Psychiatry Registrars Complete Rotation at Brown
After multiple delays caused by COVID-19, three psychiatry registrars (residents) from Moi University School of Medicine (MUSOM) spent the last two months at AMPATH Consortium member Brown University in Providence, Rhode Island, learning about various aspects of psychiatry practice in the U.S.
Drs. Isaac Kisiang’ani, Eunice Chepkoech Temet and Millicent Korir visit the iconic Van Wickle Gates at Brown University during their psychiatry rotation.
Drs. Isaac Kisiang’ani, Millicent Korir and Eunice Chepkoech Temet arrived at Brown in late May and have experienced a wide variety of clinical settings such as child psychiatry, adolescent psychiatry, neurology and geriatric psychiatry during their rotation. This is the fourth cohort of MUSOM psychiatry registrars to complete a rotation at Brown.
“Our registrars have had a rich experience during their external rotations in the U.S. The exposure to modern management of mental patients is quite informative. The world is becoming a village, hence exposure to different cultures is very enriching,” said Rogers Songole, PhD, chair of the Department of Psychiatry at MUSOM, who coordinates the educational exchange with Martin Keller, MD, professor emeritus of Psychiatry and Human Behavior, and Anne Walters, PhD, ABPP, clinical professor of Psychiatry and Human Behavior, at Brown.
The bidirectional education exchange has been a foundation of the AMPATH partnership since its beginning and has grown to include more AMPATH Consortium institutions and additional areas of study over the past three decades. “This great idea has enabled students from both Kenya and the U.S. to experience the differences in the practice of medicine across diverse populations while at the same time appreciating that the basic principles of medicine remain largely the same,” said Dr. Kisiang’ani, one of the participating Kenyan registrars.
Visiting residents Millicent Korir and Isaac Kisiang’ani experienced a variety of clinical settings while in the U.S.
“I am excited and grateful for the opportunity to work and learn from faculty and students from a leading university,” added Dr. Korir. “I have been able to learn best practices in the field and hope to be able to utilize these skills back home. I was particularly impressed by the multidisciplinary approach and how effectively teams work together to optimize care.”
“During the month-long rotation in the division of child and adolescent psychiatry, the registrars gained experience in inpatient, consultation/liaison, urgent care, partial hospital and outpatient settings,” said Dr. Walters. Dr. Walters noted excitement among all at Bradley Hospital, the nation’s first psychiatric hospital for children and adolescents, at the opportunity for this exchange between MUSOM and the Department of Psychiatry and Human Behavior at Brown’s Alpert Medical School.
The visiting registrars also traveled to Boston for a day to visit a former Brown fellow that had travelled to Kenya as a trainee and who provided an experience in an urban emergency department as well as substance abuse treatment. “They also attended seminars with Brown child and adolescent fellows, which is an opportunity for learning on both sides,” added Dr. Walters.
“Child and adolescent mental care is an area of interest for me and it was an exciting and helpful experience to work in a child/adolescent unit,” said Dr. Korir. “This is an area that is not well developed back home and based on my experience in the child and adolescent program I hope to further my studies in this area.” She added that the experience also increased her interest in research, and she hopes to be able to venture into research in mental health to provide solutions suitable for implementation in Kenya.
During a previous visit to Kenya, Dr. Walters noted the lack of settings geared toward mental health needs for youth in Eldoret and is pleased that the experience has kindled the interest in this area of practice for one of the registrars.
Training in outpatient neurology with Joe Friedman, MD, at Butler Hospital had a similar career-shaping impact on Dr. Kisiang’ani. “The most impactful experience for me was the Neurology (Movement Disorders) Clinic at Butler Hospital with Dr. Friedman. This is an illustrious teacher who changed my perspective on neurodegenerative disorders such as Parkinson’s Disease and the various types of dementias,” said Dr. Kisiang’ani. “I plan to complete my postgraduate studies in psychiatry and delve into neuropsychiatry largely because of the exposure I had during these external rotation experiences,” he added.
Psychiatry registrars Millicent Korir and Eunice Chepkoech Temet at the Rockefeller Library on the Brown University campus.
Dr. Keller said he was extremely pleased that the registrars were able to receive training from Dr. Friedman and in a broad spectrum of neurologic disorders in the outpatient clinics at Rhode Island Hospital under the leadership of Jonathan Cahill, MD. At Butler Hospital they rotated on the inpatient gerontology wards under the direction of Amy Halt, MD. “As in past years, it is apparent that residents and faculty at Butler and Rhode Island Hospital are also benefiting from their academic and cultural interactions with the visiting registrars,” said Dr. Keller who has been to Kenya several times as part of AMPATH’s faculty exchange.
Dr. Songole said that the rotation included experiences in areas such as substance use and movement disorders which are specialty areas not currently available in Kenya.
Dr. Temet plans to specialize in addiction psychiatry and hopes to explore the field of research in collaboration with experts from all over the world. She hopes to work in low- and middle-income countries where such expertise is deeply needed. “I have had several light-bulb moments of the various opportunities I have back home, which were previously not obvious to me. Leveraging on these opportunities and using these institutions as standards of reference will surely enable me to innovate and create solutions to some of the problems we experience back in Kenya,” she said.
This year’s registrar exchange is just one of the many ways that Brown University has engaged with colleagues in Kenya since joining ASSANTE (American Sub-Saharan Network for Teaching and Education) in 1997, three years prior to the name change to AMPATH. Jane Carter, MD, who has led Brown’s involvement in the AMPATH Consortium since those early days said, “The throwback to the original name here is not merely nostalgia, but the acknowledgement that a bilateral medical education program grounded in equity to train ‘physicians for a global community’ served as a base of the AMPATH program – as it still does today.” Because there were no registrar training programs at MUSOM at the time, the focus was all on medical student exchanges.
“When the internal medicine MMED program began, the Dean of Moi University and the chairman of the Department of Medicine requested exchange opportunities for the registrars, using the opportunity of a rotation in the U.S. as a draw for applicants to leave Nairobi and come to the Moi University School of Medicine program,” added Dr. Carter. As the reputation of the internal medicine MMED Program grew, targeted training began to build specific departments for MUSOM including renal, infectious disease, etc. During this time, resident rotations focused on building departments. For example, the infectious disease rotation included in-patient consultation, infection control and antibiotic stewardship as well as outpatient infectious disease. While building the curriculum of the psychiatry MMED program, Professors Lukoye Atwoli (MUSOM) and Keller (Brown) designed a similar exchange for psychiatry registrars.
Dr. Temet, a fourth-year registrar, concluded “The AMPATH educational exchange experience has been a life-changing opportunity that has positively impacted my general view of life and my practice of medicine.”