From Balance Sheets to Psychiatry: The Tale of Muzammil Ahmad's Unlikely Career Journey

Eight years ago, Muzammil Ahmad was completing a finance degree at the University of Calgary's Haskayne School of Business

01 October 2019

Eight years ago, Muzammil Ahmad was completing a finance degree at the University of Calgary's Haskayne School of Business.

Fast forward to September 2019, and the Canadian Psychiatric Association's (CPA's) Annual Conference in Quebec City.

That's where Ahmad - now a second-year student in the Faculty of Medicine & Dentistry (FoMD) at the University of Alberta - presented a poster on the results of a study on the rehabilitation and community reintegration of Forensic Psychiatry patients with development disabilities.

"Dr. Xin-Min Li, the Chair of the Department of Psychiatry, funded the entire trip, including travel, conference costs and accommodation, and Dr. K (Dr. Maryana Kravtsenyuk, an Assistant Clinical Professor in the Department of Psychiatry) guided me throughout the project. It was a great experience."

Ahmad's sponsorship to attend the CPA conference was part of a departmental strategic research initiative, championed by Dr. Li, to offer support to all levels of learners.

So how did this 29-year-old Calgary native go from studying balance sheets to presenting a research project to some of Canada's leading psychiatrists? Well, you'd better take a seat. It's a complicated tale.

It began in 2012, when Ahmad accepted a contract position with the Mental Health Commission of Canada (MHCC) as part of year-long MHCC study on Vancouver's homeless population.

"We provided people living on the streets with mental health care for four to six months in the hopes that it would help them put their lives back together, and the project went really well," he says.

Although Ahmad was hired to do accounting work, seeing the pain and suffering of those living in Vancouver's gritty Downtown Eastside left a profound impression.

He spent the next two years back in Calgary, working for energy giant Shell Canada. But he soon realized he wasn't cut out to be a bean counter.

"It was a great experience and I learned a lot, but it didn't fit what I wanted out of life. I wanted to feel like I was helping people, one-on-one, so I decided it was time to pursue a different path."

That path took him to the University of Glasgow in Scotland, where he earned a Master's degree in Psychology in 2016. "I was always interested in mental health but that got me even more interested," he says.

"My research was on body image issues among Asian men living in the UK - a very interesting topic. After that I wasn't sure if I wanted to pursue a PhD in Clinical Psychology or Medicine, so I shadowed both. Although I enjoyed both, I felt Medicine fit my needs better."

To boost his chances of getting into medical school, he spent the next year taking science courses and preparing for the MCAT (Medical College Admission Test). He passed with flying colours, and was admitted as a first-year student in the FoMD in August, 2018.

That's where he met Dr. Kravtsenyuk, who is also a Forensic Psychiatrist at Alberta Hospital Edmonton.

"Initially I wasn't even looking for a specific project. I was just shadowing Physicians but I wanted to make some connections with Psychiatrists, because that's the field I'm interested in," he explains.

"Then I met Dr. K, as I call her. We had some really good conversations, so I told her I'd love to work with her on something, and I asked if she had any research projects I could work on."

As it turned out, she did. That's what led to Ahmad's research on Forensic Psychiatry patients with development disabilities.

In February, he began reviewing the latest literature on evidenced-based and effective interventions for enhancing the safe rehabilitation and community reintegration of patients with neurodevelopmental disabilities. He completed his review over the summer and presented his findings to the CPA's annual meeting in September.

"We basically looked at whether there are any specific programs in North America that are helping these patients, and whether these programs are cost effective or effective in general," he says.

The study's conclusions:

The success of reintegration programs is defined by the availability of individualized support, housing, and mental health treatment;
Reintegration programs tend to save on long-term costs and reduce the number of days spent in jail;
Improvements in vocational and social functioning in reintegration programs decreases re-offense or recidivism rates; and
Patient-centered care can benefit forensic patients with their transition back into the community.

"As we all know, the criminal justice system is very expensive, and mental illness plays a huge role in that. Crime costs totaled $31.4 billion in Canada in 2008, and mental illness costs were $48.6 billion in 2011," he notes.

"In Alberta, our research showed that mental illness treatment costs added about 13% to the costs of running the criminal justice system, with the hospitalization of forensic patients being the biggest single cost."

If forensic patients aren't effectively treated, rehabilitated and prepared for reintegration back into the community by the time they are released, the odds of reoffending jump sharply, inflating costs further. All of which underlines the importance of investing in effective programs.

"With Forensic Psychiatry patients, the focus is generally more on criminal recidivism and risk management than health. For civil patients it's typically a more patient-centred model, which works a lot better. So in general, the studies showed that recovery improves and re-offense rates drop if you give more empowerment to the patient," he says.

Of course, such programs are expensive to operate. But Ahmad is convinced the long-term benefits far outweigh the costs.

"These reintegration programs tend to save a lot of money over the long term. They reduce the number of jail days, improve vocational and social functioning and reduce re-offense rates. So I would really like to work with Dr. K on creating a proposal for Alberta Health Services, with the goal of potentially developing a program like this in Edmonton."

As for his career goals, he says he is now focusing on completing medical school and pursuing a career in Psychiatry.

"If I do end up pursuing Psychiatry I would definitely want to do a Fellowship in Child and Adolescent Psychiatry. I think that is my number one option."