Chris Hamerski, MD, a third-year resident, was nervous. In Uganda with the Global Health Scholars Program at the University of California, San Francisco (UCSF), he and a fellow resident were scheduled to accompany a physician and a social worker on a Hospice Uganda home visit.
Now back at UCSF between shifts on his current inpatient rotation, Dr. Hamerski recalls his reluctance: “Going into someone’s home is such an intimate experience, and I was a little worried about how we were going to be viewed.”
He needn’t have worried. Despite the startled reactions from young village boys who stopped in their tracks and put down the water jugs they were carrying to stare at the visiting Caucasian doctors, the patients were “very welcoming and gracious, and happy that someone was there to look after them,” he says.
In addition to his time with Hospice Uganda, Dr. Hamerski also worked at Mulago Hospital in Kampala and the Reach-Out Mbuya Clinic, set up to serve patients with HIV/AIDS. “I found the clinic to be very uplifting and inspiring,” he says. “I think it actually works better than clinics in the U.S. because it was an all-in-one clinic, with a holistic approach to the patient.” Not only do patients see a doctor and obtain refills on the spot of their antiretroviral drugs, he explained, but they also have access to a social worker and can obtain money to send their children to school or a micro-loan to help start a business. “It was definitely inspiring to see patients living with HIV doing well in the community,” says Dr. Hamerski. “It made you feel that the clinic was making a difference and having a positive effect on the health of the community.”
Hospitalists, residents, and directors of global health programs stress that international health experiences not only broaden physicians’ perspectives but improve their approach to diagnosis and use of resources when they return to working in U.S. hospitals.
“In their one-month immersions, people have the ability to see and effect change in a more direct way,” points out hospitalist Madhavi Dandu, MD, MPH, assistant clinical professor of medicine and director of UCSF’s Global Health Scholars Program for the Internal Medicine Residency.
Nearly 60% of American medical schools offer global health electives, according to a 2004-2005 survey by the American Association of Medical Colleges—and demand is increasing. The value of a stint abroad for any physician is irrefutable, says hospitalist Tracy Minichiello, MD, who founded the UCSF Global Health Scholars program.
Dr. Bui
Dr. Hamerski chats with a patient at a clinic in Uganda.
Dr. Hamerski chose to do the global health elective because he wanted to “be more excited about medicine. At the end of residency, it can be a little hard to keep that positive outlook.”
Residents and physicians who complete international health elective courses (typically lasting one or two months) say the experience can greatly influence career choice. Many participants choose to practice with underserved populations or go on to specialize in global medicine.1 But even physicians who do not continue on to a career in global health reap huge benefits as practitioners.
Dr. Dandu has experienced those benefits, both as a resident and now as a visiting director of programs. Through participation in global health electives, she observes, “there is a palpable rejuvenation that occurs, a reminder of some of the enthusiasm that comes from practicing medicine with a little less of the structural issues that make the U.S. healthcare system difficult.”