The Global and Cultural Psychiatry (GCP) concentration provides UTSW psychiatry residents the knowledge base and clinical experience required to identify and assess disparities and strengths of psychiatric settings across different cultures and infrastructure worldwide. Residents will have the opportunity to work in clinical settings both locally and abroad to gain experience working within various health systems, while providing care to patients from different cultural backgrounds. Residents will have the chance to work at established partner sites and help develop/strengthen models of training and health delivery that will enhance psychiatric care in the respective communities and countries. Residents will be encouraged to develop a longitudinal project.

Educational Curriculum

Residents in postgraduate years (PGY) 1 and 2 will complete readings and be exposed to different aspects of global health through a supplemental curriculum that is suggested to be 75% completed over 2 years. Through these educational experiences, residents will acquire the knowledge base deemed essential for any future global health practitioner. In the PGY-3 and PGY-4 years, residents formally in the concentration will expand on their foundational global health skillset through implementation of a longitudinal project and leading discussion of journal articles with peers and faculty in monthly seminars. Seminars in PGY 3-4 will also include faculty who work in global mental health.

Local Elective: International Rescue Committee

Through our partnership with the local branch of the International Rescue Committee (IRC), residents are able to spend one halfday per week during their outpatient years (PGY 3-4) providing therapy and medication management to refugees and asylum seekers located in the Dallas-Fort Worth (DFW) area. The largest contingents of patients seen at the clinic are from Spanish-speaking Latin America, Afghanistan, Iraq, and Iran and are Rohingya from Myanmar. Interviews will be conducted using interpreters speaking various languages, reflecting the diverse backgrounds of the patient population.

International Electives

The core principle of our international work is sustainability, achieved through longitudinal global health elective experiences. In the PGY-2 year, residents will have the opportunity to embark on their first month-long international rotation to an established partner site in Guyana, China, or Turkey with the intent of engaging in clinical and educational work at the site. Through this experience, residents are encouraged to identify opportunities for growth/research within the framework of psychiatric practice at the partner site and to collaborate with the partner site to develop sustainable solutions or projects over the subsequent years. Finally, in the PGY-4 year, residents will return to the same partner site for a second month-long international rotation with the goal of implementing and/or monitoring their proposed solutions.

China (Sun-Yat Sun University)

The rotation in China is structured for residents to engage in global mental health in a bilateral pair model. Residents will have weekly didactics and journal club sessions from faculty from both academic institutions, focusing on themes of ethics/education, systems, and social determinants, as well as clinical practice. Each pair will collaboratively produce one case conference and/or one review article. Residents will have the chance to shadow and provide consultation for inpatient and outpatient care, while also participating in local cultural excursions to visit rural clinics in China. Due to the SARS CoV-19 pandemic, the rotation will be conducted virtually, during which residents will participate in didactics and scholarly projects and supplement their clinical work with local rotations, such as the IRC rotation in the local elective.

Guyana

The elective in Guyana seeks to engage UT Southwestern (UTSW) residents in creating a cross-learning / bidirectional exchange of education and knowledge between UTSW and Georgetown Public Hospital Corporation (GPHC) staff psychiatrists and psychiatric residents while providing mental health services to Guyana’s population. GPHC is located in the capital city, Georgetown. It has an inpatient unit and an active clinic, and it provides consultation to the Accident and Emergency (A&E) department and general hospital. GPHC residents and faculty also serve at outlying rural clinics, where UTSW residents may travel and provide consultation. UTSW residents may have the opportunity to travel to the National Psychiatric Hospital (NPH) in New Amsterdam, which is similar to a state hospital, to observe services provided. UTSW residents and faculty will prepare lectures for psychiatric students and residents training in Guyana, and UTSW residents may also facilitate journal club and clinical case presentations. The first half of the rotation will focus on understanding the Guyanese system, observing and learning about the Guyanese mental health patient population, learning about the available formulary, and providing targeted education requested by Guyana’s psychiatric residents. The second half of the rotation will build on the first half of the rotation while beginning work, under UTSW faculty supervision, to provide psychiatric services alongside Guyanese residents and faculty. During the rotation, UTSW residents are encouraged to identify a project related to education, a mental health need, or services provided in Guyana in order to work toward long-term improvement. UTSW residents are encouraged to work with Guyanese residents, who also have to meet a research requirement prior to their graduation, and potentially publish work together. Long-term goals also include finding ways to engage in education with Guyanese residents throughout the academic year and offer virtual consultation monthly/weekly when not together in person.

Turkey and Syria

The elective in Turkey and Syria seeks to improve Syrian refugees’ access to mental health care, utilizing a three-pronged approach devised in conjunction with our local partners, Union of Medical Care and Relief Organizations (UOSSM). First, residents from UTSW will design and deliver lectures, didactics, and journal clubs to junior doctors training in psychiatry in northern Syria, with the intent of producing sustainable and reproducible training modules. Second, residents from UTSW will travel to Turkey to shadow and provide in-person consultation to staff psychiatrists at UOSSM’s local mental health clinics around the country. Through this in-person experience, residents are encouraged to identify a gap in knowledge or health care delivery at the clinic and to develop and implement a longitudinal project to bridge this gap. Third, to promote longitudinal care for this patient population, UTSW residents will spend one halfday per week during their outpatient years (PGY 3-4) providing telepsychiatric services, staffing UOSSM’s local inpatient psychiatric unit in northern Syria as well as various outpatient psychiatric clinics.