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The Royal College of Psychiatrists Improving the lives of people with mental illness

Mental health exams

Mental health examining team in Boroma

Day 5 - Who makes the grade?

This is the big day for me here. But Dr Jibil has run the show and all goes like clockwork. We hope that Somalilanders can take over the whole exam process and mental health teaching in time. We run through our 6 OSCE stations first. A few minor adjustments. We have a varied subject matter. We brief actors on how to be psychotic, depressed, insomniac etc . There are a small group in final med this year - just seven. The examiners are briefed. The OSCEs have been rehearsed many times.

The OSCEs go brilliantly. All pass and do well. In my station the actor gave a fantastic rendition of psychosis. We had a sensitive sexual history OSCE which is always a highly sensitive area in Somaliland and all did really well in this. We had a Swedish Somaliland Psychiatrist visitor back from vacation to his native Boroma and became examiner as well.

I feel confident and happy that these seven are now ready to use their doctoring skills with a foundation of core psychiatric knowledge and skills.

Exam meeting in afternoon. We establish the scoring and passing of all the candidates with all external and internal examiners present. Some of examiners have been my students within the past few years bit have completed their internship. It is highly professional and of an international standard.

Visit to the Fistula Hospital in the afternoon. We go to the Fistula hospital as mentioned above. Having a fistula devastates a woman’s life in this region. It is usually a consequence of the dire obstetric services in the country. A girl is left incontinent. More often than not her family disown here and she is left destitute and abandoned by her husband. The fistula hospital runs as a charity subsidised by some other surgical work. Dr Gause works from about 4am every morning doing umpteen fistula repairs on women which come from as far afield as Mogadishu in Somalia. It changes the woman’s life.

She is able to return to a normality which was not possible before. It is a surgical intervention that radically improves social and psychological well being for Somali women. It is always moving to see the work of Dr Gause in the Fistula Hospital and his devotion to this charity. When Dr Jibril was there, I know he paid particular attention to the psychological needs of the women there which are significant.

Friday will be graduation ceremony where the candidates will be there with the proud parents. And most of all I can get up late Friday as a rest day. Looking forward to that.

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About this Blog

Dr Peter Hughes - consultant psychiatrist








Dr Peter Hughes is a consultant psychiatrist based at Springfield University Hospital, London. He has an interest in international psychiatry and has been travelling to Africa over the last five years doing short-term assignments in mental health. He has recently flown to Somaliland to work on a mental health programme.


This personal blog reflects Dr. Hughes' own views and does not represent any Somaliland organisation in the UK. However Dr. Hughes is indebted to KINGS-THET partnership for providing an opportunity to take part in this exciting project. He is grateful to Dr. Susie Whitwell who leads the programme for mental health, and companions Professor John Rees, Dr. Suleiman Yusuf, Helena Tabry from UK and all colleagues in Somaliland.


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