International Medical Education
Dan brings up a good question, what would an admissions committee think of
underserved US vs overseas international?
Need some opinions on this please. The perception of admissions is crucial
and is far different than my own personal impressions.
I know that overseas experiences tends to add a cosmopolitan flavor and a
well roundedness that may be of help.
I also agree that there can be some bad situations to avoid, especially for
those who are not experienced.
Regarding the personal impact of being overseas:
I have practiced in underserved areas most of my life in the US, rural and
urban.
My experiences in Haiti brought about a profound transformation in me
regarding distribution of wealth, health care, and more. I feel that my
best advice, scholarly works, and clinical work have been post-Haiti.
I never will forget the feeling of coming back to the US and dealing with
customs and seeing automatic weapons and dogs and people with the ability
to terminate my life immediately as opposed to life in Haiti where the
people were mostly wonderful, but even when agitated they did not have the
means to deal death to me. Despite material shortcomings in the worst way,
many had great spiritual wealth. In our country it seems that people are
materially rich but spiritually poor.
As a physician I think I seek opportunities to make a difference in ways
that I was unaware of before going to Haiti.
I do not think I would see the same hope in small colleges and local
education as leading to young professionals and eventually to restoration
of impoverished areas if I had not been overseas. I would not understand
what President John F. Kennedy mentioned in 1961 about the southern
hemisphere and the need to work with education, health care, and social
improvements to prevent hopelessness and a series of totalitarian
dictatorships.
Granted that it would be difficult to separate the Haiti experiences from
the Christian growth stimulated and the changes in my family and patients,
but Haiti clearly was a separation point for me.
I have given recent compliments to medical leaders for encouraging broader
admissions policies, but I also hope that they get a chance to visit
impoverished rural and overseas communities and experience health care.
Perhaps then they would understand that rural communities do not have a
"paucity of culture," but a different variety of cultures. They see this in
a great variety of urban cultures, but not having experienced this in rural
and other areas, they do not see it.
Perhaps they would understand that health care is a key component of rural
economics and that not admitting students who would return to rural
communities is taking away the very rural economics that they attribute
maldistribution to and is contributing to the demise of rural and
underserved communities instead of restoration.
Perhaps they would go to Mindanao and see that students selected from the
villages and prepared and taught in local medical schools would stay in
Mindanao 80% of the time instead of the usual Philippine medical school
where 80% of graduates go to other countries. One dean had such an
opportunity, but because of the unrest there, a faculty member was sent
(Asps, very dangerous, you go first - sorry, had to let an Indiana Jones
get in this)
Perhaps they would see the injustice of stealing physicians from other
states and nations through loans and scholarships and J-1 visa programs.
They would perhaps see that having a long term experienced physician in an
underserved area is better than a series of 3 year rookie physicians that
local people use less because they are inexperienced and not part of the
community. Right now, all they see is what their health policy people show
them. What they see with their own eyes would counter these suppositions
with reality.
These leaders are not bad or wrong, they have a "paucity of experience".
Overseas experiences can indeed be life changing, even just one!
Whether this same impact would be apparent in a student would be another
question, likely with personal characteristics impacting the same as with a
faculty.
Robert C. Bowman, M.D.
rcbowman@atsu.edu
Complimentary Experiences - perhaps rural, international, and local compliment one another
Many share the sentiment about staying in the US to serve and this is an
excellent calling for some.
Others wonder how much can be done in a short time in areas with great
needs.
People with gifts and talents must exercise these talents.
People in other countries have a great need for educated people, teachers,
those with knowledge of health and sanitation, etc.
People who serve need support and encouragement from those who visit, even
temporarily.
People with blinders on now or who could have them on in the future,
particularly those who intend to serve, need to have their eyes opened so
wide that material wealth or personal need could never close them,
something that high paying professionals can easily fall prey to in coming
years.
Serving in this country is limited by 1) all of the distractions 2) all of
the rules and regulations 3) the feeling that someone else or the
government will do it
There are risks in travel. There will be mishaps and bad times as well.
There are great rewards, however, and many will discover much about
themselves and what they value, now and in the future.
We decided years ago to send out residents in family medicine for 2 months
out of their 36. We send them away as somewhat immature learners. They come
back as practitioners. Getting away from the routine can certainly help the
maturation process.The CORE Program
Medical students interested in going to the smallest towns did twice as
much as their peers in every year of medical school in volunteering locally
and doing international missions or rotations. It would be interesting to
find out if they had already been overseas before medical school.
Rural Interested Students
rcbowman@atsu.edu
more later on why efforts are not a waste
I just want to let you know that I appreciated your comments on the
list-serve. We strongly encourage our undergrads to spend some time out
of our country, and we encourage our premedical students to participate in
medical missions.
Thank you for what you are doing.
Debbie Duke
(Chair, Health-Science Committee)
Deborah G. Duke
Harding University | Internet:
DDUKE@HARDING.EDU
900 E. Center, Box 10764 | Phone: (501) 279-4507
Searcy, AR 72149 |
I can think of some US schools such as New Mexico that might be a consideration.
I will also post your note on the international list serve in Family Medicine.
Also various schools work with certain countries or regions. If the student has
an interest in such a region or country, then she could hit the search engines
for articles about the missions and get to know people there. Just saw a medical
student, previously a lawyer, who is very good about touching all the basis to
get rotations, etc. He wanted to go to England but missed a deadline. He kept
sending emails and by chance emailed the chair of the dept of anesthesia in
Oxford and he will be going there next month. Your student needs to do some
searches and emailing in the same prospecting attempt, should our Health Prof
info not be enough.
Several responses to my request for info about a program that might meet her
needs in Israel:
From Family L listserve back in May:
Have a student interested in a 4 year MD program in Ben Gurion University in
Israel through Columbia University. The word that she has is that the education
has gone well, particularly the international and community health component.
She has heard that the students have not had difficulty getting residencies. She
is ultimately exploring an international or missionary career. She was
interested in any information about this program or other similar programs.
Would appreciate advice from colleagues in Israel as well as those program
directors who might be familiar with graduates.
Bob Bowman
rcbowman@atsu.edu
Bob - I don't know anything about the grads, but I had the opportunity to
visit BGU 3 years ago, and we've set up a senior elective with them. It's a
very impressive facility and faculty, several of which I had the chance to
meet, and chat with including via email since then. And, as you probably
are well aware, a very novel COPC-oriented school. I have to say that I
would be very supportive of an opportunity to study there from what I have
seen.
Rick Streiffer
Hi, Robert,
I did a site visit at Ben Gurion two years ago, and I was very impressed by
the students, the faculty, and the facilities. The students were extremely
involved, and participated in tent visits to provide medical care to the
Bedouin tribes nearby. This is a real university and has higher admission
rates than the off-shore Caribbean schools.
The concern voiced by the students that I met was the need for Hebrew much
sooner in the curriculum than they expected. They felt that intensive
Hebrew should have been taught immediately, and that it was difficult for
them to talk to patients who had no English. This was true even for
students who had roommates who spoke Hebrew.
While I was very impressed, I would not send a student there with the
current state of unrest.
Judy
One of the best residents we've ever had came to us after gradutating
from a similar program-- I think it was Sackler in NYC?--whereby he
did his clinical training in Israel.
--
Christopher W. Ryan, MD
We had an applicant from Ben Gurion University this year. He scored in the 90's
on his USMLE's. He interviewed very well. He was high on our rank list and
seemed to be among the best candidates we had ever seen. His profile sounds
similar to the student you are describing, as he did missionary work and showed
great promise in a humanitarian sense.
If she is anything like our recent candidate, I don't think she would have
trouble getting a
residency slot in Family Practice.
Peter
Dear Bob and othe FAMILY-Lers interested:
I'm the coordinator of the Family Medicine Clerkship of the MD Program in
International Health and Medicine, a MD program held in Ben-Gurion University,
here in Beer-Sheva, Israel, a program of BGU with Columbia University, New-
York. Next Thursday, we'll have our first graduation of MD's. This group is
realy special! They spend their fourth year in community world around the world
(mainly Assia and Africa)and they are VERY community oriented. From this first
group, about 80% are applied for residency programs in Family Medicine (I'm
realy proud, and I hope I have something to do in their carrier choice!!).
If you want more information, please contact me and I will ask the Program
Director to send you printed material.
Shalom from Israel,
Howard
Howard Tandeter, MD
Coordinator
MD program in International health and medicine
BGU
Beer-Sheva
Israel
You can contact me directly about this or you can give my e-mail address to
this student for more information.
howard@bgumail.bgu.ac.il
I know a lot about this program; I sit with their admissions committee. It
is serious and demanding, but certainly easier to get into than American
medical schools, and THIS year (is she a candidate for this fall?) both Ben
Gurion and Sackler are so hungry for applicants, it's a very great deal
easier. The first class graduates this spring and they did very well in the
match. They are a bright and cohesive group, carefully watched over. The
applicants need to have a clearly demonstrated concern for taking care of
underserved populations, particularly in the third world, and exposure to
this kind of work is also incorporated in their clinical training. The
student body is an interesting mix, mostly American, not nearly so heavily
Jewish, as one might have imagined or as is the case with Sackler, because
it attracts a large number of devout evangelical Christians, who are already
tied in through medical missionary experience or anticipation. We are very
careful with this group, some of whom are absolutely wonderful, and very
ready for the experience, but some of whom are so limited and provincial,
never having emerged from the comfy womb of their little bible colleges,
that one has to fear they will not be able to handle the contact with people
who think differently from themselves (apart from heathen to be converted).
Proselytising is also an issue. Kids whose primary concern is to spread the
gospel, with medicine merely a vehicle, are not really good candidates,
whereas those whose religious convictions have induced a very strong desire
to alleviate suffering in this world without regard to whether the patients
might choose to accept Christianity, and who are curious about other
viewpoints, do very well.
Patricia D. Geisler
Assistant Dean for Pre-Professional Programs
Columbia College and Engineering
Alfred Lerner Hall
2920 Broadway MC 2607
New York, NY 10027
Office Location:
B01 Carman
phone 212 854 8819
FAX 212 854 0042
pdg2@columbia.edu
Hope: Students From the Underserved, For the Underserved
Education - the entire pipeline