Published March 20, 2015
Seven University at Buffalo medical students spent their winter break building fundamental skills in a busy, makeshift clinic. In the process, they immersed themselves in the culture — and the many health care challenges — of the developing world.
In rural Fontaine, Haiti, the students helped care for nearly 400 patients in one week. They worked under the supervision of four physicians — a psychiatrist, an internist and two pediatricians.
“Teamwork was vital to the success of this trip,” says Lucy C. Holmes, MD, clinical associate professor of pediatrics. “We had a wonderful group who worked together and enabled us to see the large volume of patients seeking health care.”
“On these trips, first- and second-year medical students are all essentially promoted to third year,” says Vincenzo Polsinelli. The second-year medical student organized the trip with Holmes.
“We are responsible for eliciting the full patient history and performing the relevant physical to come to a diagnosis,” he explains. “Then we formulate a plan before we present our finding to the attending physicians for their input.”
“For most students, this is the first time they are able to work so independently with patients who are often very sick,” he adds.
The team saw patients with heart disease, diabetes, an abdominal mass, hypertension and cataracts. They also controlled bleeding for a motorcycle accident victim before he was transferred to a hospital.
For Polsinelli, Fontaine is a familiar and friendly place. He has helped people there on several humanitarian trips and spent most of last summer researching the prevalence of hypertension in the region.
One of the highlights, he says, was following up with patients he met last spring — like the 17-year-old with a loud heart murmur. “He might have died from heart failure in his 30s or 40s if we hadn’t discovered his condition and arranged for follow-up care,” says Polsinelli.
Several students responding to a post-trip evaluation survey said they learned a lot in a short time and built confidence in their abilities.
Students helped perform low-tech tests and procedures, including a lymph node biopsy and otoconia repositioning, a treatment for vertigo. But without sophisticated diagnostic aids and equipment that would be routine back home, they drew mostly from their own skill sets and knowledge.
“An experience in global health helps bring us back to relying on basic exam skills to make diagnoses,” says Holmes. “Medical students gain more experience in history taking and exam skills. At the same time, they gain an appreciation for the health challenges in resource-poor countries.”
Polsinelli agrees. “It really puts things in perspective for students training in a very high-tech, high-resource medical field like we have in Buffalo,” he says. “In Haiti, getting patients seen or arranging even simple tests requires weeks of contacting people across the country.”
The students also learned how to overcome language barriers and connect with diverse patients in all age groups.
The clinical associate professor facilitates experiences for medical students, residents and others who want to work with patients in medically underserved areas.
About one out of four UB medical students participates in an overseas medical program, Holmes estimates.
About 30 fourth-year students complete a four-week cross-cultural medicine elective each spring. Since the early 90s, more than 400 UB medical students have chosen this option.
Select family medicine residents also complete a focused global health scholars track.
The participants from UB were: