snowinter said:
Hi Guys,
I'm going to graduate in 2006 with my MD. I want to take a year between med school and residency. I was thinking of doing something with DWOB but I read on their website to go as a physciian you have to have completed residency and be board certified. Also, they do not take medical students. I wonder if they would take me -- to help in some other area? (not as a physician -- since i wont be board certified/finished with residency by then)
I want to take a year break between med school and residency.
Has anyone done this before? I'm not interestedi n research programs , etc. Im looking into abroad options-- so I can return to all the idealistic reasons I came to med school to begin with -- before I venture into residency and get bogged down with life in general.
has anyone out there participated in doctors without borders who can give me feedback? I checked out their website - and the since its a saturday-- their q/a phone number is closed right now!
thanks for ur input!
snowinter!~~
Hi !
First: I'm not speaking out of personal experience, however a friend of mine did a 12 month service
with MSF, so here some thoughts based on our conversations:
It's pretty correct that medical students or even medical graduates without any residency
training (=experience) are usually not considered for any medical volunteer positions with MSF.
This is actually for very good reasons: usually physicians will be expected to practice with
very limited resources (minimal diagnostic tools, drugs, instruments etc.) and an
incredible amount of freedom.
I was told that this can be extremely challenging even for experienced physicians, who are
used to the goodies and luxury of the Western world of medicine.
Basically, MSF physicians are expected to be generalists, i.e. they will have to do whatever
comes their way. Also, physicians cannot expect to be able to delegate anything - for example, as
an anesthesiologist, you are preferably also able to maintain and even repair the few devices that
may be available (i.e. a perfusor).
Also, many complicated surgeries are still done without any backup by anesthesiologists, so it's
not uncommon that surgeons will not only have to do the actual surgery but also monitor the patient
and maintain general anesthesia, often using only one single agent like ketamine - all this simultaneously.
So, it should be quite clear why MSF will only accept applications of people who can ultimately
really
work under such circumstances, simply as there is usually not any time to actually
educate or even train anybody.
Unfortunately, this also means that MSF doesn't currently accept any applications of medical students/graduates
who'd wish to do a rotation or even part of their residency with MSF.
So, as a med school graduate there isn't much left that you could do if you don't happen to be also
qualified in any of the other relevant fields.
However, depending on your post graduate experience, you should check out the
MSF associations/webpages for different countries, as the actual requirements may vary a bit.
For example, some European MSF associations don't have such strict requirements, i.e.
you may be eligible to apply as a surgeon/anesthesiologist even without having completed
the corresponding residency, depending on the exact requirements they may also accept
physicians who want to interrupt their residency for at least 6 months, but who've at
least 1-2 years post graduate experience.
Actually, my buddy knows a physician who's been serving with MSF for quite a while now and hasn't
formally completed any residency since his graduation.
Likewise, physicians who aren't yet doing any residency training, can be eligible for the
position of a "public health physician" if they do have some general experience (i.e. surgery, peds,ob/gyn).
Your job as "public health physician" could come down to:
- determining potential and feasible improvements for the local health system
- planning and organizing the implementation of such improvements
- determinig the medical requirements (i.e. supply & demand of drugs)
- you might plan/organize and evaluate medical activities
- counselling, education and training of local health care workers
- doing relevant statistics (mostly epidemic stuff)
- implementing preventive medicine plans (i.e. vaccinations, education etc.)
- assess potential health risks, develop plans to face them
- plan/coordinate and supervise activities to fight epedimics
etc.
This is actually a short summary of the potential activities of a "public health physician"
that are outlined at some webpages of European MSF associations.
While the job of a "public health physician" doesn't formally require any type of completed
residency, your odds to be actually accepted for such a position are definitely better if you
do have some -and preferably very broad AND applicable-
experience
(i.e. surgery, peds, ob/gyn, tropical medicine, preventive medicine).
So, the general idea is again that you'll be most efficient if you do have at least some
basic experience in the relevant fields.
Hence, my suggestion would be to think about what you finally want to do, do you really want
to work for MSF, or do you generally want to do any volunteer service (abroad) ?
If you really want to work for MSF, I'd try to get in touch with 3-5 major MSF associations,
provide them with your background, experience (rotations) and your motivations.
If you're lucky, you might then be required to gain some more experience before they would
ultimately consider you eligible for the position of a public health physician.
On the other hand, if it doesn't work out this way and you don't have any other skills that
might be required, I would seriously think about dropping the idea about serving with MSF
right now, and consider some of the other volunteer organizations - that may not have such
strict requirements - so, if you're really interested in 3rd world medicine, there are many
other possibilities to actually go abroad and work under similarly challenging circumstances
(think about Africa, Mexico etc.) - usually under supervision.
However, as a medical student or even graduate from a western country, there can be an entirely
new problem: it is not uncommon that local health care professionals in 3rd world countries will
actually overestimate the level of your education and training because of your origin, so I've
heard various stories about some places in Africa where medical
students (on rotations !)
get asked whether they want to do an appendectomy all on their own, or if they'd like to take care
of the gen. anesthesia of the 5yr old pediatric patient (REALLY !).
Actually, in some places of Europe, these situations have occassionally even led to some sort
of "medicine tourism" to some 3rd world places where medical students hope to be allowed
to perform procedures that they couldn't do otherwise anytime soon, so this "trust" into
the abilities of Western medical students can be another problem if the aspiring physician
is way too eager to finally "practice", this may possibly also be attributed to the fact
that 3rd world physicians usually won't have to fear any lawsuits...
Well, apart from that it's actually good to finally read something about volunteer services
here on SDN.net, actually I find it kind of sad (even though understandable, given the
service/salary ratio) that organizations such as MSF aren't more popular amongst physicians.
Also, it would probably be really a good idea to actually strive to implement accrediation
of abroad services, so that services (procedures) performed abroad could eventually really
be counted towards rotation/residency requirements.
Hope this helps a bit, and sorry for any typos - way too tired now, to remove all of them