Not doing Fulbright...can I still mention it?

[Mad Jack]

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I put in a transfer request but the likelihood of them being able now to find me a placement is low.

I still have hopes I might be in a safer area, but I accepted a job offer here in D.C. about a week ago. My chances aren't great.


And also, all of these arguments are really useless. If you could avoid getting a disease, wouldn't you? Being a physician (and all the occupational hazards that go along with it) is in no way comparable to living in an area with an endemic, incurable illness.

Your risk of getting that incurable illness is, as SS noted, not nearly as high as you believe it to be. Conversely, your risk of acquiring an illness in the hospital is far higher than you believe it to be. I've been on PEP, and had to hope that I didn't acquire HCV since the patient had an incalculably high viral load and there is no PEP for that. I'm colonized with MRSA, and have had several infections secondary to it that have required courses of antibiotics, one of which nearly landed me a hospital admission. And then there was the swine flu- I never got it, but I saw a lot of patients die from it. I saw people in their 20s and 30s die in front of me, and any one of them could be me. Oh, and the multi-drug resistant tuberculosis patients... If your N95 mask is on a bit funny, you're face to face with someone that's coughing some of the deadliest, hardest to treat bacteria in the world right in your face.

Again, I don't fault you for not going. I'm just making sure you've got the reality of what you'll be doing and dealing with during MS3, MS4, and residency down. Because it's actually way worse than you'd expect, and we're a lot less adept at treating and stopping the spread of many of these infections than you'd imagine.

 

[Snakes]

I am convinced that the OP has seen the one pic I can always remember as the example of elephantiasis in my biology books. The men in my classes always totally and completely freaked out over that picture. Not linking it here but it was pretty amazing and I'm sure could easily be googled.

 

[Mad Jack]

I am convinced that the OP has seen the one pic I can always remember as the example of elephantiasis in my biology books. The men in my classes always totally and completely freaked out over that picture. Not linking it here but it was pretty amazing and I'm sure could easily be googled.

You'd need elephant-sized balls to take on the risk of ending up like the guy in that picture...

 

[ridethecliche]

Speaking of reading things into my posts that weren't there. What I actually said was that the OP didn't understand the epidemiology, incidence, pathology, or treatment of the disease and therefore his claims, particularly the 10% claim, was absurd:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1405918/

Thus, it appears that the course of filarial infection in individuals who have not been previously exposed to filariasis is that of quantitative clearance without the development of patent infection. In those instances where the infection is of a limited intensity and duration, as in the case of American GIs, it appears that the disease does not develop and these individuals remain clinically normal for the rest of their lives.

(Note that this historical data was in completely untreated individuals)

Hah, interesting. I wonder if they've done an incidence study looking at relative risk between people of different ages to see how long of an exposure is required to get a load large enough that the body can't clear it and that it leads to a chronic issue.

Ok, that's your research. I still wouldn't give it more credit that an email from the Fulbright committee telling me to reconsider, isn't that a matter of worry? When in a small village of 250, 28 people have been infected over the past 4 months.

And @Goro, while practicing in America, I'm fine with having that risk, because there are facilities available, and adequate healthcare.

In the country I'd be in, I'm literally in a village, and even the closest hospital is a flight away.

Translation: GTFO with your science!

 

[LizzyM]

Hah, interesting. I wonder if they've done an incidence study looking at relative risk between people of different ages to see how long of an exposure is required to get a load large enough that the body can't clear it and that it leads to a chronic issue.



Translation: GTFO with your science!

I looked at "Up to Date" a online resource we have for the latest medicine information (basically a constantly updated text book of everything medical) and there is a specific section about "ex-pats" and people who live in such areas for relatively short periods of time but who were not born & raised there. "●Travelers and expatriates usually have insufficient exposure to filariasis to develop the chronic complications of infection observed with high worm burdens."

There is a lot more to the life cycle of the worms and immunological responses to infection than I can go into here but it is a fascinating topic. It does seem to take more than one mosquito bite to get you into trouble.

 

[NeuResurgens]

The danger of Ebola didn't stop many of the selfless doctors and other healthcare providers from answering the call to go and help its victims.

I don't think it would look good to Adcoms if you opted out of a Fulbright because you were scared of a local disease, and then still tried to claim the Fulbright acceptance on your resume.

You'd undoubtably have to state your reasons for not participating and your reason probably wouldn't go over well.

 

[philosonista]

This forum is spinning the drain of where soooooo many medical ethics conversations go. As a philosophy major, I must say that this gets old.

But newsflash: Doctors do not all have to be saints, just like all teachers need not be saints. We paint these occupations with angelic moral standards and it's weird. Why can they not be just like the rest of us? Why do we paint other workers as subjects purely calculating their gains exchanged for their obligations and responsibilities and we're fine with it? We say the plumber is an ***hole if he doesn't go out of his way to please us, but we don't say, "He hasn't the character to be a plumber!"

How much of a risk it is for a foreigner to contract the disease vs. what the OP perceives is a separate issue. Let's go with the OP's belief that he is at high risk of contracting the illness.

What matters is what OP should be willing to sign up for, and, since we are extending this to doctors, what a doctor should sign up for in terms of risk. If you want to be a doctor in general, you must go into it knowing that you are going to be at risk of catching various illnesses and other risks. But let's entertain the idea, which I suspect is backed up by fact, that that risk is marginal. Perhaps OP is willing to sign up for that and he should be willing to accept it if he wants to go to med school. He has to live up to those expectations.But lets also suppose OP specializes in a field for which there is a huge (>= 10%) risk of contracting, say, HIV for a seldom done surgery done on HIV patients. And the surgery is so seldom done that he has never heard of it before he enters residency. You cannot then, in my eyes, expect him to take on such a case, because when he took on the roll of a specialized physician, he didn't agree to that level of risk when he entered the field. OP can refer the patient to another doctor and encourage researchers to find a way to minimize the risk.

Can doctors be saints? Sure! Great! Do they have to be? Only to the extent that they signed up for it knowingly. OP didn't knowingly sign up for the risk involved in the Fulbright and I suspect the risk most doctors put themselves in is less than what OP perceives to be the risk of contracting the illness.

And, as a side note, as a die hard utilitarian, if being a doctor is about promoting good in the world, what good in there is having no net gain when a patient lives and a doctor dies?

 

[ridethecliche]

I looked at "Up to Date" a online resource we have for the latest medicine information (basically a constantly updated text book of everything medical) and there is a specific section about "ex-pats" and people who live in such areas for relatively short periods of time but who were not born & raised there. "●Travelers and expatriates usually have insufficient exposure to filariasis to develop the chronic complications of infection observed with high worm burdens."

There is a lot more to the life cycle of the worms and immunological responses to infection than I can go into here but it is a fascinating topic. It does seem to take more than one mosquito bite to get you into trouble.

I actually applied to work for them a few years ago. Hah! We used to use it in the last clinic I worked all the time.

I think OP has a greater risk since they're going to be in the field for 9 months. That's not insignificant.

I got malaria after missing one dose of my meds. And I apparently tested positive for west nile after being in Boston. So **** happens.

I don't blame the OP entirely here since there's no real treatment out there. I do think they're overstating the risk though. C'est la vie.

 

[Old&InTheWay]

Thank god a philosophy major finally showed up. I was getting worried for a moment that this would not be resolved.

 

[Goro]

Newsflash: Doctors do not have to be saints; but OP needs to recognize that he is still at risk for a lot of nasty diseases (and conditions: PubMed depression and physicians) by being in NYC or Akron and not merely by being in Ghana for a short time.

Look out! Filaria!!! AAAAAHHHHHHHHHHHHHHHHHHHH!

This forum is spinning the drain of where soooooo many medical ethics conversations go. As a philosophy major, I must say that this gets old.

But newsflash: Doctors do not all have to be saints, just like all teachers need not be saints. We paint these occupations with angelic moral standards and it's weird. Why can they not be just like the rest of us? Why do we paint other workers as subjects purely calculating their gains exchanged for their obligations and responsibilities and we're fine with it? We say the plumber is an ***hole if he doesn't go out of his way to please us, but we don't say, "He hasn't the character to be a plumber!"

How much of a risk it is for a foreigner to contract the disease vs. what the OP perceives is a separate issue. Let's go with the OP's belief that he is at high risk of contracting the illness.

What matters is what OP should be willing to sign up for, and, since we are extending this to doctors, what a doctor should sign up for in terms of risk. If you want to be a doctor in general, you must go into it knowing that you are going to be at risk of catching various illnesses and other risks. But let's entertain the idea, which I suspect is backed up by fact, that that risk is marginal. Perhaps OP is willing to sign up for that and he should be willing to accept it if he wants to go to med school. He has to live up to those expectations.But lets also suppose OP specializes in a field for which there is a huge (>= 10%) risk of contracting, say, HIV for a seldom done surgery done on HIV patients. And the surgery is so seldom done that he has never heard of it before he enters residency. You cannot then, in my eyes, expect him to take on such a case, because when he took on the roll of a specialized physician, he didn't agree to that level of risk when he entered the field. OP can refer the patient to another doctor and encourage researchers to find a way to minimize the risk.

Can doctors be saints? Sure! Great! Do they have to be? Only to the extent that they signed up for it knowingly. OP didn't knowingly sign up for the risk involved in the Fulbright and I suspect the risk most doctors put themselves in is less than what OP perceives to be the risk of contracting the illness.

And, as a side note, as a die hard utilitarian, if being a doctor is about promoting good in the world, what good in there is having no net gain when a patient lives and a doctor dies?

 

[philosonista]

Newsflash: Doctors do not have to be saints; but OP needs to recognize that he is still at risk for a lot of nasty diseases (and conditions: PubMed depression and physicians) by being in NYC or Akron and not merely by being in Ghana for a short time.

Look out! Filaria!!! AAAAAHHHHHHHHHHHHHHHHHHHH!

We have to compare apples to apples. If you want to draw parallels between OP's opinion of this and his capacity to be a good doctor, compare the risks involved in contracting illnesses as a doctor vs. the OP's perceived risk of doing the Fulbright. Perhaps OP would knowingly and willingly accept the marginal risk in being a doctor, but not 10% risk he perceives to be at stake in the Fulbright.

It's also assumed that the risk of physician depression, sleep deprivation, other lifestyle risks of being a doctor are accepted by the OP as a pre-med. If not, well then, Hell yes, he has a lot more to worry about than the risk of coming upon Filaria.

 

[Hobakie]

This forum is spinning the drain of where soooooo many medical ethics conversations go. As a philosophy major, I must say that this gets old.

But newsflash: Doctors do not all have to be saints, just like all teachers need not be saints. We paint these occupations with angelic moral standards and it's weird. Why can they not be just like the rest of us? Why do we paint other workers as subjects purely calculating their gains exchanged for their obligations and responsibilities and we're fine with it? We say the plumber is an ***hole if he doesn't go out of his way to please us, but we don't say, "He hasn't the character to be a plumber!"

How much of a risk it is for a foreigner to contract the disease vs. what the OP perceives is a separate issue. Let's go with the OP's belief that he is at high risk of contracting the illness.

What matters is what OP should be willing to sign up for, and, since we are extending this to doctors, what a doctor should sign up for in terms of risk. If you want to be a doctor in general, you must go into it knowing that you are going to be at risk of catching various illnesses and other risks. But let's entertain the idea, which I suspect is backed up by fact, that that risk is marginal. Perhaps OP is willing to sign up for that and he should be willing to accept it if he wants to go to med school. He has to live up to those expectations.But lets also suppose OP specializes in a field for which there is a huge (>= 10%) risk of contracting, say, HIV for a seldom done surgery done on HIV patients. And the surgery is so seldom done that he has never heard of it before he enters residency. You cannot then, in my eyes, expect him to take on such a case, because when he took on the roll of a specialized physician, he didn't agree to that level of risk when he entered the field. OP can refer the patient to another doctor and encourage researchers to find a way to minimize the risk.

Can doctors be saints? Sure! Great! Do they have to be? Only to the extent that they signed up for it knowingly. OP didn't knowingly sign up for the risk involved in the Fulbright and I suspect the risk most doctors put themselves in is less than what OP perceives to be the risk of contracting the illness.

And, as a side note, as a die hard utilitarian, if being a doctor is about promoting good in the world, what good in there is having no net gain when a patient lives and a doctor dies?

I don't think the back lash the OP received was because he or she wasn't "saintly" whatever that means. The point they were trying to make was to refuse an award that would likely help an under-served population solely because of the possibility (not guarantee) of contracting a disease and to then try to use this to impress people who put their lives and well-being in danger every day is almost like a spit in the face. Unfortunately it didn't sit well with him or her when they got told the truth on the matter. Whether they or anyone else likes it or not putting yourself in at least some risk with various patients is apart of the job description. Doctors do it because not everyone can, all OP would have done by promoting the award is prove that they are just like the majority who can't.

 

[philosonista]

Thank god a philosophy major finally showed up. I was getting worried for a moment that this would not be resolved.

Squinting eyes to discern sarcasm from honestly.

Maybe I don't want to know the answer to that. God knows I've heard enough stereotype-fueled cracks about phil majors.

 

[Meowgical]

I made a pros and cons list and I think you should go!

PROS:

• You can talk about this ethical dilemma and the difficult choice you had to make in interviews or maybe in a secondary. This is a great opportunity! You can also talk about the lessons you've learned about disease, epidemiology, and how you had to overcome your prejudices and fears of a different culture.

• This also sounds like an excellent opportunity for meaningful research if you can get the right contacts and connections! You wouldn't necessarily have to find a cure while you're teaching but maybe you can hook up with someone at the WHO and write about cases in the area you're staying in (with all the proper permissions and paperwork filled).

• And if you DO end up sick you can write about that too!!!!!! Maybe you can even write a book! You'll be an inspiration to pre-meds across the globe.

• It might make a teaching Fulbright look that much more impressive.

CONS:

• When all is said an done, maybe this will be an experience to convince you if medicine is truly right for you! (Or maybe if it isn't...)
• You will have to try to not be exploitative through the process. Some people struggle with this.
• Might need to find a way to continue your contribution after you leave. You're worried about 9 months but some people have to live there all their life... If you abandon the place and never look back, your concern about the people in this location may come off as insincere.

I'm joking but only sort of.

 

[gettheleadout]

The needless rudeness in this thread reflects poorly on the community here, and only serves to confirm the stereotypes many people hold about SDN.

 

[IlDestriero]

This thread was good for a lot of laughs.

 

[packersfans]

Giving OP a hard time for wanting to mention the Fulbright they are not accepting, ok.

Riding the hell out of OP for not wanting to go to an area with a possible disease risk that is completely unrelated to the work they are doing. Jeez.

A lot of armchair quaterbacks in here.

 

[NeuResurgens]

I simply answered OP's question, which I think was sufficient - regardless of the ethical issues surrounding the degree to which doctors should accept risk, I don't think this reason for forgoing the Fulbright would look great if they still tried to put it on their resume (from a purely "Adcom opinion" perspective). I think that's all OP really needs right now

 

[tiedyeddog]

I don't know, a few people from my school that are declining mentioned it on their law school apps, so I was a bit confused.

Maybe you should apply to law school then? A major bonus is no risk of getting major disease, other than being one yourself to society.

 

[blueharbor]

The needless rudeness in this thread reflects poorly on the community here, and only serves to confirm the stereotypes many people hold about SDN.

This. I can hardly believe some of these comments. But given how many likes they received, I'm clearly in the minority.

 

[bonedoc5576]

I'm offended by the callous remarks of those who are in the business of training future physicians.
The mindset that you so glibly spout is an anachronism from the bygone era where harassment and brutality spewed down the ranks.
Hopefully the OP recognizes that his/her health and safety is priority one.
@Goro: For someone charged with training future MD's you demonstrate a shocking lack of compassion

 

[PantherPride]

I don't think the back lash the OP received was because he or she wasn't "saintly" whatever that means. The point they were trying to make was to refuse an award that would likely help an under-served population solely because of the possibility (not guarantee) of contracting a disease and to then try to use this to impress people who put their lives and well-being in danger every day is almost like a spit in the face. Unfortunately it didn't sit well with him or her when they got told the truth on the matter.

I'm pretty sure the OP realized early on in the thread that mentioning the fullbright was a dumb idea. Only reason they got defensive was because people were insinuating they wouldn't make it as a doctor based on his or her decision. I assume going through medical school the OP will get proper training and education for the handling of communicable diseases in the workplace, life-threatening or not.

 

[tiedyeddog]

Occupational death rate for physicians is roughly 17 to 57 per 1 million per year. Compare that to about 7-14 for lawyers or 1081 per 1 million for construction workers. CDC does admit that their numbers are rough estimates and need to be further studied. But let's stop acting like physicians are out there putting their lives on the line every night.

http://wwwnc.cdc.gov/eid/article/11/7/pdfs/04-1038.pdf

No one is talking about occupational death. HIV, Hepatitis, TB, etc don't kill people instantaneously, you'll figure this out when you actually see patients in the clinical years of medical school. It is the morbidity associated with those diseases that is the terrifying part. Plus, factor in if a physician contracts HIV it WILL alter his or her practice, maybe even force retirement. You are also ignoring the fact that if a medical emergency is declared and a city is quarantined, you know who still has to go to work? Medical professionals.

If a lawyer gets HIV they don't have to alert all of their clients about it, nor do they have to alter their practice in anyway.

 

[Goro]

Never, ever move to NYC.

I'm offended by the callous remarks of those who are in the business of training future physicians.
The mindset that you so glibly spout is an anachronism from the bygone era where harassment and brutality spewed down the ranks.
Hopefully the OP recognizes that his/her health and safety is priority one.
@Goro: For someone charged with training future MD's you demonstrate a shocking lack of compassion

 

[tiedyeddog]

I assume going through medical school the OP will get proper training and education for the handling of communicable diseases in the workplace, life-threatening or not.

Everyone does get training on it. Everyone assumes ALL patients and bodily fluid is infected, However, this does not prevent accidents from occurring.

 

[Chansey]

Not to be an obnoxious pre-med, but a Fulbright looks very, VERY impressive on an application. It's one of the most universally prestigious awards. If you decide to go, your Fulbright will net you interviews at Harvard, Yale, Stanford, etc. You'd be silly to give up this opportunity.

 

[tiedyeddog]

I'm offended by the callous remarks of those who are in the business of training future physicians.
The mindset that you so glibly spout is an anachronism from the bygone era where harassment and brutality spewed down the ranks.
Hopefully the OP recognizes that his/her health and safety is priority one.
@Goro: For someone charged with training future MD's you demonstrate a shocking lack of compassion

The problem we are having is OPs mindset. He/she expressed multiple times that it is fine from his/her point of view to be exposed to a transmittable disease while practicing as a doctor in the safety net of a tertiary medical center. This is a flawed mindset.

I became TB + as a medical student after being exposed, and thankfully was always latent, so I paid tuition just to get a disease that took months of treatment to be "safe". What if I actually had active TB? What if it was MDR TB? Just because you live in the US doesn't mean what you can catch is always treatable, or even manageable. I don't think OP realizes the seriousness of catching HIV or Hepatitis from a patient. You just don't take antivirals and continue on with your life. You have to alert all of your patients about it, and if doing procedures, tell them there is a risk they'll catch it. Not to mention the antivirals don't always work and they often have nasty side effects.

While training has become less brutal since you trained residents still have to treat patients with HIV, AIDS, and Hepatitis. You might have to do a LP on someone with presumed Jakob-Creutzeldt, one stick with that and you are DEAD. And just because you are a resident doesn't mean you can object to doing the procedure.

 

[tiedyeddog]

Not to be an obnoxious pre-med, but a Fulbright looks very, VERY impressive on an application. It's one of the most universally prestigious awards. If you decide to go, your Fulbright will net you interviews at Harvard, Yale, Stanford, etc. You'd be silly to give up this opportunity.

A teaching one does not look that great.

 

[LJN Ltd.]

Not to be an obnoxious pre-med, but a Fulbright looks very, VERY impressive on an application. It's one of the most universally prestigious awards. If you decide to go, your Fulbright will net you interviews at Harvard, Yale, Stanford, etc. You'd be silly to give up this opportunity.

Yeah, you're a premed. Applied yet? A teaching Fulbright is not a equivalent to a service Fulbright.

 

[RutgersAR]

Yeah, you're a premed. Applied yet? A teaching Fulbright is not a equivalent to a service Fulbright.

This point had already been addressed in the post above yours, and we can already see that Chansey applied because they have the tag on their username.

I will never understand some peoples need to mock others on the internet

 

[LJN Ltd.]

This point had already been addressed in the post above yours, and we can already see that Chansey applied because they have the tag on their username.

I will never understand some peoples need to mock others on the internet

You're right. I'm on my phone and wasn't able to see her profile unless I clicked it. We're not mocking. Just pointing out the general ridiculousness in the claim that a teaching Fulbright will auto land IIs at top schools, because...no.

 

[RutgersAR]

You're right. I'm on my phone and wasn't able to see her profile unless I clicked it. We're not mocking. Just pointing out the general ridiculousness in the claim that a teaching Fulbright will auto land IIs at top schools, because...no.

I'm not accusing tiedyeddog of mocking, there is a very distinct difference in the two messages. I'm not debating that you're point is incorrect, just that it came off as snarky.

Compare these two posts:

Yours: " Yeah, you are a premed. Applied yet? A teaching Fulbright is not a equivalent to a service Fulbright."

Simplified: "A teaching Fulbright is not a equivalent to a service Fulbright."

 

[Chansey]

Yeah, you're a premed. Applied yet? A teaching Fulbright is not a equivalent to a service Fulbright.

I did not know that teaching Fulbrights are not considered as impressive as research or service Fulbrights. I interviewed at some top schools this year, and quite a few candidates I met had done overseas research on a Fulbright grant, so I assumed the Fulbright name carried some weight.

And yes, I've applied and been accepted to med school. But good luck to you this cycle, hah.

 

[LJN Ltd.]

I did not know that teaching Fulbrights are not considered as impressive as research or service Fulbrights. I interviewed at some top schools this year, and quite a few candidates I met had done overseas research on a Fulbright grant, so I assumed the Fulbright name carried some weight.

And yes, I've applied and been accepted to med school. But good luck to you this cycle, hah.

Congrats on the acceptances. Thanks! Any luck is always much appreciated.

 

[MightBeACylon439]

I still have hopes I might be in a safer area, but I accepted a job offer here in D.C. about a week ago. My chances aren't great.

.

You want to be in a safer area...so you want to go to D.C.....while we're considering safer places for you to go I hear Baltimore is good this time of year.

 

[LJN Ltd.]

You want to be in a safer area...so you want to go to D.C.....while we're considering safer places for you to go I hear Baltimore is good this time of year.

Or Nepal

 

[NeuResurgens]

Maybe you should apply to law school then? A major bonus is no risk of getting major disease, other than being one yourself to society.

+1 for lawyer jokes! Malpractice attorneys are a scourge to the practice of American medicine.

 

[GoPens]

While its true that everyday physicians aren't constantly putting their lives on the line, they do still have a very real risk of contacting a serious infectious disease. The problem here is that OP would experience probably about this same amount of risk on this trip (with their risk coming mainly from mosquitos, as opposed to all the potential routes involved in clinical care), and seems to have a serious problem with it.

Yes, it does "only take one bite" from that particular infected mosquito. But as a physician, it only takes one accidental needle stick, one skipped handwashing, one one uncovered cough--all involving that particular infected patient. The risk of each of these is fairly small (though taken together, the risk gets higher), but I feel like if you have a big problem with the mosquito risk, you should seriously consider your risk as a physician. Sure, it is scary that the mosquito may bite you in your sleep and you won't see it coming. But in grad school I read a heartbreaking story of a physician who contracted HIV from an accidental needle stick in the early days of the HIV epidemic, and he sure never saw it coming either.

 

[youmed]

Instead of worrying about contracting the disease, I think it would be awesome if you can help the village to prevent the disease by establishing a long-lasting program there (i.e., making mosquito nets). I think Fulbright ETA is just more than teaching; it can be used as an opportunity to help the village as a whole. Personally, I think you are missing out on more than the prestige of the scholarship.

 

[Stumpyman]

Instead of worrying about contracting the disease, I think it would be awesome if you can help the village to prevent the disease by establishing a long-lasting program there (i.e., making mosquito nets). I think Fulbright ETA is just more than teaching; it can be used as an opportunity to help the village as a whole. Personally, I think you are missing out on more than the prestige of the scholarship.

I know a lot of Fulbright ETAs who also participate in research at institutions abroad. It's not entirely a "teaching vs research" Fulbright; you can do both and sometimes (although not as frequently) the research from an ETA might be more successful than a research grant in the same country.

 

[efle]

this thread
oh god my sides

 

[AllopathicApplicant]

So, I was particularly interested in this thread because I did peace corps, and specifically asked not to be in a south east asian country because I knew of former PC'ers that had contracted LF.

taken from the WHO website: "In endemic areas, chronic and acute manifestations of filariasis tend to develop more often and sooner in refugees or newcomers than in local populations. Lymphoedema may develop within 6 months and elephantiasis as quickly as a year after arrival."

OP, not to ensnarl you in another back and forth between some...very ill-informed people, but if I were in your shoes, I honestly would not go. Putting yourself in danger, as a basic human instinct, is always a solid NOPE.

 

[Narmerguy]

I think people are being a little hard on the OP, or perhaps holding him to a standard most doctors would likely fail at. It is enough that he is willing to treat patients who are sick, but without serious risk of himself contracting their illness. Certainly many of us will come into contact with bugs and diseases that will put our welfare at risk, but it is uncommon enough that few of us seriously have to worry about this, and when it does happen we make a big deal about it (e.g. when doctors die treating Ebola patients). While I would obviously prefer physicians willing to do their job even if it might increase their risk of exposure, the modern medicine in the developed world seldom demands this. I am interested in oncology and have no doubt that my readiness to commit fully to this path would be tested if I seriously faced some risk of getting cancer as a result of interacting with my patients.

 

[Salt Salt]

I think people are being a little hard on the OP, or perhaps holding him to a standard most doctors would likely fail at. It is enough that he is willing to treat patients who are sick, but without serious risk of himself contracting their illness. Certainly many of us will come into contact with bugs and diseases that will put our welfare at risk, but it is uncommon enough that few of us seriously have to worry about this, and when it does happen we make a big deal about it (e.g. when doctors die treating Ebola patients). While I would obviously prefer physicians willing to do their job even if it might increase their risk of exposure, the modern medicine in the developed world seldom demands this. I am interested in oncology and have no doubt that my readiness to commit fully to this path would be tested if I seriously faced some risk of getting cancer as a result of interacting with my patients.

This is a good point, but I would go even further---this was for TEACHING in a lymphatic filariasis-ridden area, not DOCTORING. OP said no to the risk/benefit ratio when TEACHING was the denominator, not doctoring. For me, that's a fair decision. Teaching is great but not worth necessarily putting your life at risk for; medicine is. For me at least.

 

[GoPens]

I don't think there's anything wrong with OPs decision to not go. Something like this is above and beyond the call of duty (especially given Salt's point about this being for teaching, not doctoring). So if they opt to not go, whatevs. My issue here is with the logic.

As for the "ill informed" posters, I think maybe we're just looking at the risk differently. I'm an epidemiologist, so I tend to look at this kind of thing from the population level and accumulated risk over time. There may be a burden of disease in that area, but the amount of risk for one particular person being in that area for a couple months wouldn't be nearly as high as for the general population who spends their entire life in the area. The risk involved in the short duration of the teaching deployment would likely be a bit in line with the risk assumed over many, many years of practicing medicine.

 

[AllopathicApplicant]

OP, not to ensnarl you in another back and forth between some...very ill-informed people, but if I were in your shoes, I honestly would not go. Putting yourself in danger, as a basic human instinct, is always a solid NOPE.

@SouthernSurgeon not to be aggressive, but if you aren't familiar with the disease why would you so vehemently support a notion that endemic peoples are more susceptible than non-endemic? Especially when the World Health Organization's idea is exactly the opposite.

Perhaps you aren't familiar with this but in aid worker circles, Elephantiasis is discussed regularly. I'd find it hard to imagined some having served as a peace corps volunteer, been a Fulbrighter, or given much time to Southeast asian medical missions and not come upon many discussions of this very disease. Maybe you haven't served in these areas. But then, why would someone who has no experience in this area of the world go about bashing someone on the internet when they themselves aren't aware of the magnitude of the problems this chronic illness causes? Because it's SDN.

OP, stick with your gut. Do meaningful work elsewhere. There is no logic in putting yourself in harms way, especially when the Fulbright Committee has communicated the threat of this illness with you. I would advise you to reach out to Fulbright and try to get a reassignment. I was able to get a reassignment through Peace Corps, so it's worth a shot!

 

[AllopathicApplicant]

I don't think there's anything wrong with OPs decision to not go. Something like this is above and beyond the call of duty (especially given Salt's point about this being for teaching, not doctoring). So if they opt to not go, whatevs. My issue here is with the logic.

As for the "ill informed" posters, I think maybe we're just looking at the risk differently. I'm an epidemiologist, so I tend to look at this kind of thing from the population level and accumulated risk over time. There may be a burden of disease in that area, but the amount of risk for one particular person being in that area for a couple months wouldn't be nearly as high as for the general population who spends their entire life in the area. The risk involved in the short duration of the teaching deployment would likely be a bit in line with the risk assumed over many, many years of practicing medicine.

I get that but it's well known that people who are newly introduced to the area have a higher risk of contracting Elephantiasis. Why this is, I'm not sure, I'll admit, I'm no expect on the mechanisms of the disease.

I'm surprised there aren't more Peace Corps people on this thread. I feel like we all get pamphlets upon pamphlets about this tropical disease when we get a SE Asia placement. Those pamphlets were the reasons I turned it down.

And WHO is a pretty reputable source, trustworthy for sure.

 

[GoPens]

I'm surprised there aren't more Peace Corps people on this thread. I feel like we all get pamphlets upon pamphlets about this tropical disease when we get a SE Asia placement. Those pamphlets were the reasons I turned it down.

This cracked me up a bit. Everything remotely involving public health seems to involve an ungodly amount of pamphlets.

You do have me wondering about that newcomers vs. residents thing now. It does seem odd. Maybe people from there have acquired some sort of resistance? Yet another reason why it would be nice if there was more research on tropical diseases.

I seem to remember reading in this thread at some point that this Fulbright program was only a few months (I lack the patience after an evening of studying to confirm). I still feel like the risk in a matter of months wouldn't be all that bad, but maybe I'm being a bit nit-pickey in my statistical reasoning. Accumulated over an entire career, the risk to physicians stateside is definitely there, but I guess ultimately, if the person volunteering overseas does not feel comfortable with it, they shouldn't do it.

The obvious solution here: let's all become awesome doctors and figure out how to cure or treat diseases like this so no one has to even worry about it.

 

[AllopathicApplicant]

This cracked me up a bit. Everything remotely involving public health seems to involve an ungodly amount of pamphlets.

You do have me wondering about that newcomers vs. residents thing now. It does seem odd. Maybe people from there have acquired some sort of resistance? Yet another reason why it would be nice if there was more research on tropical diseases.

I seem to remember reading in this thread at some point that this Fulbright program was only a few months (I lack the patience after an evening of studying to confirm). I still feel like the risk in a matter of months wouldn't be all that bad, but maybe I'm being a bit nit-pickey in my statistical reasoning. Accumulated over an entire career, the risk to physicians stateside is definitely there, but I guess ultimately, if the person volunteering overseas does not feel comfortable with it, they shouldn't do it.

The obvious solution here: let's all become awesome doctors and figure out how to cure or treat diseases like this so no one has to even worry about it.

Haha I had TWO binders for my pamphlets!