Voices from the Field 

After completing their clinical electives, residents are required to evaluate their rotation experience. Below are some responses from the partner site evaluation.

How did the experience affect your career decisions, if at all?
  • "Working in the Newborn Unit helped solidify my decision to pursue Neonatology as a career. I learned that I can incorporate Global Health into my life with this career choice."

  • "My career decisions were already made, but it was interesting to see endocrine cases and how they managed them in Kenya." 

  • "Reinforced my desire to continue pursuing a career that involves global health principles."

  • "Did not alter my career decisions, but useful to see stages of diseases I will encounter that I will very rarely see." 

  • "Affirmed my decision to pursue a career in emergency medicine." 

  • "I am interested in outpatient Gen Peds. There was good outpatient experience with hospital follow ups at Thika on Wednesdays and sick visits at Mulumba. Inpatient peds at Thika helped us to recognize sick/non-sick patients."

  • "I am very interested in global health and this experience solidified my goals to be involved in global health in my future career."

How did the experience impact your approach to and thoughts on providing care to U.S. families?
  • "This experience taught me to always put the patient and their health first, rather than catering to Press Ganey scores as we are often taught to do. Of course, it is always important to explain the condition and plan to the family, but treating the child supercedes all else."

  • "It made me more grateful to have the resources that we do and thankful that children here don't die from something as simple as dehydration." 

  • "I will try not to over-utilize resources while providing care. I will consider socioeconomic factors that play a role in health and healthcare."

  • "It helped me to realize the child is at the center of my care and the one I should advocate for. The 'doctor-patient relationship' is more paternalistic in Kenya, which is not appropriate for US medicine. However, it does help to remember that one must advocate for the patient instead of putting satisfaction scores or appeasing the family first, as can sometimes happen in the USA."

  • "I believe that this experience has strengthened my clinical skills and confidence. I also appreciate all the extra support and equipment that we have in the US."

  • "I realized there are many alternative methods to treatment and made me more mindful about waste." 

  • "While the practice of pediatric medicine is fairly uniform regardless of where I may be, the
    interactions with the community and hearing their stories and history reminds me the
    importance of being able to practice cultural humility and sensitivity, which is a skill I can apply
    to in my interactions with my patients back at home."

  • " Once a provider can better understand how a culture approaches health, it makes it more feasible to address the health concerns in the community in a respectful and impacting way."

Describe the nature and quality of your interactions with local health care personnel. 
  • "I loved working with international colleagues. In Thika, we became especially close to the medical interns. Towards the end of the second week, as they got used to our presence, we became friends. They taught me so much--I watched admit patients, put in IV lines, present patients to the attendings, and come up and implement a plan on our own. For a patient configured with the bubble CPAP apparatus, using their oxygen tanks and taught the interns to do the same." 

  • "We frequently interacted with local health care personnel and found the interaction to be very valuable on both ends. We learned procedural skills from them and we taught them many clinical medicine pearls. We learned about the Kenyan health care system and taught them about our system."

  • "With attendings: courteous and respectful. With fellow clinical interns: mutually educational and beneficial to daily work at the hospital."

  • "We worked closely with various members of the healthcare team--physicians, nurses, medical student, MOs, COs, etc. We helped with procedures, participated on rounds, devised management plans, and delegated tasks. Overall, it was a mostly positive experience, especially teaching various workshops to the students who demonstrated willingness to learn.

Describe lessons learned from your overseas elective, skills gained or enhanced.
  • "I gained confidence in doing bedside teaching for other trainees such as interns or COIs. I put in IVs in the preemies...and now feel more comfortable with NRP after running a real-life code for the first time."

  • "Too many to write in this space! Learned about the way medicine is practiced in a low resource setting. Learned to start therapies on physical examination alone and not waiting for imaging or lab work." 

  • "It is important to think outside the box and use resources you have available to care for your patient." 

  • "Better clinical skills, e.g. auscultation, less reliant on labs/imaging, better at IV insertions, and understanding relatively rarer disease processes, e.g. tuberculosis and rickets."

  • "Learning Helping Babies Breathe really well. Most lessons taught patience, resourcefulness, teamwork, and coming to terms with our mortality."

  • "Overall, the skills gained from this elective boil down to being given the opportunity to be put in a more independent role. Personally, I think my confidence improved and my ability to be put in a teaching role as well. Also was able to practice procedural skills quite a bit!"

In times of limited travel, can we still gain global health experience?
  • "I entered medicine hoping to work with the underserved and global populations, and that hasn’t changed, but the time-consuming nature of residency has forced me to put those goals on the back burner. This rotation has reminded me why I went into medicine in the first place, which is invigorating"

  • "The meetings with the providers from North Dakota also continue to be very enlightening and valuable additions to this rotation. Everyone has been very generous with their time, and I sincerely hope that providers in North Dakota also feel the sessions have been helpful for them."

  • "The Kenya sessions were enlightening, inspiring, and frustrating all at once – hearing about the differences in their healthcare infrastructure made me want to address some of their needs through my work in fellowship and beyond. Important concepts I learned revolved around that, as well as the lack of diagnostic resources available in Kenya that lends itself to a very different and heavily clinical scope of medical practice there. I don’t fully understand the interplay of politics and infrastructure involved in the current challenges we face in improving Kenyan public hospitals, and this is something I would love to dive deeper into so that I may one day hopefully contribute something to this multi-level problem."

  • "Still the most engaging part of the elective is the sessions with India and Kenya. It's fascinating to hear their perspectives and treatment algorithms in countries with different diseases and treatment processes than America. It gives me a new appreciation for what we have here. I very much enjoyed learning what they know about MIS-C and how they manage it in India. It was fascinating!"

  • "I especially enjoyed the meetings with the attendings and residents in India. Their introductions of each other always made me smile and reminded me of the beauty and importance of friendships along the challenging journey of medical training. Witnessing the strength of the lifelong friendships between the attendings makes me excited for the future with my co-residents."

  • "In the Kenya and India lectures, it was great to hear from physicians in other countries tell us about the various ways they practice. It made me realize the differences in pathologies and treatments there are from country to country in the way medicine is practiced. I learned that developing countries are greatly lacking in resources and cannot help but depend on medical aid from other countries, but this assistance can only be a short term fix, not a long term solution."

To read more about our residents' thoughts, visit our blog!