Tag Archives: international medical elective

Robbie Sparrow is a medical student in the Class of 2019 at Western University

 

For individuals facing deep personal struggles, the path to recovery is often daunting and overwhelming. Support from others who have overcome similar challenges can be extremely beneficial. For example, the best people to help heroin addicts are those who have fought to stay sober for two years, and women facing domestic abuse are best aided by women who have escaped it. Doctors who care for patients living through crises are often disadvantaged when trying to empathize with them because they themselves haven’t faced the same struggle. Difficult experiences throughout a physicians’ life can help them approach this ideal of empathy and improve the care they offer patients. ...continue reading

Chloe MacAuley is an intern (junior doctor) at Tallaught Hospital in Ireland who graduated from medical school at Trinity College Dublin in 2017

 

Armed with an email outlining the ‘Dangerous Abbreviations NOT to Use’, a certificate showing I had passed an online test on how to use the hospital computer system, and a dictation number — what was a dictation number? I wondered — I boarded my plane from Dublin to Vancouver for a medical student summer elective.

Canadian students in my class at Trinity College Dublin had warned me that Canadians expected more of a hands-on approach from their medical students. Navigating the unfamiliar streets to St. Paul’s Hospital on my first day in downtown Vancouver, I was thinking about how much easier it would have been to stick with the familiar commute to St. James’s Hospital in Dublin. I was nervous, but I had resolved to throw myself in the deep end before final year. ...continue reading

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Jessica Bryce is a medical student in the Class of 2018 at Western University

 

On July 4th, 2016, I fainted in the OR.

It was the beginning of my clinical placement at Centre Hospitalier Universitaire de Kigali in Kigali, Rwanda. I had crawled into bed at 8pm the night before feeling like crap. It seemed I had finally caught the same bug as the other Canadian medical students.

But a multi-hour forearm tendon/nerve repair was planned for the next day, and I didn’t want to miss it. So, in the morning, I donned the thick cotton scrubs, scrubbed in, and entered the impossibly hot OR. ...continue reading

Patrick_ODonnellDr Patrick O’Donnell is a Clinical Fellow in Social Inclusion at the Partnership for Health Equity, a pilot project of the the University of Limerick’s Graduate Entry Medical School in Ireland

It was a one of those endless days in the medical library in my third year of studies that I had an epiphany. I had become pretty disillusioned with my life as a medical student and I was starting to doubt my reasons for choosing this path. I remember leafing through a fairly dull journal when I came across a series of reports on student electives to far-flung impoverished parts of the world. My attention was immediately seized and I quickly set about finding out how I could become part of the wave of idealistic students who go abroad every summer to help people less fortunate than themselves. To be able to marry my passion for travel with an interesting medical experience seemed like an incredible opportunity.

This was the start of a journey that led me to India, the Solomon Islands, Haiti and Nepal to take part in IHEs (international health electives) over the next four summers. They were all very different experiences, but I returned with the same positive feeling; “I have helped in a meaningful way”. These were experiences I could not have gotten at home, I felt. These were making me a better person and hopefully a better doctor in the future. The feelings they created in me and the reactions of those I told about my experiences on my return made me feel like I was definitely making good use of my knowledge and skills.

Looking back, I doubt I made a difference at all, as a recent CMAJ editor’s blog suggested. I was ill prepared and very naive. Language was a barrier to being any way useful in all four of the countries I visited. Often a member of staff (usually a qualified nurse or doctor) was assigned to translate for me as I chatted to patient in the clinics. This ‘baby-sitting’ was a waste of skilled professional time in services that were often overstretched to begin with. I didn’t know very much about the common conditions in these far-flung parts of the world, and often the little I did know related to advanced tests and expensive treatments unavailable in the countries I visited. I brought with me some old textbooks, antibiotics and some surgical supplies to donate to clinics. I had done a little general research on each country I visited, but still managed to encounter civil unrest in both the Solomon Islands and Haiti. I had no plan B, no formal emergency contacts and my medical school did not know anything about my exploits.

Don’t get me wrong, I had the time of my life, and the experiences I had and the people I met have moulded me as a person and a doctor.

That medical student worldwide are attracted to IHEs electives is not surprising. A recent study in Ireland on the attitudes of university students to global development reported that 83% of those surveyed felt it was important to do something to improve the world in which we live and 81% felt that traveling abroad to volunteer is the most effective action to take.

It is not surprising then that bright, enthusiastic medical students act on these impulses. I know I certainly felt as a medical student I had much more to offer on a developing country elective than my colleagues studying arts or business. I also know, however, that as a medical student I was less inclined to examine my reasons for travelling, my activities while away and the effects of my trip with a critical eye. I had never been to a homeless shelter or an addiction service in my own country, yet I was delighted to fly half way around the world to meet similarly marginalised patients in distant places.

I now have the benefit of age, experience and a higher qualification in global health and yet I am still conflicted on the issue. Do IHEs serve a purpose? What do students actually gain from them? Do they cause harm? Are they safe? Who is ultimately responsible for the students and their welfare while on IHE? These are some of the many difficult questions generated by the phenomena that are IHEs.

One area that is beginning to be looked at is the ‘host’ experience of these IHEs and their effects on health services in the developing countries visited. The studies that have so far been published do show despite all the expected problems with IHEs; such as cultural incompetence and language difficulties, there are benefits (Bozinoff et al. 2014, Kraeker and Chandler 2013). Most of the positive gains reported relate to improved partnerships between developed and developing country academic institutions and that concept of reciprocity that is often mentioned, but very hard to achieve in this context.

There are now a huge variety of resources for students to encourage practical preparation and that provide thought provoking scenarios that focus on the inevitable dilemmas faced on IHE. Many medical schools now have modules on global health and cultural competencies. Post-exposure prophylaxis kits for HIV exposure are much more widely available. Students are a lot better informed on world news and issues in foreign parts. Communication with home and emergency contacts are easier. All of these factors should make for better informed, safer and more knowledgeable IHE students.

Whether IHEs are truly successful as a life changing learning experience, however, rests with the attitude of the students themselves.

In addition to those mentioned in the previous blog, some international resources include:

The Ethics of International Engagement and Service-Learning (EIESL) project from UBC, Canada
Elective guidelines from the UCL Centre for International Health and Development
• Ethical scenarios on the Responsible Electives website
General advice and actions for volunteers