US Foreign Service - Regional Medical Officer

[MidwestMD2015]

I have read quite a bit about the Psychiatry Regional Medical Officers that are in the Foreign Service.

Though I am only a fourth year medical student applying to psychiatry residency currently, this has always been something on my radar as a potential career option. For reference: Medical Officer Listing - Psychiatry So, a few questions:

1) Do you know anyone who has taken this career path? Any anecdotes about whether they liked it?
2) Are there other opportunities like this for psychiatrists? Doctors Without Borders, the UN, and the Red Cross are places to look I know--any others?
3) Are there residency programs that are known to focus on training the sort of psychiatrist that would take advantage of these opportunities?

Thanks! Any information is helpful!

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[notdeadyet]

1) I have a colleague that did this and enjoyed it. If I remember correctly, he typically did a series of two year tours punctuated by two year tours in the DC area. If you make it a career, you will spend some years in DC.

2) There are a lot of headhunter companies and organizations (easily googled) that offer up contracts in all sorts of places. I know of a few folks who went the New Zealand route, and a couple who went to Scandinavia. You take a bit of a pay cut compared to what you can make otherwise, but for the most part they seem to work less. In terms of working with NGOs and relief agencies, you are going to have a hard time finding paid employment. MSF/Doctors Without Borders takes psychiatrists for gigs, but you essentially volunteer.

3) People always ask about this. If you're really interested in practicing medicine abroad, go to a program that will give you the best clinical training you can. You might consider programs that have have a significant portion of their training at typically cash-strapped county hospitals so that you learn to do more with less. You might also consider programs that emphasize medical education; as much fun as you might picture it being getting muddy and practicing psychiatry in developing countries, if you really want to make meaningful contributions to the locals, you will work in a train-the-trainer capacity so that your work is sustainable. Programs with a "global health" track/emphasis/fellowship is nice (and might particularly be helpful if you want to be a policy wonk), but it wouldn't be a value-add worth sacrificing any improved clinical training you might get elsewhere.

Incidentally, unless things have changed, the Foreign Service used to require 5 years experience. The CIA hires fresh out of residency though, or at least they used to. You can find their recruiters at the national APA meeting.

 

[TexasPhysician]

When I interviewed at Duke, they had an option to do a year in another country.

 

[MidwestMD2015]

You might also consider programs that emphasize medical education; as much fun as you might picture it being getting muddy and practicing psychiatry in developing countries, if you really want to make meaningful contributions to the locals, you will work in a train-the-trainer capacity so that your work is sustainable. Programs with a "global health" track/emphasis/fellowship is nice (and might particularly be helpful if you want to be a policy wonk), but it wouldn't be a value-add worth sacrificing any improved clinical training you might get elsewhere.

Incidentally, unless things have changed, the Foreign Service used to require 5 years experience.

Very helpful response! I've pulled out a couple things that you said that I think we're especially useful.

I have definitely been looking at programs that focus on medical education and leadership in addition to the clinical training for precisely the reasons you mention, but I hadn't thought about it quite the way you framed it so thanks! I'm not into 'voluntourism' or whatever they're calling it these days (I've done that in a different professional capacity, and it was not fulfilling), so the 'train the trainer' sort of work is what I'm looking for. I also like the feedback that good clinical training = potential for more effective work on a global scale. Lastly, I come by my 'policy wonk'ishness naturally and don't really need a 'track/emphasis/fellowship' as much a I think I just need to look for the best clinical training possible.

Yes, the Foreign Service still requires the 5 years of work post-residency, but I'm not in any hurry! It's nice to hear that the person you knew who went into it enjoyed it. I'm excited, seems like some potentially interesting options out there.

 

[Aiki]

I have read quite a bit about the Psychiatry Regional Medical Officers that are in the Foreign Service.

Though I am only a fourth year medical student applying to psychiatry residency currently, this has always been something on my radar as a potential career option. For reference: Medical Officer Listing - Psychiatry So, a few questions:

1) Do you know anyone who has taken this career path? Any anecdotes about whether they liked it?
2) Are there other opportunities like this for psychiatrists? Doctors Without Borders, the UN, and the Red Cross are places to look I know--any others?
3) Are there residency programs that are known to focus on training the sort of psychiatrist that would take advantage of these opportunities?

Thanks! Any information is helpful!

I am a RMOP and have been in this position for 14 years, with numerous overseas appointments as well as a Wash DC leadership tour. My answers to your questions are noted below:

1. This is a great and exciting career, but it's not for everybody. The work is challenging and varied. It requires extensive (50-60% or more) regional travel, so this career path is very hard on one's family. Tour lengths are 2-3 years, and the first 2 assignments are directed, most often to hardship posts in the Middle East, Africa, Russia, China, India, or Latin America. Travel to war-zones (e.g. Afghanistan, Iraq), other unaccompanied posts, conflict zones, and disaster/crisis areas (e.g. Haiti, Ebola-impacted countries, Nepal) is common. There are approx. 20+ regional psychiatrists based overseas; the program is managed in Washington DC; most regional psychiatrists make this into a career. The clinical work involves practicing psychiatry in integrated clinical settings with nurses, mid-level independent practitioners (e.g. NPs, PAs), local physicians, and regional medical officers (mostly Family MDs); telemedicine is used a lot. The diplomatic workforce and its dependents - often made up of 40+ overseas federal agencies - is fairly healthy, but the clinical work involves a large amount of child/adolescent psychiatry, as well as advising children/families with special educational needs. Basic medical skills (including BLS, ACLS, ATLS, TCCC) are an asset, as are broad-based , solid psychiatric skills. A large part of the job involves disaster/crisis response and consultation to senior leadership, so the ability to interact diplomatically with other colleagues, patients, and locals is very important. Good writing and public-speaking skills are also important, as well as flexibility and a high tolerance of ambiguity, and the ability to make practical decisions independently with often-limited information. Because we exist solely to support the US diplomatic mission overseas, a strong interest in foreign affairs and in foreign cultures is also important. While the positions are not language-designated, Spanish is useful for the positions in Mexico and Bogota, and French is useful for several of the positions in Africa.

2. Similar positions in other international agencies are less common, and hard to come by. Occasionally, ICRC, DWB, and other such organizations will have an opening.

3. Clinically-strong residency programs prepare one well for such work. Several regional psychiatrists are boarded in child/adolescent psychiatry, and others are boarded in other sub-specialties such as geriatric, addiction, psychosomatic, or forensic psychiatry. Back issues of Psychiatric News have had articles about regional psychiatrists. Also, there is generally a recruitibg booth at the APA meeting.

 

[clausewitz2]

When I interviewed at Duke, they had an option to do a year in another country.

They still do this, although it is actually substituting a year in a foreign country for the last eight months of fourth year, so you are still graduating just a bit behind schedule. Still, this was almost sufficiently compelling to make me attend my invited interview there. Almost.

 

[Psychotic]

There are approx. 20+ regional psychiatrists based overseas; the program is managed in Washington DC; most regional psychiatrists make this into a career.

For the return stints in DC, is there cost of living pay adjustment for the high cost of housing? For the posts abroad, is there a housing allowance, or housing provided? It seems like this career would work best for a singleton; do many people who do this have families, children?

 

[Shikima]

I was wondering if there are extra allowances to pay due to the high debts people have coming out of training?

 

[DD214_DOC]

Anyone know more about the CIA gig?