Medical students get hands-on global health education

On any given day, medical student Tim Wetzel might be found delivering a baby or administering vaccines at a hospital or clinic in rural Maasai Mara, Kenya. His month-long rotation, provided by Ohio State’s Global Health Elective program, included a wide range of clinical opportunities. “We visited rural schools to provide medical education, deworming medication or vitamin A,” he reported. “We set up mobile clinics, where we would assess patients and prescribe medications or refer them to the hospital if needed.” He assisted with C-sections, did checks on laboring mothers, and resuscitated neonates. In inpatient wards, he placed IVs, administered medications, and performed ultrasound tests. He also worked in an outpatient clinic, doing sutures and injections, and helping diagnose conditions.

It’s a global world, and every physician knows that disease knows no borders. The Global Health Elective (GHE) is offered to fourth-year medical students by the College of Medicine’s Office of Global Health. It’s a unique clinical experience in a low-income and low-resource country. Students have the opportunity to perform hands-on clinical work under the supervision of, typically, an in-country physician. They receive credit and funding for the elective, but the experience provides much more than that.

A life-changing experience

 "Besides the different types of medicine that we were exposed to, I think it was extremely important to see how a low-resource hospital operates. We had to learn to make decisions with limited information—no STAT labs, no CT scans, limited medical history, etc.—which is an extremely valuable skill, especially for my field, emergency medicine.” He found the opportunity to experience a new culture equally valuable and plans to do another GHE rotation during his upcoming residency at the University of North Carolina. “The people of the Maasai Mara were so welcoming and so appreciative of our care,” he said.

Dr. Diane L. Gorgas, executive director of the Office of Global Health, said the GHE is a fantastic opportunity for students. ”The program has been associated with students choosing residency training programs and subsequent careers that serve socio-economically disadvantaged patient populations,” she noted. ”The experience is a pillar of an education that enhances not only the medical school curriculum but contributes to long-term career satisfaction.”

By April 2019, 73 students had taken the elective in 15 countries on three continents—the largest group of GHE’s in one year to date—42 percent of a class of 174. To participate in a GHE, students first choose where they would like to go, usually through an affiliated institution. Once the elective and location are approved, they submit learning objectives to the Office of International Affairs. Returning participants then write a detailed report on their experience.

Learning from patients

Ariana Prinzbach recommends the GHE program to every medical student. She traveled with seven other students to hospitals in Tanzania and Zanzibar, sampling different specialties. “We saw unique pathology, much of which was very advanced, and different anesthetic techniques and airway and vitals monitoring practices,” she reported. In Zanzibar, she assisted in intubating patients, monitoring vitals, and putting in lines while learning their anesthetic approach to cases and helping monitor pre- and post-op patients. While in Dar es Salaam, she also worked in the pediatric oncology ward. “It was called ‘Upendo,’ which means ‘love’ in Swahili,” she said. “We saw kids with very advanced presentations of nearly every type of cancer. I not only got to know some of the kids well by speaking with them every day, but they also would teach me words in Swahili and about their culture.

“We’ve gained better perspectives on how economic disparities and cultural practices can affect patient care. We saw numerous problems that were fixable and, due to lack of resources (such as lack of blood donation and available blood to transfuse), would take complex educational and institutional changes to solve. We made lasting memories and I know each of us will bring this experience with us when we start our residency training.”