Dr. Mwamba Malekani ’19 is a third-year resident in psychiatry at Authority Health GME Consortium in Detroit, Michigan. This summer, she is planning to fast-track into a child and adolescent psychiatry fellowship at Cincinnati Children's Hospital, where she will have the opportunity to work with a diverse patient population, develop expertise in treating eating disorders, and gain experience with new psychiatric treatments like transcranial magnetic stimulation (TMS) and ketamine therapy. Dr. Malekani became interested in pediatric psychiatry after working at a residential unit for young women during medical school. Dr. Malekani credits her time at the University of Medicine and Health Sciences (UMHS) for teaching her the importance of asking for help and building lifelong friendships and mentors. Dr. Malekani encourages students interested in child psychiatry to get involved with the American Academy of Child and Adolescent Psychiatry and gain as much exposure to pediatric rotations and child psychiatry as possible.
Dr. Mwamba Malekani at the APA (American Psychiatric Association) annual meeting in May 2024 at the Jacob Javits Convention Center in New York, NY. Photo: Courtesy of Dr. Malekani.
UMHS spoke to Dr. Malekani on a recent winter morning about her upcoming fellowship.
Upcoming fellowship at Cincinnati Children’s
UMHS Endeavour: Dr. Malekani, I want to welcome you today and thank you for your time. Can you please tell us what you're doing now and about your upcoming psychiatry fellowship at Cincinnati Children's?
Dr. Mwamba Malekani: Thank you for having me. I am a third-year resident in Detroit, Michigan at Authority Health GME Consortium. We're affiliated with Michigan State University. I'm planning to fast-track now into child and adolescent psychiatry, meaning I'm leaving general psychiatry residency a year early to start my fellowship training.
Okay, great. And can you just tell us a little bit about how you became interested in pediatric psychiatry and what some of your goals are for your upcoming position in Cincinnati?
Sure. I became interested in child and adolescent psychiatry after graduating from medical school. I worked at a residential unit that had a population of young girls aged 13 to age 17, and then another part of the unit also had young adult women. This was at McLean Hospital, a teaching hospital for Harvard Medical School. But that experience I had in particular after medical school, where I was exposed to child and adolescent psychiatry, really solidified why I wanted to go into psychiatry first, but then in addition, wanting to work with that particular population.
Do you have any particular goals for your upcoming position at Cincinnati Children's?
A big reason why I chose Cincinnati Children's is because they have a lot of resources in terms of development. I'll see very young patients around two, or three years old who have developmental disorders all the way to older young adults who are sort of graduating or aging out of the pediatric population. They also have strong eating disorder training, which was something that I observed was not necessarily offered everywhere. So, I'll be able to learn more about eating disorders. I'm particularly interested in that because I think eating disorders are something that's sometimes overlooked in minority populations because the presentation may be different because of cultural aspects. And then finally, Cincinnati Children's has neuromodulation, and I think that's a big way that psychiatry is kind of moving forward. We're trying to do more targeted therapies. We've had ECT for a very long time, but we're doing more targeted therapies like TMS and ketamine, and moving away from medications that have a lot of side effect profiles.
Why UMHS?
How did UMHS as a med school help you become the doctor that you are today?
I think a lot of aspects. I think UMHS was one of the places where I really learned that it's okay to ask for help. I found that on the island and through rotations, there were professors that really cared about our learning, and mentors that I made. I also found that just with my colleagues and my peers, I have lifelong friends from UMHS and I really accredited my story and my journey to UMHS.
Dr. Mwamba Malekani's ID badge at Authority Health in Detroit. Photo: Courtesy of Dr. Malekani.
Career path for pediatric & adolescent psychiatry
What would you say is the career path for a pediatric or child psychiatrist? Do you have any advice for current and prospective students out there who might be considering going into child psychiatry?
Sure. I would say if you have any inkling or interest, I would say join the national chapter. The American Academy of Child Adolescent Psychiatry has a whole division for medical students and residents. They have Zoom calls once a month. They offer scholarships to attend the annual meeting. They have a mentorship program. I got involved in AACAP [American Association of Child and Adolescent Psychiatry] and really found some great mentors there. I would also say to do pediatric rotations and as many psychiatry rotations as you can when you're in medical school because child psychiatry is not exactly the same as psychiatry for adults. It's important to see how your interviewing skills are adjusted and how you're working more with parents and schools as well. And finally, I would say in residency, try to get as much exposure as you can. So, I was able to do an inpatient pediatrics rotation as a resident during my intern year, and I was also able to do four months of inpatient child psychiatry as a resident. So that really solidified my interest.
Is there anything else that you'd like to add about child psychiatry or UMHS or just medicine in general for people out there?
Child psychiatry is a growing field and we have a physician shortage. So, if you have any interest in child psychiatry, definitely look into it. It is worth the return on longer training, but it is worth it and it's a rewarding field.
Raised all over the USA
Can you just tell us a little bit about yourself? Where did you grow up and did you always want to be a doctor?
I grew up in the Midwest, kind of all over. South Dakota, Kansas, and then my family was in Pennsylvania for some time. Basically, I've always been interested in math and science, but in particular, I enjoyed the service aspect of medicine, although I don't have any doctors in my family. I kind of expressed my interest to my primary care physician when I was in high school and she kind of took me on board, had me work as a nurse's assistant in her office and I was actually able to get exposed.
After graduation, you started a psychiatry residency at Authority Health GME in Detroit. Can you tell us a little bit about your experience there in Detroit?
Detroit, Michigan has a very diverse population. Authority Health kind of works as a safety net program. So, we work in multiple underserved areas and underserved hospitals in the area. So, we kind of see some of the sickest patients you would see in terms of pathology. The program is also very service-oriented, so we have training in cultural humility, health equity, and anti-racism training as well, too. The program is very aware that we're working with these diverse populations and also equipping us with the appropriate training and bias training to work with these populations. What I do really enjoy about Authority Health is having that family feel that I've felt at UMHS too as well, where if I have a concern or if I'm struggling with something, I can always ask for help and the door is open to get that help.
New treatments in psychiatry and common misconceptions
Let’s talk about the field of psychiatry in general, specifically child psychiatry. I remember you telling us back in 2022 that child psychiatry is the perfect blend of pediatrics and neuroscience. What are your thoughts on the specialty now in that respect?
I think psychiatry—we're still really learning and trying to understand why the brain and mind do things the way they do, why people have certain pathology, and I think that's exciting to be kind of at the forefront of that. In particular, pediatric psychiatry or child psychiatry. I think there are developing treatments that we're learning how to do. Child psychiatry also has aspects of development that are a little bit different than adult psychiatry. I'll be able to see patients who have neurodevelopmental disorders, like kids who are on the autism spectrum, ADHD diagnosis, and being able to manage that as well as their psychiatrists and working closely also with their pediatrician. I think the neuroscience aspect is interesting because of neuromodulation. We're doing more targeted treatments that are actually mapping the brain and looking at what aspects of the brain to target.
What are some of the new treatments, medications, and technological breakthroughs in child psychiatry that you're aware of or that you think are relevant or you'd like to talk about?
First, I say this humbly, I'm not an expert by any means and I'm still learning, which is why I'm going to training. But with children, we have protocols that are being used now for children who have catatonia, for example. A disorder where you have a lack of movement and we're using electroconvulsive therapy for that. There's a trial that started out at Stanford for TMS, a way to reduce the amount of time for TMS, and that is now being started in adolescent populations as well. And I imagine hopefully there'll be more research and evidence on how to target tick disorders and OCD as well too, because we're looking at more of what happens in utero to a patient and how we can target those disorders as well, too.
What are some of the common misconceptions about child psychiatry that people have and would you like to discuss them or dispel some of those myths?
I think one of the most common misconceptions I'll hear is we're just trying to over-medicate children. And I think a big aspect of psychiatry, especially child psychiatry, is hopefully catching an issue or concern early on and maybe even having non-medication treatments. Being able to figure out if a child is struggling behaviorally, how do we maybe do behavioral therapy before we go onto medication? And ideally trying to target disorders and disease processes before they get really bad. I think that's one of the biggest misconceptions I've heard out there.
Dr. Malekani in front of the Michigan State Capitol Building in Lansing on Advocacy Day. Photo: Courtesy of Dr. Malekani.
Facts about ADHD
I know that there are a lot of misconceptions about ADHD. People think psychiatrists just prescribe Ritalin or Adderall, but I know there are so many new, drug-free treatments, like behavioral therapy, and CBT therapy, for example, about various things like clutter or not wanting to study and ways to... I know there's a lot of stuff online, but of course, you should go to a psychiatrist. Is that what you mean? Just a lot of new things that are not medication-related. I think people tend to think that, oh, they just drug the kids, but it's not really true. There are so many things out there. Would you agree?
Yes. So, the child's psychiatrist almost works [like the] conductor. We're doing an evaluation with the child, with their parents or caretakers. We even contact the schools. If they're in the foster care system, we're reaching out to maybe if there's a case manager. So, we are getting multiple histories and making sure that everyone's kind of on the same board in terms of the treatment plan. And especially for ADHD, if a kid needs an education plan, we're advocating for the child to get those steps in place so we don't necessarily always have to reach for medication as our first solution.
Favorite UMHS professors
Let’s talk a little bit about UMHS. Any professors or staff members or anybody that helped make a difference when you were going to med school at UMHS?
Yeah. I don't know if I mentioned him before, but definitely Dr. Michael Doherty. He passed away, but he was teaching neuro on the island. Probably my first... He helped me really realize I had an interest in neurosciences. Dr. Prakash Mungli from biochemistry. He was very helpful in teaching pathways and processes and there is a little bit of genetics in that.
Is there anything else that you would like to add?
I'm a PGY-III at Authority Health. I'm also in what's called the SAMHSA Fellowship. Substance abuse and mental health services admin. SAMHSA has actually been really helpful this year for me because it actually provided me with grant funding for professional development. And so, as I mentioned AACAP, I was able to attend the conference with SAMHSA funds and I'm the minority fellows’ chair. So, for my cohort, I'm the chair right now. I forgot to mention that, but that came up during all my interviews for Fellowship.
I mentioned that only because APA and SAMHSA fellowships are actually open to medical students and so that is an excellent way for medical students to attend conferences and to meet people and get mentors. And they are open... Sometimes some of this stuff is only available to US medical students, so APA actually is open to international students as well, too.
How to contact Dr. Malekani
If any current or prospective students are possibly interested in child psychiatry or just UMHS in general, is there an email address where you can be reached—or would you like to give your LinkedIn page?
Feel free to contact me. I'm on LinkedIn. My email is malekani@msu.edu
Top photo: Dr. Mwamba Malekani '19. Photo courtesy of Dr. Malekani.
Scott is Director of Digital Content & Alumni Communications Liaison at UMHS and editor of the UMHS Endeavour blog. When he's not writing about UMHS students, faculty, events, public health, alumni and UMHS research, he writes and edits Broadway theater reviews for a website he publishes in New York City, StageZine.com.
