The Best Specialty for Medical Missions?

[SuckySurgeon7]

Hello all. I want to know what you think the best specialty is for doing medical missions. I really don't think a radiologist's training would be as valuable as family practice training, for example.

A friend of mine has a father who works full time in Africa. He did an Orthopedics fellowship and then a family practice fellowship afterward. He said that if he could do it all over again he would have done plastic surgery, since he uses it so much in the field. I just want a few more specifics, so I am wondering if anyone can tell me the pros/cons of FP, EM, IM, Gen. Surg, etc. when one is actually out in the field.

The two I really want to know about are FM and Gen. Surgery.

Thanks.

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[tideleonheart]

Honestly, in the mission field, you just need a well-rounded education in FM, OB, and Surg. Either FM or surg would probably give you a basis enough to obtain the other knowledge on your own. My school, VCOM, is currently starting a 5-year missions residency program that integrates all 3. You actually rotate through our missions locations in El Salvador and Domicin Republic (and one more I ca'nt remember). I think the 1st year they'll accept residents is 2012. I'm not sure if it's DO only or not.

 

[nlax30]

It's also going to depend on what sort of things you actually want to do, as in procedures, surgeries, or just general care clinic type stuff.

If you really want to do surgery medical missions then yea, look at Surgery, plastics, orthopaedics, etc...

If more general medicine clinic type work then FP, IM, EM would be fine. Last summer went to Jamaica for medical missions and we were there with a Family Practice physician and a Dermatologist and both focused on doing the sort of things that normally fell in their respective fields.

But there's a need for all sort of medical care around the world, so it's not like you wouldn't be able to help if you went into a certain field. Go into what you're interested and then use those skills when you go and help.

That said I would think fields such as FP, IM and even Derm may be a little more flexible as you wouldn't need the infrastructure compared to if you were going to do provide orthopaedic surgery help. We went to a small coastal town in rural Jamaica and the closest "hospital" was probably at least an hour away, and not always fully operational so it's not like you're just going to jump into a small village and start performing surgery.

 

[Kedan]

Radiology. It sounds weird but think about it.

 

[TexasTriathlete]

hair transplant surgery or breast augmentation

 

[Re3iRtH]

Radiology. It sounds weird but think about it.

OK I thought about it. Still can't think of a worse specialty for medical
missions than rads.

 

[crx7]

Unless, you could send some old X-ray and MRI machines to the third world countries, and then have the local practitioners send back the films for consultation while you're in the U.S.

 

[meliora27]

I hear OB/GYN's are useful. They can do a lot of the primary care stuff as well as women's health, prenatal counseling, deliveries, all that good stuff. I met a guy on vacation who does Peds Anesthesiology as well as being boarded in Critical Care medicine. He goes on missions to Ecuador and he can pass the gas for the surgeons as well as run to PACU once pt's are out of surgery.

 

[SuckySurgeon7]

I appreciate y'all's answers. I like the thought about OB/GYN; they receive surgery experience and can handle some of the important women's health and prenatal issues.

I am somewhat curious about the EM specialty being good at missions, though. I talked with my advisor, and he told me that EM was specifically for keeping people alive in emergencies, not for maintaining the health of the individual once he or she recovers. What are y'all's thoughts?

Also, I am curious if you all know of any missions teams that have a reputation for faith-based approaches. In other words, are there any missions organizations in which the physicians are allowed to pray and/or teach the people there, or do you mostly have to do anything of that sort on your own time?

 

[Bjams]

I'm taking a tropical medicine elective right now. The instructor does a lot of overseas work and mentioned that for those of us interested in working overseas, family med was the way to go. Also of note, we had a pulmonologist in talking to us today about his experience with tropical respiratory diseases. He had a couple CT scans, but specifically mentioned that doing that kind of imaging in his overseas work was very rare. He did show a ton of x-rays, though, and radiologists do interpret x-rays from time to time!

 

[Kedan]

OK I thought about it. Still can't think of a worse specialty for medical
missions than rads.

Are you sure? Maybe you're just not seeing it. I'd explain but I'm dead tired now so later.

Man, you're gonna be pissed when you figure this out.

 

[GeraldMonroe]

I'm guessing that the reason for radiology is that it means you could help folks in the third world without leaving your house. No risking your life trying to bribe your way past a 15 year old kid manning a checkpoint and holding a loaded AK-47. No worrying you might contract a drug resistant variant of the many, many diseases that are rampant in the third world. Or worse, a disease that no treatment exists for at all, such as Ebola. No complaining about the heat or lack of internet...

Then again, since you never see the patients you are doing reads on, it probably feels a lot like work except less pay. It might be simpler to assuage your feelings of guilt by donating money.

 

[chiz2kul]

I'm guessing that the reason for radiology is that it means you could help folks in the third world without leaving your house. No risking your life trying to bribe your way past a 15 year old kid manning a checkpoint and holding a loaded AK-47. No worrying you might contract a drug resistant variant of the many, many diseases that are rampant in the third world. Or worse, a disease that no treatment exists for at all, such as Ebola. No complaining about the heat or lack of internet...

Then again, since you never see the patients you are doing reads on, it probably feels a lot like work except less pay. It might be simpler to assuage your feelings of guilt by donating money.

?

 

[GeraldMonroe]

You're probably right. It probably isn't that bad. There must be unpleasant aspects though, and there is probably more risk than staying home.

 

[DrJosephKim]

I've gone on a few medical missions trips. The most useful specialty is family medicine. If you're in a group/team, then IM, peds, and others general specialties are great. Finally, there are huge needs for general surgeons.

Having said all that, there are specialty teams that go out and fix cleft palate, do orthopedic surgery, etc. So, there are still roles for subspecialists

 

[AmoryBlaine]

The best way for you to contribute to international health is to pick a field that you love and then make it work. The ability to work in 3rd world countries is an extremely poor factor to have on your specialty decision tree.

The other excellent factor is to be open to the idea that your trips overseas have very little impact. I mean I would think that if you go into radiation oncology, make $500k/year (definitely possible in a smaller city) and donate a bunch of money to the Red Cross or some other such organization over the course of your career you're going to have ended up doing an impressive amount of good even though you won't have sweet digital pictures.*

 

[justdoit31]

The ability to work in a 3rd world country is actually a HUGE factor to me because it has been my goal throughout life- maybe not full-time but at least annual visits...

I was actually talking to a Peds Hem/Onc attending about residency and missions early this week- she said basically any specialty will work... she does missions a lot and just reviews the basics of family med before she goes. She said obviously she can't diagnose and treat hemophilia or leukemia in a 3rd world country but the stuff you will see is basic (like Diabetes, hypertension, or AIDS) or strictly location specific (malaria, typhoid, etc.) so reviewing the basics is the key...

She advised me not to do a Med-Peds residency (I was thinking it might make me better prepared for missions) and when I checked the doctors without boarders website I did find plenty of opportunities for pediatricians.

 

[bodonid]

Radiology? I don't get it.

I don't think you have to be that "good" or in one particular field to help out. I think the main thing is making sure that you actually do it when you are in the position to. Once you have the capacity to make money and pay back loans, I am sure it would be difficult to pack it up and go to Mexico city or Somolia or something.

 

[deuist]

I just got back from my 4th medical mission. I think you'll be fine with any specialty as they're all needed: ob, FM/IM/peds/EM, and surgery. You can also try a fellowship in international health. I've worked with a few fellows in the past and have always been impressed. The fellowship gives you an MPH and you spend two years traveling around the globe.

 

[rmcusc]

I have been on multiple foreign missions trips. The best specialty for missions work has to be family medicine. Family practitioners can handle anything that you will see on a missons trip that could possibly handled. There are some surgeries that can't be done, but there ussually aren't facilities to do those surgeries anyway. OG/GYN is out, because family practitioners are trained to do this, and because most countries have "midwives" that help with births. Births have been happening for generations without doctors. Most missions trips that I have been on, the people would rather have their babies delivered by the local midwife. I have been on missions trips with doctors of many specialties and the FP always saw the most patients and had to be consulted the most by the specialists. FP can calso do most basic "surgeries" that would be done on a missions trip, such as lancing abscesses, suturing and etc. FP is definantly the way to go for missions trips that do not have an advanced surgery center.

 

[RxnMan]

Hello all. I want to know what you think the best specialty is for doing medical missions...The two I really want to know about are FM and Gen. Surgery...

Staying there a long time, most useful = FM
Staying busy the entire time you're there = G Surg

FM can help all around from the FPs I've spoken to, and do a lot of good work, but the surgeons are busy all the time.

 

[asmallchild]

I'd vote FM or Gen Surg.

But I could throw in a vote for derm too.

(Warning, the video is kinda gross. Even for someone interested in pursuing derm for a career)

http://www.telegraph.co.uk/news/worldnews/1569156/Tree-man-who-grew-roots-may-be-cured.html

There are some amazing dermatological conditions out there. Many of which derm residents would only see via textbooks if it weren't for these opportunities to travel and practice.

 

[bodonid]

Are you really considering Mexico a "third world country"?

To start off- no offense intended.

pretty sure the OP wasn't consciously trying to make that association, but I will. I have been to one of the poorest cities in mexico, and based on my own personal judgement I'd say yes. There were many people starving and virtually absent medical care. Hillside shacks made of trash... a million people but you've never heard of the city because everyone is destitute.

The term "third world country" is dated, but for what its worth in popular culture, I'd say mexico is "developing"... "3rd world"... whatever you want to call it.

 

[surftheiop]

what about ophthalmology, awhile back I saw some documentry on national geographic about an ophthamologist going to North Korea to do various eye surgeries. Seeing as eyes heal so fast seems like it could be an ideal specialty for doing surgeries in places with not much medical infrastructure.

 

[apricotattack]

To start off- no offense intended.

pretty sure the OP wasn't consciously trying to make that association, but I will. I have been to one of the poorest cities in mexico, and based on my own personal judgement I'd say yes. There were many people starving and virtually absent medical care. Hillside shacks made of trash... a million people but you've never heard of the city because everyone is destitute.

The term "third world country" is dated, but for what its worth in popular culture, I'd say mexico is "developing"... "3rd world"... whatever you want to call it.

Since we have none of these things in the US...?

Oh wait, yes we do. So that settles it: both Mexico and the US are "third world"

Regarding specialties: marry another med student, one of you do FM, the other do EM, and make sure you both know how to do C-sections.

 

[bodonid]

Since we have none of these things in the US...?

Oh wait, yes we do. So that settles it: both Mexico and the US are "third world"

I know nothing of poverty or of third world countries. I know little about poverty in our own country. But there is no reason for you to call me out. I was stating an opinion.

we don't have entire million-person cities made up of poor people. And no, before you decide to get smart, Detroit doesn't count.

 

[apricotattack]

I know nothing of poverty or of third world countries. I know little about poverty in our own country. But there is no reason for you to call me out. I was stating an opinion.

we don't have entire million-person cities made up of poor people. And no, before you decide to get smart, Detroit doesn't count.

Most big cities around the world have a lot of poor people, and some rich ones (even in the poorest of countries) - just like our cities. We just have more middle class people, too.

Sorry if I was harsh... I just always think it's strange when people call Mexico 3rd world, etc. They aren't generally classified as such on a nation-level, though certainly some cities and much of rural Mexico is still "developing."

 

[Bleurberry]

Most big cities around the world have a lot of poor people, and some rich ones (even in the poorest of countries) - just like our cities. We just have more middle class people, too.

Sorry if I was harsh... I just always think it's strange when people call Mexico 3rd world, etc. They aren't generally classified as such on a nation-level, though certainly some cities and much of rural Mexico is still "developing."

I feel you. I don't think the term is reflective any longer - it's outdated.
But Mexico is a country in crisis. I hope we legalize soon so the wars and corruption can subside.

 

[SleepingJune]

When people think of Third World countries, they typically think economic weakness, underdeveloped infrastructure, and very poor health/sanitation standards.

I agree the term "Third World" country is outdated, since it's original meaning was derived during the Cold War (First world being Western/capitalist US and allies, Second being Eastern bloc/Soviet allies, Third being the countries that were politically non-aligned. Yes, Mexico was considered a 3W country at the time.).

Skip to post-Cold War era, when many countries in Africa, Asia, and Latin America were struggling through post-colonial restructuring, and the term "Third World" country eventually began to be connected with those (and many other) states not because of politics, but because of the characteristics I listed at the beginning of this post.

The UN now terms the poorest countries LDC's (Least Developed Countries), and has very specific economic and structural criteria - all of which must be met - to be labeled as LDC. Mexico, even though it understandably has downright awful areas, is not on the UN's current list of LDC's.


Anyhoo, didn't mean to run off on a tangent. My original question...I'm interested most in anesthesia. I keep seeing that surgery is pretty in demand; would I make a correct assumption in thinking that MDA's would be just as welcome overseas?

 

[Blesbok]

Family medicine with OB training or general surgery (with the ability to perform CDs)

 

[Preop]

in college, i spent a few weeks with some plastics surgeons, anesthesiologists, nurses, etc at a medical mission on colombia where they operated on several kids with cleft palates and other smaller facial malformations. it was awesome. i think its definity something i'm considering.

 

[badasshairday]

I'm surprised that no one mentioned Opthal yet. I think it is something like 80% of blindness in the world is due to cataracts. Become an opthal, go to a small village in a developing country, pull out cataracts, and make the blind see... sounds pretty cool to me.