Dr Rashwany is a consultant liaison psychiatrist at Central and North West London NHS Foundation Trust. She is one of 25 women to be highlighted as part of a special project that celebrates the stories of 25 amazing women psychiatrists.
Dr Rashwany's story
I completed foundation training in Erbil, in the Kurdistan region of Iraq. As a medical student at Baghdad University, I was inspired by the consultant psychiatrists who were mostly also neurologists. I was fascinated by the clinically challenging cases of medically unexplained symptoms and conversion disorder on the ward. My one-month rotational job in psychiatry convinced me that this was the specialty that I wanted to practise in as a career. After foundation training, I did mandatory GP work in rural areas and as a medical officer in Erbil for three years before I was eligible to apply for a training post in psychiatry at Erbil Educational Hospital.
I was the first female trainee in psychiatry in my city. Being a female psychiatrist helped the women patients to express more private concerns, also the patients’ female carers were able to approach me to seek help for their own mental health needs. At that time there was a lot of stigma around psychiatry not only amongst the public but also within medicine. My colleagues’ reaction was, “She must be crazy herself to work in psychiatry”, and they would joke about it whenever I passed by. My parents were a little worried about what this would be like as a career choice, although as always, they stood by my decision to pursue this. The consultant psychiatrist who was the head of the department was very supportive, which encouraged me further to pursue my chosen specialty.
It was a privilege for me to be able to serve the most deprived and stigmatised patients in the community. Because of the prejudice around mental illness, people from a more privileged background would only attend private clinics or go to the bigger cities, where no one knew them, for inpatient treatment. On one occasion, I received an elderly man with no shoes on, who was brought by staff from the only care home in the area; he had severe depression. The staff reported that his wife threw him out because his depression meant he could no longer work. At the time, Iraq was under international sanctions and the currency went downhill dramatically; my own junior doctor salary was so low that I could not even buy a pair of shoes. I went home and asked my father for a pair of his shoes to give to my patient. I did not wait for his reply, but just took the shoes and gave them to my patient.
On another occasion while doing the evening round, I found out that the hospital kitchen forgot to send the evening meal to the psychiatric ward. When staff members called the kitchen, they were told there was no more food. The patients had no money on them to buy a meal. Fortunately, my husband arrived to give me a lift home, and he had bought a large amount of cheese earlier in the day. We went to buy bread from the bakery opposite the hospital, the ward made tea, and the patients were able to have an evening meal.
When I came to the UK, I sat the IELTS and PLAB exams1, and after a few short-term locum positions, I was offered a place for core psychiatric training. I passed my MRCPsych exam at the first attempt2. I did a long clinical attachment in psychiatry when I first arrived in UK, which helped me to familiarise myself with the mental health services and legal frameworks. I often helped colleagues with interpreting too. It was also useful to get accustomed to the multidisciplinary approach in the UK, since in Iraq, like most developing countries, psychiatry is still practised as a medical model.
When applying for higher specialist training I thought about what special achievements would make my application stand out. I called the Royal College of Psychiatrists to ask how many Kurdish women were members of the College, and was informed that I was the first Kurdish woman to have become a Member of the Royal College of Psychiatrists. I proudly included that information in my application, and was successful in my application for higher training and subsequently for consultant posts. I am pleased that I can help with interpreting for patients who only speak Kurdish or Arabic, as this can assist in reassuring them and building a quicker therapeutic relationship.
Over the course of my career I have encountered conflict, mental health-related stigma and discrimination, both against patients and against mental health professionals, and sex discrimination, both in Iraq and in the UK. Fortunately, nowadays there
are many more female psychiatrists, and the society is more open minded about mental illness, although stigma and discrimination are still widespread. When I was a higher trainee and preparing to apply for a consultant job, one of my consultant supervisors
advised me to be aware that there could be unconscious or even conscious discrimination in interviews as I was a female overseas doctor who covered her hair. Despite these challenges, I have reached my goal and I am now a consultant in the largest
department of liaison psychiatry in North West London, supervising a team of junior doctors and psychiatric liaison nurses. I work alongside two consultant colleagues, and we see over 4,000 referrals each year. I am a strong advocate for patients
with mental health needs and for the specialty of psychiatry.
- Exams which most doctors who have trained abroad need to take to demonstrate their English and medical skills are ready to practise in the UK.
- This is a series of exams which when passed lead to Membership of the Royal College of Psychiatrists; the set of exams is taken in the early stages of specialist training and needs to be completed in order to progress to higher stages of training.