Psychiatric and neurological disorders are dominant contributors to the global burden of disability and mortality, are linked to substantial social and economic costs, and are associated with worse general health and chronic disease outcomes. The current dearth of mental health research in low to middle-income countries, and the limited human capacity to conduct rigorous, culturally-appropriate, clinically relevant studies in these areas with the highest needs, hinders the development of evidence-based policy and practice, and stunts the advancement of effective service delivery.
As communicable diseases are supplanted by non-communicable, chronic, and neuro- and psychiatric diseases, the academic medicine workforce must be realigned with the emerging health priorities of the new century. The MGH Global Psychiatric Clinical Research Training Program will prepare a cadre of researchers committed to working collaboratively across disciplines and cultures to address priority global mental health challenges through a well-defined clinical career path, rigorous training in clinical research methods, cross-cultural and public mental health competencies, and significant global mental health research experience in resource-constrained areas, conflict-affected settings, and countries ravaged by poverty.
- Select outstanding psychiatrists, clinical psychologists, and PhD candidate from an accredited School of Public Health and wide applicant pool, targeting candidates’ motivation and potential for an independent research career in academic medicine.
- Provide fellows with the financial support, scientific mentorship, didactic training, supportive institutional environment (domestic and abroad), and challenging research questions to assist productive independent research careers in global mental health.
- Create a cadre of health professionals who are committed to long-term global mental health in resource-limited areas, and who are able to work collaboratively across disciplines and borders.
- Harness the growing interest in issues in global health to attract high-quality trainees to the field of mental health and position graduates to become the mentors and educators of the future.
- Address the national shortage of globally oriented researchers in clinical psychiatry and psychology who can meet the mental health needs in resource limited and post-conflict areas.
- Massachusetts General Hospital
- Mbarara University of Science and Technology (Uganda)
- Addis Ababa University (Ethiopia)
- University of Cape Town (South Africa)
- Stellenbosch University (South Africa)
- Barbados (Barbados Nutrition Study)
Please submit all required documents as one complete PDF file using this naming convention: last name_T32 Fellowship and email to Ms. Anne Stevenson at MGHGlobalpsychiatry@partners.org. You will be notified upon receipt of your application. Incomplete applications will not be reviewed.
- Application form
- Curriculum vitae
- Personal statement: This should be a brief (2-5 pages) statement and should include the following:
- A description of your substantive areas of interest
- The type of project you wish to undertake
- The particular methods/approach in which you want additional training
- Copy of passport and/or green card
- Proof of a full medical license or of completion of PhD in public health or completion of psychology PhD and internship (psychology licensure not required). [Note: if you are applying during your final year of residency, PhD, or psychology internship, you are required to send a letter from your program director stating that you are in good standing and the date you are scheduled to graduate. If you are a fourth year psychiatry resident, you must additionally send proof that you are eligible for a full medical license by submitting notarized copies of your USMLE I, II, and III results.]
- Three letters of reference
- In addition to your PDF application please submit your medical and/or graduate school transcript(s): Transcripts should be sent in a sealed envelope from the university and bear the official institutional seal. You may have these sent to the Global Psychiatry Clinical Research Training Program directly from the issuing university to:
Ms. Anne Stevenson
Freedom Trail Clinic
25 Staniford Street
Boston, MA 02114
The core curriculum, which includes didactical instruction, coursework at the Harvard T.H. Chan School of Public Health, and mentored research projects, will position graduates to become productive leaders in the field of global mental health and create an established collaborative research base to conduct further study. It will provide a rich environment for fellows as they refine their research questions and career paths. Global mental health is a broad, interdisciplinary field that requires diversified methodological training in quantitative and qualitative methods; an understanding of the impact of culture on the expression of and treatment strategies for mental illness; an appreciation of the nature and impact of psychosocial and other environmental factors on individual, community and society well-being; and a general knowledge of the clinical phenomenology of mental disorders in cross-cultural populations.
The program will provide fellows with a basic knowledge base in conducting psychiatric-related studies in global settings; field methods including measurement approaches and application in both clinical and community settings; and analytic methods for investigating prevention, intervention and health promotion strategies in a global, public health and resource-limited context.
The program will include study in seven thematic areas, of which fellows can then focus their research training: child-adolescent psychiatry, complex trauma/disaster psychiatry, mood disorders, psychotic disorders, mental health services research, behavioral medicine, and HIV/AIDS related mental health. These thematic areas leverage the strength of the faculty, the breadth of the NIMH, the interest of potential trainees, the available research and training opportunities at the global sites, the needs of the populations in the training environments, and the general demands of the field.
Through a learn-by-doing approach, fellows will learn how to create a project of realistic scope, map a time-line for conducting a global study, select appropriate methodologies, and understand the country and population. Fellows will be able to develop research questions that are clinically and culturally relevant to identified community and public health needs; develop and manage a global research team; conceptualize mental health policies and plans; develop and evaluate mental health systems; build productive global collaborations; work with government, NGOs and academics abroad.
Based on the potential applicant pool, the strengths of the faculty, and the research needs of the field, we have structured the program for 3 years with 2 fellows (psychiatrists, clinical psychologists, or a PhD candidate from an accredited school of public health, depending on quality of applicants) per year. Key components of the proposed program include:
- Fellows will identify a primary mentor and a broad area of focus prior to start of the program.
- The fellowship will include thematic core areas of focus: child-adolescent psychiatry, complex trauma/disaster psychiatry, mood disorders, psychotic disorders, mental health services research, behavioral medicine, and HIV/AIDS related mental health.
- Fellows will complete the Harvard Clinical Effectiveness Program at Harvard T.H. Chan School of Public Health at the start of year 1; they can take supplemental courses, as needed, during years 2 and 3, under the advisement of Dr. Blacker.
- Fellows will have a core global curriculum spanning the duration of the program (via a biweekly seminar)
- Fellows will have clinical rotations at MGH sites that serve immigrant communities and global populations for a half day per week; they will focus on their area of interest when possible.
- Fellows will conduct a global research project at one of three Africa-based training sites or Barbados; they will generate a proposal, obtain IRB approval and collect data at this location.
- Fellows will have access to data sets and ongoing faculty research in the US and at the global sites. Fellows will generate an NIMH research proposal with their mentor or global preceptor as PI within the first 18 months of arrival.
- Fellows will be expected to periodically provide in-depth updates on the status of their research projects and to provide critical feedback to their peers during regularly-scheduled working meetings.
- Fellows will participate in a monthly Research-in-Progress seminar with mentoring faculty.
- An annual conference will coincide with the advisory board evaluation meeting and will be held on a rotational basis at the global sites. This will expose new fellows to faculty and prior trainee research, develop a training community environment amongst the sites, help identify areas of common interest, and foster cross-country, collaborative research opportunities amongst and between MGH/Harvard and global groups.
- Fellows will prepare an NIH K-award application by the end of the program when they have obtained adequate data and publications to be competitive for submission.
Mentored Research Experience
To gain the skill sets and confidence to perform independent research, fellows will conduct an independent, mentored research project tailored to their unique career goals at one of the African sites or Barbados; in addition, they will work on secondary data analysis projects to both develop analytical and research skills, and meet authorship requirements of the program. Each site has an established research infrastructure for protocol development, IRB approval and data collection, and a proven track record for participant recruitment and study completion. Fellows will have broad access to patients, clinical samples, relevant patient databases and laboratory/equipment to support their projects. The global sites, supported by the primary training site (MGH) will provide a rich research training environment for fellows. The history of scientific and training collaborations amongst the departments, and the available resources of the institutions, will ensure fellows rapidly immerse themselves in a research project and focus within the existing infrastructure.
The faculty’s methodological expertise is expansive, enabling fellows to conduct the following types of research: outcomes and evaluation research, testing multiple outcomes, large-scale clinical studies, drug utilization and effect of pharmaceutical and medical procedures in cross cultural populations, behavioral interventions for chronic diseases, longitudinal studies, epidemiological studies, pharmacoepidemiologic methods, and qualitative research, among others. The research activities of the participating faculty will enable trainees to engage in projects locally and globally at the interface of the thematic topics and methodological areas.
Below are representative research areas available to fellows, in brief:
- Mood Disorders (Drs. Chang, Cohen, Fava, Nierenberg, Trinh, Fekadu, Yeung): population-based epidemiological studies of depression, its antecedents, characteristics, consequences, and morbidity; strategies; expression of mood disorders; biological and behavioral treatment strategies for mood disorders in resource-limited and cross-cultural settings; indigenous characterizations of mood disorders, etc.
- Trauma/Complex Emergency (Drs. Belfer, Betancourt, Earls, Good, Henderson, Kagee, Mollica, Raviola): interactions of social environmental factors on the development and course of PTSD; resilience in war-affected youth; indigenous characterizations of trauma and PTSD; impact of trauma on family and community, etc.
- Psychotic Disorders (Drs. Asmal, Borba, Cather, Chiliza, Freudenreich, Henderson, Holt, Roffman, Fekadu, Hanlon): origins and outcomes of schizophrenia in resource-limited areas; treatment use and effectiveness for schizophrenia in African populations; gender differences in presentation and treatment of schizophrenia; neurological impairments, brain structure and function; genetic studies and phenotype characterization; effectiveness of medication; social impact of schizophrenia on household functioning and economics, etc.
- Behavioral Medicine (Drs. Bangsberg, Becker, Borba, Fricchione, Gouse, Greenfield, Kagee, Joska, O’Cleirigh): stress and resilience; substance abuse; adherence to ART; effectiveness of CBT in depression, etc.
- Childhood Disorders (Drs. Beresin, Belfer, Betancourt, Earls, Raviola, Galler): cognitive function outcomes in HIV/AIDS infected children; depression treatment and impact on functioning and school/learning, childhood risk factors for psychiatric disorders, interventions to reduce substance abuse and early sex, etc.
- HIV Mental Health (Drs. Bangsberg, Earls, Kagee, Joska, O’Cleirigh, Rukundo, Tsai, Ware): social determinants of ART adherence; impact of HIV on social network and economics, comorbidities with psychiatric disorders, interventions for high risk behaviors in adolescents and adults, etc.
- Health Services Research (Drs. Good, Henderson, Ware): mental health service improvement, cost and systems effectiveness, dissemination strategies, examination of clinical data to understand effective treatment across a number of psychiatric disorders, outcome research, program evaluation, etc.
- Food Insecurities (Drs. Bryce, Galler): infantile malnutrition and its long-term effects on behavior, health and epigenetics. Effects of malnutrition on psychiatric disorders and epigenetics.