Any resources that site the most needed specialty in the developing world? Please post! Thanks!
Most needed specialty in developing world
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I don't have any proof of this, but I think that family and surgery would be the ones of most use.
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Family with OB
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I would assume family with some extra specialized training......
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Sort of related question to this thread -- is there any need for EM physicians in developing world? I really want to do medical outreach when all is said and done, and it will probably affect my choice of specialty (i.e. rads/path are probably out of the question!).
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probably, but EM is too specialized and there's enough overlap with generalists. world's biggest killers are still cardiac disease, infectious diseases (malaria, cholera, TB, HIV...), malnutrition, maternal death. communicable & noncommunicable disease were the causes for 90% of premature mortality in low income countries, and 78% of premature mortality in middle countries vs only 10% of premature mortality in low income countries, 22% of premature mortality in middle income countries being caused by injuries. so, highest impact, potentially, is through preventive medicine services + knowledge of internal med, peds, OB, or an attempt at this, ie, Family Medicine w/ OB. look in WHO 2010 for your country of choice
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1) preventive medicine/public health >>> family medicine with minor surgical skills > surgery, OB, EM > most other things
2) prevent the brain drain from the 3rd world
check out http://www.msf.org/ for an example of needs under their volunteer page. they currently are recruiting for extra ppl in surgery and gas, but I am guessing that is more of a reflection of trying to do full-up for the traumatic events (e.g., Haiti) and the low number of these ppl over all in their organization.
2) prevent the brain drain from the 3rd world
check out http://www.msf.org/ for an example of needs under their volunteer page. they currently are recruiting for extra ppl in surgery and gas, but I am guessing that is more of a reflection of trying to do full-up for the traumatic events (e.g., Haiti) and the low number of these ppl over all in their organization.
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Yes, absolutely. I'm peds EM trained and have done a lot of work in the developing world (the flexibility of EM allows me to travel a lot). The extra pediatric training is a huge help in addition to the EM training because I can also deal with general pediatric issues (which come up a lot). I also have training in travel and tropical medicine and global health. I would highly recommend taking a course in global health/tropical medicine is you plan to work in the developing world.
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While I'm sure developing areas need lots of physicians (generalists especially), I would venture to guess that they need more infrastructure than anything. You could have a ton of physicians, but if the nearest hospital/clinic is miles and miles away, and you have very little in the way of developed roads or access to vehicles, then it probably won't matter much.
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There is a huge need for OBs in the developing world. You can get a sense of what's needed more than others by visiting Doctors Without Borders and see that they're urgently requesting OBs and surgeons.
EM is absolutely in need, but it's in less demand than the surgical fields partially because of the ease of EM scheduling. It's not nearly as difficult for an EM guy to get a few weeks off here or there to go overseas, it's not like he has a whole practice full of patients that are going to be pissed he left. OBs, on the other hand, are pretty committed to being with their patients 24/7, so if they took off for a month to go overseas their patients here would go bananas.
EM is absolutely in need, but it's in less demand than the surgical fields partially because of the ease of EM scheduling. It's not nearly as difficult for an EM guy to get a few weeks off here or there to go overseas, it's not like he has a whole practice full of patients that are going to be pissed he left. OBs, on the other hand, are pretty committed to being with their patients 24/7, so if they took off for a month to go overseas their patients here would go bananas.
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Most needed for a mission trip or most needed to establish a permanent practice somewhere?
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Dermatologists.
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This, albeit unfortunately. Lots of African medical missions are stymied because of the equipment problems.
Generalist are obviously needed, but I think EM is one of the biggest needs. How the developed world deals with serious injuries and big traumas is drastically different than the develop-ing.
I talked to a guy who did a mission in South Africa biannually. Patients would come in with roughly the same problems (he was an orthopedist), but the equipment he used and became skilled with here was non-existant there. Often times he would write the patient a list to take to hardware stores and pharmacies to buy supplies themselves (because doctors don't keep there own supplies there), and then make do with whatever they came back with.
Heard some very interesting innovation on his part, to say the least.
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Ah this is good to know, thanks! If I went into EM I was also thinking about doing the peds fellowship, so this is something I will keep in mind. For some reason I had this impression that EM docs would be ineffective, but it appears that this is not the case.
Thats true....physicians (esp quality phsicians)are needed the most in my region......unfortunately most of the newly graduating physicians find the job monetariy less rewarding (since physicians do not have any procedure that would fetch money....whereas all other specialities have something).....so either they go for further specialization or remain in "less demanding" jobs (like jobs as physicians in setups with not much "name".....lower the name lower will be the expectation)
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I've participated in a number of medical missions trips and the most needed specialist is a really good generalist who's willing to do many procedures. If you train as a family med physician in a non-urban, unoppposed residency program, you'll be well prepared for the types of things you'll face in developing nations.
So pretty much everyone is saying:
OB/FM/EM and possible some GS?
I'm interested to hear how people balance helping out while paying back 200k+ in loans.
I'm sure that the EM scheduling is pretty easy to work with, but surgery seems much more difficult to pay back loans while working and contribute to developing countries.
Would an EM physician pretty much act like a FM physician while on a mission? I would think there would be less trauma and more general issues to deal with.
OB/FM/EM and possible some GS?
I'm interested to hear how people balance helping out while paying back 200k+ in loans.
I'm sure that the EM scheduling is pretty easy to work with, but surgery seems much more difficult to pay back loans while working and contribute to developing countries.
Would an EM physician pretty much act like a FM physician while on a mission? I would think there would be less trauma and more general issues to deal with.
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Infrastructure infrastructure infrastructure. Also prevent brain drain. Short term help from well meaning American doctors visiting for a month in anything beyond an acute disaster need can actually do more harm than good. (you devalue any attempt at a local medical infrastructure)
It cannot be stressed enough that the way to help the developing world effectively is to help them help themselves. (teach a man to fish and whatnot) Its a super complicated subject though. (this is why you have people dedicating careers to trying to find solutions to this sort of thing and it still perpetuates)
If you want to work in the developing world I would have to agree with the people above that mentioned tropical medicine and preventative medicine.
It cannot be stressed enough that the way to help the developing world effectively is to help them help themselves. (teach a man to fish and whatnot) Its a super complicated subject though. (this is why you have people dedicating careers to trying to find solutions to this sort of thing and it still perpetuates)
If you want to work in the developing world I would have to agree with the people above that mentioned tropical medicine and preventative medicine.
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I've seen some short-term surgical teams that functioned very well--as long as they partner with an organization that can effectively do all necessary follow-up care. Surgical teams that come in, do surgery, and then leave without doing appropriate follow-up care can cause a lot of problems. Post-op complications need to be able to be recognized and dealt with.
For other specialties, I'm much less optimistic about the ability to do much on a short-term medical trip (and there is the potential for causing harm). I'm definitely of the opinion that if you're going to be involved, long-term involvement is important. You may not be able to live there full-time, but you can return to the same place, and work with the same people over time. Learning the local language and culture is really important. Connecting with local organizations is key. We should strive to work alongside and partner with local/national staff as much as possible. Get as much training as you can before going.
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I had this convo with my advisor recently and bottom line was everything, in reality, is useful. There's many more programs than DWBs and there's a lot more to IM than just generalists. Specialists are rare and hard to come by abroad and so can be a great thing to go into if you want to help. For example, peds endo seems specific, but it's one of the top needed docs because of the growing DM prob worldwide. Maybe there's soome fields (path, radio)--mostly ones that requires fancy things, but I wouldn't stress out too much about it. Opthalmo, GI, ID..
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yeah so it's not so much they need the specialists... it's more that they don't have even close to the same resources that the developed world has - I cannot name specifics but a couple of visiting residents spoke to our group the other day about how they (as hospitalists) just don't have the same drugs, supplies, etc. Cost is also a major issue with care in developing countries.
so I'm not sure why you want to know about specialists. I have no proof but I'm sure they could use more of pretty much everything but without the proper resources having specialists doesn't help too much.
so I'm not sure why you want to know about specialists. I have no proof but I'm sure they could use more of pretty much everything but without the proper resources having specialists doesn't help too much.
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ENT attending at my school goes on trips and does stuff like fixing cleft palates and removing H&N masses. Probably not the biggest need but definitely useful
When I was doing my rural rotation my FM preceptor left for a week on a mission trip and there were a few ortho docs going with hi,
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What type of training and courses are you referring to? Like 'certificates in global health', the masters programs at London School of Hygiene? Or like fellowships or other clinical training in tropical medicine and global health?
Piggy backing - there are orthos, uros, surg oncs (plus the usual usual suspects) that go abroad regularly. The ones I know go to the same areas/hospitals once (or more) a year and have been doing so for many years.
For me, I'll be doing my residency in ob/gyn as my base. I'm still thinking of ways to be most helpful in the Caribbean & Central America. You should think about what field you are most interested in and most passionate about. You should also think about the way you want to help - do you want to do relief work like after disasters or work on more sustained issues. Then you can look at organizations/hospitals that work on those issues ans see what type of expertise they need.
