Faculty Bibliography

As many low- and middle-income countries (LAMICs), Ghana is affected by a severe shortage of mental health specialists: there are 11 practicing psychiatrists for a population of 25 million. The pipeline for Ghanaian psychiatrists remains restricted for the foreseeable future given the low expressed interest in the field by junior medical trainees. The few senior psychiatric specialists are overextended with clinical and professional duties leaving them with minimal time to teach and mentor trainees. This limits opportunities for mentorship, modeling, teaching, and curricular development, leaving trainees with little exposure to psychiatric practice, and therefore, little motivation to enter a highly stigmatized and underresourced field. To support the training of Ghanaian medical students in psychiatry, the New York University School of Medicine-University of Ghana School of Medicine and Dentistry (NYUSOM-UGSMD) Psychiatric Education Initiative, and the NYU Global Mental Health Elective were formed (1) to provide educational support to medical students and residents at UGSMD and (2) to provide a sustainable international experience for NYUSOM residents with a strong interest in leadership in global mental health and underserved populations.

Access to technology in practice helps physicians manage information, communicate, and research topics; however, those in training receive almost no formal preparation for integrating web-based technologies into practice. One reason for this is that many faculty-aside from junior faculty or those in recent generations-did not grow up using Internet communication, may use it minimally, if at all, in their own practices, and may know little about its forms and varieties. This report presents a case to illustrate how these disparities may play out in the supervisory situation and makes suggestions about helping supervisors integrate technology-awareness into their teaching.

Background Burnout is a state of mental and physical exhaustion related to work or care-giving activities. Distress during medical school can lead to burnout, with significant consequences, particularly if burnout continues into residency and beyond. The authors reviewed literature pertaining to medical student burnout, its prevalence, and its relationship to personal, environmental, demographic and psychiatric factors. We ultimately offer some suggestions to address and potentially ameliorate the current dilemma posed by burnout during medical education. Methods A literature review was conducted using a PubMed/Medline, and PsycInfo search from 1974 to 2011 using the keywords: 'burnout', 'stress', 'well-being', 'self-care', 'psychiatry' and 'medical students'. Three authors agreed independently on the studies to be included in this review. Results The literature reveals that burnout is prevalent during medical school, with major US multi-institutional studies estimating that at least half of all medical students may be affected by burnout during their medical education. Studies show that burnout may persist beyond medical school, and is, at times, associated with psychiatric disorders and suicidal ideation. A variety of personal and professional characteristics correlate well with burnout. Potential interventions include school-based and individual-based activities to increase overall student well-being. Discussion Burnout is a prominent force challenging medical students' well-being, with concerning implications for the continuation of burnout into residency and beyond. To address this highly prevalent condition, educators must first develop greater awareness and understanding of burnout, as well as of the factors that lead to its development. Interventions focusing on generating wellness during medical training are highly recommended.

BACKGROUND: The declining numbers of clinician-researchers in psychiatry and other medical specialties has been a subject of growing concern. Residency training has been cited as an important factor in recruiting new researchers, but there are essentially no data to support this assertion. This study aimed to explore which factors have influenced motivation to conduct research among senior psychiatry residents. METHODS: The authors surveyed senior residents, inquiring about their level of interest in research, demographics, background, research experiences, and factors influencing motivation for research. The authors had confirmed participation from 16 of 33 residency programs with a class size of 10 or more. They received 127 responses, a 67% response rate, from participating programs. RESULTS: Residents with high stated interest in research differed from those with low and moderate interest in their research-intense post-residency plans. They were more likely to have graduate degrees. Those planning research careers had a consistent pattern of interest and involvement in research, starting well before residency. The majority of residents had had research exposure in college, but research involvement of those with very high versus lower interest diverged sharply thereafter. Those with high research interest were overwhelmingly male and tended to have lower debt than those with less interest. CONCLUSION: The great majority of residents appear to have decided whether or not to pursue a research career by the time they reached residency, and few of those with less than the highest research interest were enrolled in research tracks. Efforts to increase recruitment into research should center on identifying early developmental influences, eliminating barriers specific to women, and ensuring adequate funding to provide secure careers for talented potential researchers.

OBJECTIVE: The authors surveyed Psychiatry Residency Training Directors' (RTDs') attitudes about the role and feasibility of international rotations during residency training. METHOD: A 21-question survey was electronically distributed that explored RTDs' beliefs about the value, use, and availability of international clinical and research experiences during residency. RESULTS: Of 171 RTDs, 59 (34.5%) completed the survey; 83% of respondents rated the importance of global mental health education as 3-or-above on a scale of 1 (least important) to 5 (most important), but only 42% indicated that such opportunities were made available. The value of such opportunities was thought to lie primarily in professional development and cultural exposure, less so for enhancing core knowledge competencies. Obstacles to such opportunities included lack of accreditation, financial resources, and faculty/administrative support and supervision. CONCLUSION: RTD respondents endorsed the value of international experiences during residency, but their availability and educational impact are not fully supported.