service organizations and/or with local populations, but I’m going to assume that will require specialized skills in addition to issues with licensure that would likely be significant hurdles to jump in order to get that kind of situation set up.

I was thinking more along the lines of doctors without borders or something of that sort, rather than a career involving international work.

 

[clausewitz2]

I was thinking more along the lines of doctors without borders or something of that sort, rather than a career involving international work.

MSF does deploy psychiatrists, so you could just do that. You will be way more useful to them if you speak a world language other than English (French, Spanish, Russian) and it is a multi-year commitment, but if you want to do doctors without borders, you can do doctors without borders.

If you are looking to do short term voluntourism, don't bother, this is the wrong field.

 

[NickNaylor]

I highly doubt the CIA or State is going to substantively "help" improve the lives of anyone in other nations, much less their mental health. Sadly, though, that's where most of the $ probably will be.

Well, sure, but I dunno what the OP was looking for. If the idea was simply to get a "cultural" experience of living abroad, going one of those routes is probably the easiest as 1) you're treating an American population (thus no need for additional language skills) and 2) there are no additional requirements for licensure. If the OP is wanting to work with local populations with psychiatric issues, then I would agree with you.

 

[clausewitz2]

@surfguy84 if you are still monitoring this thread, Singapore is constantly recruiting foreign Anglophone docs, including psychiatrists. You can contact recruiters or reach out to the major hospitals there directly. Of note you have to be board-certified OR have graduated from one of a short list of "recognized" American medical schools.

More info here:
http://www.healthprofessionals.gov.... Registrable Basic Medical Qualifications.pdf

 

[luckrules]

I know some psychiatrists who do a lot of international work in New Zealand and rave about it. I think initially they did it via a locums company but eventually were hired directly by the government organization. I don't think they made much money or had much in the way of family ties dragging them back to the states. They eventually left because leadership changed and they felt like they were being asked to provide sub par clinical care. I think it sucked because they had just bought a house there but they are pretty much nomadic and have no children so it was no big deal.

My school had a presentation from a global mental health guy from Duke or Emory (can't remember where) who did a lot of work in Nepal. He had formerly done peace corps there so was pretty familiar with language/customs. I remember he said initially a lot of his work was PTSD like symptoms in people who had been internally displaced as a consequence of globalization, but more recently his work was like capacity building through education of local psychiatrists or other medical providers on how to treat primary psychiatric disorders like schizophrenia. I remember him saying that the biggest challenge was not finding work to do but finding funding and work that allowed him to spend some meaningful amount of time at home with his family in NC/GA. Once you start doing this stuff it seems like it would be harder to transition to regular domestic work later in your career if you want to chill out.

I also got roped in on this email chain for a working group in global mental health awhile ago and it was insane the amount of work people were doing. I eventually left because the email etiquete wasn't very good and there wasn't much I could contribute. But none of it was like "wow that's so exciting I'd love to go do that!"

I also remember a nytimes article recently about people with mental illness in Venezuela not having access to antipsychotics. They won't let me link here but you can google it pretty easy.

The WHO has recently prioritized non communicable diseases as a priority in the coming decade, which includes mental illness. They list depression as the leading cause of disability worldwide. I think they had the number at 300 millions, which I remember thinking offhand seemed kind of low.

I think it would be really interesting to study mental health globally more from an anthropological perspective. We know that these diseases have powerful social and cultural mediators, and furthermore have had religious significant attached to them historically. Maybe there are some lessons globally that we could take home?

I don't think we're ever going to have super sexy interventions like flying in, fixing a couple of dozen cleft lips or doing a bunch of ophthalmologist procedures (whatever the heck it is they do) and flying off with cool pictures and stories of gratitude. But I don't think you're going to get that one Emergency Medicine either. It might be possible to open a clinic in a resource limited setting for patients with severe mental illness and training some mid levels to provide care and coming once a year to do Med management. Hard to fund though, requires a ton of organization.

I don't think there are many global mental health rotations for Med students, but I do remember that Yale had one in Mexico. Might be worth reaching out to whoever organizes it to see if you could arrange an away.

If you are in these settings, I wonder how realistic it is to provide other basically medical services that people might not have access to that might not be standard of care in the US. Antibiotics, seizure prophylaxis (maybe more in line with our work historically), etc. Anyone have any insight on this?

For what it's worth, I hope you stick with it and figure something out to inspire us all!

 

[Shikima]

I highly doubt the CIA or State is going to substantively "help" improve the lives of anyone in other nations, much less their mental health. Sadly, though, that's where most of the $ probably will be.

Not really others, your mission is specific to those in the dept you're aligned with (state & spook). Pay great? Not so much - like the VA is kinda crappy for all that you need to do. It's on the GS or something similar pay scale. Look it up, public knowledge. Lots of unpaid call and increased duties apply too.