Medical Trainees Gain Clinical, Cultural Experiences Worldwide

About one out of four UB medical students participates in an overseas medical program, says David M. Holmes, MD, clinical associate professor of family medicine and director of global health education.

A select group of residents in UB’s family medicine global health scholars track participates in several international medical experiences throughout their residency.

At the Global Health Electives and Medical Relief Projects event March 13, nine UB medical students and three family medicine residents discussed the challenges and rewards of caring for patients in the Republic of the Congo, Uganda, Peru, Guatemala, Haiti and Mexico.

UB trainees volunteer with various nonprofit medical relief organizations. Most earn course credit by completing a family medicine global health elective.

In 2014, a group of first-year medical students will spend their spring break volunteering with Friends of Fontaine in Haiti. Another group of first- and second-year medical students will work with Floating Doctors in Panama.

For more than a decade, Holmes has directed the global health elective, helping more than 400 UB medical students serve in developing countries around the world. During that time, he also led teams of UB medical students in Haiti and the Dominican Republic. In addition, Holmes has volunteered in Kenya, India and Costa Rica.

Volunteers gain distinctive medical experience, such as exposure to tropical medicine.

“You see diseases that you just don’t see here in the U.S.,” says fourth-year medical student Julie Garchow, who volunteered at a hospital in rural Uganda for four weeks.

She and two other UB students worked with many HIV patients with comorbidities, including malaria and typhoid. Garchow developed a color-coded labeling system for medications so patients with minimal literacy could follow instructions even if they couldn’t read.

Due to the lack of medical practitioners of all kinds, UB medical trainees often take on increased responsibility, supervised by a physician.

“As a medical student in the U.S., you’re usually delivering the placenta, not the baby. But in Uganda, we were able to do first assist on C-sections,” Garchow says.

Participants not only experience a different culture, but learn how deeply cultural beliefs affect health care.

“One woman needed an emergency caesarean delivery, but she didn’t want it,” Garchow recalls. “We thought she was just scared, but then we found out that in her culture, laboring is a badge of honor. People believe that if you don’t push the baby out, you’re not a woman.”

With encouragement and support, the mother did undergo the procedure and delivered a healthy baby.

Garchow also recalls a woman seeking birth control methods “that don’t require a husband’s approval.”

Often working in areas that lack even basic health care, the volunteers encounter the stark realities of medical systems in developing nations.

UB family medicine resident and global health scholar Alisha Razack, MD, remembers one older patient she helped at a remote mountain clinic in Haiti.

Razack recommended some blood tests and optimized the woman’s hypertension medications, provided free to patients by clinic sponsor Heart to Heart International. The woman’s adult son and caregiver was so thankful he broke down and cried, sharing how his father had died of cholera.

Volunteers are usually expected to pay for their travel and accommodations, but scholarships, community support and fundraising can offset costs.

The three residents per year selected as family medicine global health scholars receive full funding for their international experience.

UB’s International Health Interest Group strives to make it as easy as possible for medical students to do global rotations, says Garchow, a former leader and co-founder of the medical student organization.

The group identifies valuable programs and helps students find resources to support their trips, Garchow says. Members also share information and discuss issues in international health.

UB medical trainees may apply for financial assistance or scholarships through the UB Family Medicine Interest Group, the Christian Medical and Dental Associations of WNY and other sources.

In addition, grassroots fundraising efforts have proven successful. Through an art sale featuring handmade works by Haitian artists, along with numerous donations, first-year medical students raised enough money to send a group to Haiti and also buy needed medications for a clinic there.