Statements of Excellence for Residency & Fellowship Positions on Behalf of Applicants in Psychiatry
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Residency Position in Psychiatry, Syrian

A Syrian doctor with experience practicing Psychiatry in Damascus, Syria, before immigrating to America, for the last 4 years I have been calling North Carolina home. Now a US citizen, I have been laboring since my arrival to prepare myself for re-entry into medicine here in the USA. Since Syria has been embroiled in a bitter civil war that began approximately one year before I left, I was happy to make a new home in America. By the time that I arrived in the USA, Damascus itself had become a huge battlefield.

I love the global nature of medicine, solidarity, interchange, and I hope to be selected for a residency position not only on the basis of having demonstrated my competency, but also my language skills, since I look forward to practicing Psychiatric Medicine, ultimately, in four languages, at least to some extent as the opportunity arises throughout my career: Arabic and Farsi as well as German, in addition to English.

I have long excelled at languages and began learning and speaking English while still a child. Arabic is my mother tongue and I also learned Farsi in school. I became a near-native speaker of Farsi as a result of attending medical school in Iran, the Shahid Beheshti University of Medical Sciences in Tehran. My school sponsored 12 educational hospitals which served very large and diverse communities, where I interned for 18 months.  I was elected head of the Foreign Students Association, entrusted to assist and represent students of more than 20 nationalities as well as a representative of the National Union of Syrian Students (N.U.S.S) in Iran.  I was also invited to work as Health News editor and interviewer at Arabic Kawther TV and News TV. Following my rotation in Ibn Roshd Hospital, I initiated the establishment of a research team committee. I picked up German beginning in high school and I can also communicate well in this language.

Before I left Damascus, Syria, I had been working long hours, fully immersed in a substance abuse ward for nearly a year. This experience will always be with me since it confirmed my desire to make Psychiatric Medicine and substance abuse issues central to my medical career, and my research as well as practice for many decades to come. I am grateful to America for giving me a new home and the opportunity to return to what I love most, practicing medicine. It brings me a great sense of fulfillment to be able to give something back by responding on the front lines of a massive substance abuse problem in the USA.

By background helps me to fit in with people from minority ethnicities in particular, and I hope to make my greatest contribution in this regard, with minorities, immigrants, the residents of America’s inner city with such diversity, requiring a great sense of respect for global cultural issues. As a resident in the substance abuse ward, I received an award from Syria’s Ministry of Health because of the exceptional care that I gave to my patients. I had the joy and the satisfaction to see many of my patients go back to their normal lives and jobs. I dealt as best I could on a daily basis with the stigma that is attached to those who face mental health challenges and I worked very hard to educate the patient and their families – as well as the larger community - by spreading awareness through many presentations, social media, and newspaper brochures. I started a group on fb (facebook mental health for all) which now has over 24 thousand members.

I have been in love with Psychiatry since my first rotation in this area while still in medical school.  I was intrigued with neuroscience, in particular, and the great change that a psychiatrist can make to patient’s life. Thus, I have felt strongly for a long time that I wanted to be a psychiatrist.  While I was a resident in Damascus, I came to more fully appreciate the great value of teamwork and how important it is to cultivate a team spirit. I arrived at a better understanding of the critical role played by nurses and social workers, in particular, working to make the most of their singular contribution to patient outcomes. I served as head of the education committee for residents and I conducted a presentation every week on such things as neurotransmitters, serotonin syndrome, Neuroleptic malignant syndrome, OCD, etc.; and I completed extensive research on agomelatine, in particular. I look forward to continuing to do research on anti-psychotics and schizophrenia – especially insofar as they are related to addictions.

Here in the United States, I have worked on several initiatives to improve health care for the local and underserved community by serving at a free clinic, working closely alongside volunteer doctors and assisting them with a number of duties, mostly counseling patients. Since 2013, I have been volunteering extensively at the XXXX Clinic in Greensboro, NC. My experiences have helped me to better understand the importance of Psychiatry to the future of primary care with collaborative care models and a holistic emphasis. I especially enjoy interviewing patients and taking their histories.  I design treatment plans and follow-up visits, lab ordering and note-taking (under supervision), and prepare presentations on issues in Psychiatry for our group. I also support several psycho-social rehab programs. 

My long-term goals, following the completion of a residency program in Psychiatry include completing a fellowship in child and adolescent psychiatry. I continue to follow events in Syria closely, especially the fate of children, victims of war. I think often of how to perhaps help them at some point in the future, if the war ever ends.

I thank you for consideration of my application.

I have invested well over a decade in researching what makes the personal statement for medical residency or fellowship as effective as possible - particularly in the area of Psychiatry. I invite you to fill out my Online Interview Form and send me your CV and/or rough draft for a free evaluation:

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An Expert in Humanitarian Mental Health Programs

Peter Locke studied humanitarian psychiatry and the politics of post-traumatic stress in Sarajevo, Bosnia-Herzegovina, under his mentor João Biehl. His PhD dissertation focused on how small psychosocial support organizations and their beneficiaries have survived, searched for resources, and adapted to the many challenges of everyday life after times of war and conflict.

Through his extensive fieldwork, Locke discovered how survivors’ experiences of psychological distress were shaped equally by the socioeconomic and political challenges of the present as by the traumatic events of the recent past.

“One role of anthropological research, I saw, was to open up the idea of trauma—to show all these other determinants that shape people’s mental health symptoms after a war,” explains Locke.

After finishing his doctorate, Locke worked as a postdoctoral fellow and then as a lecturer at Princeton, to develop a global health program for the institution.

For three years, he led undergraduate global health students to Sierra Leone every summer, to pursue research internships in collaboration with the medical humanitarian NGO Wellbody Alliance.

Locke and his students observed the deep poverty and limited public health infrastructure firsthand, as well as the deep distrust left by the fragmented aid projects of the colonial and postcolonial eras.

“The students, understandably, would come in with a lot of idealism about the possibilities of medical humanitarianism and their own immediate contributions,” said Locke. “I learned how important it is to help students transform natural disillusionment into a potentially lifelong commitment to the field.”

Locke’s position as Assistant Professor of Instruction at Northwestern University allows him to devote much of his time to building and delivering global health courses for undergraduates, including seminars on international public health, medical humanitarianism and war and public health.

Locke is also looking to develop a new undergraduate summer research program based in Bosnia in 2016. Students will have the opportunity to explore public health and mental health challenges in the aftermath of a war and the fall of Yugoslavia’s socialist political and economic order on the program.

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Statements of Excellence for Residency & Fellowship Positions on Behalf of Applicants in Psychiatry

The Humanitarian Side of Psychiatry

The humanitarian side of psychiatry could be considered to be a lot more fascinating and rewarding than humanitarian work in other fields.

According to Kaanthan Jawahar, a final year medical student who wrote an article on mental health in humanitarian emergencies: mental illness is the most common non-communicable ‘disease’. But when compounded with the stressors of disasters and conflicts, the baseline level of mental illness in the locality usually rises considerably. Jawahar states that this causes people with a pre-existing illness to be subjected to higher levels of stress.

The International Medical Corps (IMC)

The IMC is one of the largest non-profit humanitarian aid organizations in the world. They focus their efforts on disaster relief health care, training and development programs. They currently operate in more than 25 countries and are working on integrating mental health into their community-based primary health care.

The IMC argue that too much emphasis has been placed on the more ‘fashionable’ mental disorders, such as post-traumatic stress disorder. According to Peter Medway, the director of the International Medical Corps (IMC), there is also a largely Western focus when delivering treatment. Peter Medway argues that psychiatric health care needs to be location and context specific to achieve the most appropriate outcome.

Mental health seems to be a largely forgotten area in humanitarian aid missions, says Jawahar. Where it is addressed, it usually takes second place to other aid packages, which tend to be viewed as ‘more important’. Local practices, customs and many presentations of mental illness are often ignored.

This raises further questions about psychiatric diagnostic labels – can DSM-IV/ICD-10 criteria be effectively applied to extreme situations like those experienced in conflict and disaster zones?

The IMC is different. They deploy their mental health care services by using local knowledge to treat symptoms. They train the host country’s health care workers, so that when the IMC leave the disaster zone, there is a sustainable infrastructure for continuing care. Here´s more information on the IMC´s mental illness work.

The Effectiveness of Humanitarian Psychiatric Interventions

It appears that little work has been done by researchers to determine the efficacy of the most commonly used interventions in this field.

In October 2011, a group of doctors and academics, including Dr. Wietse Tol, Dr. Corrado Barbui, Ananda Glappatti, MSc, and Dr. Anne Golaz published a review of mental health and psychosocial support in humanitarian settings.

The review linked practice, funding, and evidence for interventions for mental health and psychosocial wellbeing in humanitarian settings. They studied practice by reviewing reports of mental health and psychosocial support activities between 2007 and 2010; funding by analysis of the financial tracking service and the creditor reporting system between 2007 and 2009); and interventions by systematic review and meta-analysis.

In 160 reports, the five most commonly reported mental health and psychosocial support activities were basic counselling for individuals (39%); facilitation of community support of vulnerable individuals (23%); provision of child-friendly spaces (21%); support of community-initiated social support (21%); and basic counselling for groups and families (20%).

Most interventions took place and were funded by organizations outside of the national mental health and protection service systems. The group used thirty-two controlled studies of interventions, 13 of which were randomized controlled trials (RCTs) that met the criteria for meta-analysis.

Two studies showed promising effects with regard to strengthening community and family supports. Psychosocial wellbeing was not included as an outcome in the meta-analysis because its definition varied too much across studies.

In adults with symptoms of post-traumatic stress disorder (PTSD), meta-analysis of seven RCTs showed beneficial effects after several interventions (psychotherapy and psychosocial supports). Meta-analysis of four RCTs failed to show an effect on the symptoms of children with PTSD (–0·36, −0·83 to 0·10), but a beneficial effect was caused by interventions (group psychotherapy, school-based support, and other psychosocial support) for internalizing symptoms (six RCTs; SMD −0·24, −0·40 to −0·09). Overall, the research and evidence reviewed focuses on interventions that are infrequently implemented, whereas the most commonly used interventions have had little scrutiny.

Other Resources

For an interesting webinar on the subject of the role of psychiatrists in humanitarian settings, check out the webinar link on this page.

And for some interesting reading, check out this book on US Army Psychiatry in the Vietnam War.

Dr. George Nurnberg M.D. UNM Department of Psychiatry Residency Program

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