Stories From the Field:

GHANA

Teaching Psychiatry in Cape Coast, Ghana

Carol Wool, MD
Mass General Psychiatry

For the past seven years Dr. Thad Ulzen, a Ghanaian who is the chief of psychiatry at Tuscaloosa Medical School has organized the psychiatry teaching for medical students at the School of Medical Sciences at Cape Coast University. This medical school is the newest in the country and he realized that they lacked sufficient faculty to instruct the students. For the past seven years, he has assembled psychiatrists from Ghana and abroad to teach the psychiatric curriculum to the medical students in their 4th and 5th years. I have been privileged to join this group since it’s inception.

This year, similar to the previous years, I travelled and taught with a faculty member from MGH psychiatry as well as a PGY IV resident.   We instructed the 4th year students in diagnosis of psychiatric illnesses as well as differential diagnosis from the perspective of the general practitioner. Most of the students will pursue medical practice as primary care physicians or surgeons.

The 5th year students received instruction in similar topics, but with more of an emphasis on clinical material. We also saw patients at the psychiatric hospital at Ankafu. There the task was to teach the psychiatric interview. Groups of students would interview a patient from the inpatient units or the outpatient department. We would be present during the interview to help guide them and then we would discuss the case so that they could complete the entire interview with a good differential diagnosis, assessment and treatment plan.

Thus we provided the students with a solid foundation of knowledge of psychiatric topics, differential diagnosis, patient centered interviewing and possible treatment that can be accessed locally. In addition, we tried to convey our approach toward this population of patients and help to lessen the stigma of mental illness that that is pervasive in Ghana.

Seven years ago, there was one psychiatric residency in Accra and 8 working psychiatrists in Ghana with a population of over 28 million people.  Now there are two residencies and 20 psychiatrists in the country. The PGY 4 resident who taught last year and this, has established a tele-education program for the residents in Kumasi. Faculty from MGH deliver lectures to the Kumasi residents and they  are able to ask questions of the lecturers. This has extended the contact between MGH and Ghana throughout the year. This year the first students whom we taught will be choosing their specialties. We hope that the number choosing psychiatry will increase, and more importantly we hope that the students whom we taught who will become general practitioners, surgeons and other specialists in the country will know that there is no health without mental health.