Teaching psychiatry in poor countries: priorities and needs. A description of how mental health is taught to medical students in Malawi, Central Africa.

CONTEXT: In developing countries poor standards of clinical service may be an obstacle to medical education. The paper outlines the inadequate mental health service in Malawi, Central Africa, which as well as failing patients obstructs the training of health workers. AIMS AND
OBJECTIVES: A new mental health curriculum at Malawi's medical school is described. The notion of psychiatry as a medical specialty is abandoned and the focus moved to psychological and psychiatric factors as they present in general clinical settings and primary care. Students are encouraged to consider how they may address mental health issues through the many and varied roles which doctors in resource poor countries must fulfil (administrator, trainer, primary health care doctor, hospital physician). RELEVANCE: This training strategy accords with a shift of attention among health service planners world-wide from specialist services towards primary care, and may generalize to other settings in which specialist clinical services are poorly developed.