Faculty and Resident Information
Situated in the horn of Africa, Ethiopia has a population of approximately 77 million people; with a growth rate of 2.4%; the population is estimated to be 110 million by the year 2020. Up until 2003 there were only nine practicing psychiatrists in the country, all of whom had been trained abroad, and three of whom are on faculty in the Department of Psychiatry at Addis Ababa University. The need for more psychiatrists has been recognized for the last 10 years and due to the remarkable ability, energy and determination of our Ethiopian colleagues, the psychiatry residency program opened in January 2003 to seven incoming residents.
The Toronto Addis Ababa Psychiatry Project (TAAPP) was created to meet the educational needs of this new three-year training program as well as the need of the Department of Psychiatry in Toronto, Canada to develop international educational outreach expertise. The letter of agreement between the two universities was signed in the summer of 2003, and the first University of Toronto educational month-long visit took place in November 2003. Currently, the residency training program has completed its fifth year. The first seven Ethiopian psychiatry residents graduated in 2006, a further seven graduate in 2007, and thirteen Ethiopian psychiatry residents are currently registered in the program.
TAAPP is charged with bringing an academic syllabus of contextually relevant seminar and clinical material from the University of Toronto to teach to the residents in Addis Ababa. Guided by the original curriculum developed for the program by the Ethiopian faculty, the Toronto syllabus responds to the subsequent needs of the program as it continues to evolve. The syllabus is devised sequentially with each educational trip flexibly pre-negotiated between the two departments and organized to include time for the on-site clinical supervision of the Ethiopian psychiatry residents by the Toronto team in the wards, clinics and emergency department in Addis Ababa.
From November 2003 until April 2007, TAAPP has recruited and put together over 10 teaching teams, each one consisting of two members of the University of Toronto psychiatric faculty and one University of Toronto psychiatry resident. Each team visits Addis Ababa for a one-month period; there have been three trips a year.
end of three years, TAAPP was considered
sufficiently successful by both
departments of Psychiatry to expand the original mission to a TAAPP
Two. This extends TAAPP for a
further three years (for a total
of six years) and has two goals. First, it will continue to
the residency training as originally negotiated for TAAPP
Phase One, by
providing two, not three, month-long educational trips a year. Second,
enable three new faculty members drawn from the graduating Ethiopian
to acquire postgraduate training as leaders and educators in their
profession. This component of Phase Two will involve the new
both in-country and out-of-country training. With regard to
training, the new junior faculty members will work closely with the
University of Toronto faculty members to develop, plan and co-teach the
residents for the month-long TAAPP visit twice a
regards to out-of-country training, each new junior faculty member will
in turn, to Toronto for a 12 month educational block at the University
Toronto. This out-of-country module will aim to provide clinical
the specialty areas of their choice and will focus as well on the
skills involved in research, leadership, teaching and advocacy
the predicted needs of psychiatry in Ethiopia.
Teaching in Addis
The main focus of the University of Toronto’s teaching trips to Addis is to share the huge load of teaching and clinical supervision with the Ethiopian faculty, freeing them up to fulfill their various other professional responsibilities. As invited guest faculty, we are relieved of the responsibility of passing or failing residents and of any major evaluation of them. We are welcome and honoured guests, but we need to be mindful that we are strangers to the Ethiopian culture and context and have much to learn.
We are now in TAAPP Phase Two and have an additional focus of facilitating the new faculty's role as educators. Each trip will thus incorporate a new faculty member from Addis in the planning stage by email and in co-teaching once we are in Addis.
Teaching the residents in the Addis program can be compared usefully to teaching psychiatry to GPs in Canada. The psychiatry residents in Addis have worked for a minimum of four years as general practitioners and benefit from a teaching approach geared to adult learners. Unless a patient is admitted to Amanuel Hospital, he or she may only be seen as an outpatient one or two times. Brief models of consultation and psychotherapy are useful. Toronto faculty who have worked in Baffin Island or in other outreach centers in Canada are often familiar with effective one to three visit models of outpatient treatment.
It is hoped that many of the University of Toronto faculty who participate will return to Addis again. The consensus is that it is easier to teach and learn once a relationship is established, so the development of long term educational relationships is encouraged. Many of the returning University of Toronto faculty have become long distance supervisors of the Addis residents' research projects.
We have no clinical license to practice psychiatry in Ethiopia and our teaching does not involve treating patients.