Which MD speciality would be the most "useful" in the Third World?

[vanelo]

Who wants to go blind?

Ophthalmology all the way baby!!!

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[epalantequevoy]

infectious disease (malaria, tb, and aids)

obstetrics and gynecology (maternal mortality is still a huge problem)

ditto. i live and work in a health clinic in a developing country and would agree that these are probably the two most useful specialties. in our general medicine clinic, i would say 75 percent of the patients we see are pregant women (as an aside, it´s not uncommon for women to have 7 or 8 kids), and a good majority of the others are infections.

general or ortho surgery would also be useful as we see lots of shootings and machete wounds, yet have no capability of real treatment for these people. for example, in the number one public trauma hospital, the lab can run 20 tests a day, there is no nursing staff to care for patients post op, there are chickens walking around the hospital lobby, there is no microsurgery or ability to put screws in legs, and the traction system they use is weighted with a rum bottle filled with water or sand. however, this is a PUBLIC hospital. there are plenty of good private ones, which unfortunately do nothing for those who need them most.

 

[maia]

Plastic surgery... I'm pretty sure it's primary care though.

Okay. I'm from the third world...PC: a perrenial "developing country" that sends its nurses to the US.

from my experience as a government doc's kid in an grossly understaffed, undersupplied(?), and all the "unders", government hospital and shadowing my mom there..and then...as a nursing student rotating in the communities of indigenous people (i think, this is similar to your "hillbillies"-sorry not PC)...
PRIMARY CARE... a lot of them need PRIMARY CARE...or community health...
but for those who want a short experience, say just weeks in the 3rd world, general surgery is helpful...lots of goiters, cleft palates, ortho cases...
general surgery because surgery is eeextreemeelyyyy expensive.... and the clefts repairs/construction--it's necessity is equated to that of cosmetic surgery--not very important for people who just want to earn money for 2 square meals the next day...
i hope this helps..

 

[lagringa87xc]

Id

 

[kdwuma]

i am so happy there is even a discussion on this issue. as a former UN volunteer ( 2 years) I am encouraged that at least there are people who think about the rest of the world, sometimes it feels lonely in the "i care world" I guess there is still hope for the world. As an experienced traveler and well versed person in this world here are my two cents
ANY DOC WILL BE NICE
THE PROBLEM IS ALL POLITICAL
THE DAY MOST PEOPLE BEGIN TO SEE THESE PROBLEMS AS OUR PROBLEMS, CHILDREN OF THE WORLD , NOT THOSE OR THESE PEOPLE...SOLUTIONS WILL COME. HOPE IT IS NOT TOO LATE.
i could bore you with details, facts and figures but i am soo happy to see that you folks even care that all i have to say is keep it up!

 

[burton117]

i am so happy there is even a discussion on this issue. as a former UN volunteer ( 2 years) I am encouraged that at least there are people who think about the rest of the world, sometimes it feels lonely in the "i care world" I guess there is still hope for the world. As an experienced traveler and well versed person in this world here are my two cents
ANY DOC WILL BE NICE
THE PROBLEM IS ALL POLITICAL
THE DAY MOST PEOPLE BEGIN TO SEE THESE PROBLEMS AS OUR PROBLEMS, CHILDREN OF THE WORLD , NOT THOSE OR THESE PEOPLE...SOLUTIONS WILL COME. HOPE IT IS NOT TOO LATE.
i could bore you with details, facts and figures but i am soo happy to see that you folks even care that all i have to say is keep it up!

kdwuma.. Where did you volunteer? I'd love to hear about it sometime. That's great that you are excited about the rest of the world's needs and have some exposure to the "real world" which is how the majority of the world lives.

It is always amazing to me to see the lack of responses to issues relating to the developing world. The evening news spends at least twice as much time on weather and sports as it does international issues.

I have heard the relative apathy referred to as the "new fridge syndrome." I belive it goes something like this: You come back from volunteering in another country where there are very few resources, and you find yourself telling your stories at the dinner table about countless lives being impacted by unbelivable things. After a while, your mom says: "That's nice, but did you hear that we got a new fridge?"

Hey - I'm not saying nobody cares. I'm just saying that not enough people do.

 

[Geronimo]

It just depends!

 

[blue2000]

I think it's important to differentiate what type of commitment you are asking from physicians. If you're thinking about medical mission trips, where teams drop in for a few weeks, and then pull out, the surgical fields (including OB-GYN) have high return in that they can do many procedures, do the follow-up and "solve" the problem (hence, why people love surgery). But if you're talking about long-term, actual change in health status in third world countries, ID/IM physicians would probably be the most helpful.

Really though, since so much disease is caused by water borne illness, to really improve health in so many areas, engineers are in many ways more valuable in preventing the illness that inadequate sanitation causes.

 

[burton117]

The needs of the poor needs to be looked at from the perspective of the poor. Regardless of a physician's committment, the impact is still going to be there. So, I was looking at this issue independently of the commitment that a physician would make.

Deciding what the most useful specialties in the third world are should be based on what would have the most impact over the same period of time.

Short-term or long term, the bottom line is this: Any physician can make a huge impact anywhere.

So, then... The question still remains: Which specialty would you choose to combat the needs of the third world most effectively?

 

[burton117]

bump

 

[CerealBox]

Infectious Disease

i agree

 

[mineshMD]

Coming from a third world country and talking with a chinese researcher that I work with in the lab, the most important thing a medical doctor can do for a third world country is to get a Doctorate in Public Health after acheiving a MD. There are three main aspects of disease that every great doctor should consider: 1. How to prevent a disease, 2. How to treat a disease, & 3. How the disease affects the body-internal pathways of the disease- and how the disease affects human populations. For third world countries, prevention of diseases should be a main concern. We are fortunate to live in a country where most infectious diseases have been contained or eliminated through vaccines and medications, while third world countries are not as fortunate. When there is a flood in China or India or Indonesia, one of the main pathogens that arise are parasites. A medical doctor should be aware of how to prevent parasitic diseases, otherwise with the quality and quantity of medicine in third world countries, it would be very difficult to treat patients that number in the thousands.

U of TN HSC COM '09

 

[PTPoeny]

I agree with public health.

My personal favorite is understanding the public health impacts of infectious diseases, but I'm kinda biased there.

 

[burton117]

Infectious Disease seems to be mentioned a lot on this survey... What are the requirements (residency length, etc...) to specialize in ID?

Does ID work through a lot of case studies of diseases in other countries? Or do they primarily focus on the diseases afflicting North America? I am curious about this one...

 

[gujuDoc]

Infectious diseases is a subspecialty of internal medicine.

So basically, you do 4 years of Internal med residency and then a fellowship in Infectious diseases. Try looking on the residency forums for Internal medicine and its subspecialties.

 

[sunnyjohn]

kdwuma.. Where did you volunteer? I'd love to hear about it sometime. That's great that you are excited about the rest of the world's needs and have some exposure to the "real world" which is how the majority of the world lives.

It is always amazing to me to see the lack of responses to issues relating to the developing world. The evening news spends at least twice as much time on weather and sports as it does international issues.

I have heard the relative apathy referred to as the "new fridge syndrome." I belive it goes something like this: You come back from volunteering in another country where there are very few resources, and you find yourself telling your stories at the dinner table about countless lives being impacted by unbelivable things. After a while, your mom says: "That's nice, but did you hear that we got a new fridge?"

Hey - I'm not saying nobody cares. I'm just saying that not enough people do.

New fridge... yes you nailed it my friend.

 

[gujuDoc]

I agree with Sunnyjohn, you hit it right on the nail with what the heart of the problem is.

As per Infectious Diseases, it is useful especially in the subtropical countries because many of the problems and diseases which exist there are those that involve bacterial, viral, or fungal infections. Most of which are categorized under Infectious diseases. Often times these are diseases that the US doesn't really come into contact with, but that exist in more native and rural areas of Africa, Asia, and the middle east or Central/SouthAmerica.

Things like TB or Cholera which are not of a problem to us, are the roots of many of the biggest problems in other countries.

So having a background in ID helps a great deal. But along with ID, surgical subspecialties help a lot in such situations because of their versatility in situations like childbirth or other major procedure based things that occur.

 

[doublepeak]

i'm surprised that im the only one, so far, who has voted for anesthesiology. According to MSF, MDA's and surgeons are the only ones who will be given special consideration for shorter terms of service due to the shortages of their respective specialties.

I was at an informational session from MSF while in South Africa. MSF is an emergency organization. They go into areas of conflict or otherwise severe crisis that will have an end date. The representative said that their work in the Western Cape is the first time that they have served a community without a specific end-date (they are providing ARV's, which require lifelong commitments); all other projects are not for the long term sustainability, just immediate support in times of extreme need. For the conflict/crisis situations that they do, sugeons and anesthesiologists are very useful.

But, most of the third world is not in conflict...most citizens are way below the poverty line and there is not enough physicians or money in the health system. In South Africa, probably the richest African nation, a clinic that saw 200+ patients a day had only 4 nurses and 1 part time doc (he was responsible for 2 clinics of this size that he would go back and forth). Docs complain that they don't have enough time to see their patients in the US...it's not even possible there. Any type of doctor would help on longterm basis, however primary care, ID, OB/GYN, and peds will be the type of specialties that could possibly shift the public health problems. But other professions are very useful too- nursing, public health, etc.

 

[blkprl]

Farmer is kind of annoying. I saw him speak, and he was a boring (talked all evening about statistics), and arrogant ("when I was at Harvard...when I was at Harvard"). I was not in the least impressed, and I certainly do not find him to be the model of international medicine. In fact, I think he is so famous only because he's at Harvard. There are many people out there in the third world who dedicate their lives to people there full time, but we don't even know about them and there aren't any webpages or books about them - again probably cuz they're not a haavaad.

As far as the survey goes, I shadowed a surgeon in a third world country. It was clear that surgery was the most useful specialty. He did obstetrics, emergencies, orthopedics and amputations, thoracic and abdominal surgeries. Not only that, but his enormous breadth in surgery insured that he knew TONS of IM as well, so he was kind of a back up in IM, when things were a bit slow in surgery (which was practically never).

So, definitely surgery, and definitely general surgery at that. If you specialize in pediatric neurosurgery, that's not very useful in the third world (although it's great for those poor kids who do need a pediatric neurosurgeon). In terms of sheer volume, surgery will help them most, as it addresses many diseases, accidents, war injuries, even birth defects.

Other than surgery, probably IM is most useful...vaccinations, antibiotics, anti-parasitic drugs, etc.

I have read all the replies to the original post and I must say everyone is pretty much correct.
I guess I can give a pretty honest opinion being that I am from a poor african country.
All specialties are important; OB, GS, Plastic surgery, denstists (I never saw one when I was growing up... and yes my teeth are fine ), opthamologists (glaucoma is totally preventable but is the number cause of blindness in africa), peds, ortopedic surgery, infectious diseases.......

So my suggestion is that if you are really interested in helping the third world, just do whatever specialty it is your heart desires you so that at least you'll happy when you aren't making as much money......

 

[blkprl]

Infectious Disease seems to be mentioned a lot on this survey... What are the requirements (residency length, etc...) to specialize in ID?

Does ID work through a lot of case studies of diseases in other countries? Or do they primarily focus on the diseases afflicting North America? I am curious about this one...

most ID fellowships focus on diseases that afflict North America, you might find one that will focus on diseases in latin america.

make sure the program you apply to has rotations etc in africa or asia etc.

 

[blkprl]

Sorry dope, but you're wrong here, imho. Most of the third world is NOT in active conflict with anything other than sheer abject POVERTY. People die of stuff that is ridiculously preventable. You don't even need EM phyisicans just a frikkin ambulance and some paramedics would have a huge impact.

OH GOD!!!!!!
HOW TRUE THAT IS!!!!!!OH GOD!!!!!! HOW TRUE THAT IS

 

[blkprl]

I think that " training doctors there would be the most benefical "speciality" for the 3rd world

ACTUALLY KEEPING THE DOCTORS THAT ARE TRAINED THERE IS A BIGGER PROBLEM....

 

[blkprl]

How do you propose a country such as Haiti do that, when there is sooooo much political turmoil tha the only medical school in the nation is shut down????

There are situations where people have no choice but to go outside to study medicine so that they can return to their own country to do such a thing. I think its great that there are outsiders willing to go to countries such as my own country of India, or such as Haiti, to help these people.

THE QUESTION IS "DO THEY ACTUALLY GO BACK AND HELP?"

 

[clumpymold]

Yep, ID all the way.

 

[gujuDoc]

THE QUESTION IS "DO THEY ACTUALLY GO BACK AND HELP?"

Well that's just the thing, with the Haiti example...

There is sooooo much political turmoil that most Haitians I talk to are tooooooo scared to go back and often fear for their life. One of my premed Haitian friends was of the ligher skinned african american haitians. They drove her and other ligher skinned haitians out of the country and told them never to come back. They made threats to that particular friend's family. So with that kind of stuff going on, I can see why people are afraid to go back to a place like Haiti.

But I agree with your other post.........

That the root of the problem with both third world countries, and rural areas in our own country are.......

That the distribution or number of doctors and medical supplies are lacking. The same thing can be said with food distribution in African countries. A lot of African countries have enough crops to feed all the citizens but don't distribute it enough. Distribution and other government caused issues are where the roots of problems in third world nations come from. And in medicine, lack of medical supplies plays a huge role too.

 

[blkprl]

Well that's just the thing, with the Haiti example...

There is sooooo much political turmoil that most Haitians I talk to are tooooooo scared to go back and often fear for their life. One of my premed Haitian friends was of the ligher skinned african american haitians. They drove her and other ligher skinned haitians out of the country and told them never to come back. They made threats to that particular friend's family. So with that kind of stuff going on, I can see why people are afraid to go back to a place like Haiti.

But I agree with your other post.........

That the root of the problem with both third world countries, and rural areas in our own country are.......

That the distribution or number of doctors and medical supplies are lacking. The same thing can be said with food distribution in African countries. A lot of African countries have enough crops to feed all the citizens but don't distribute it enough. Distribution and other government caused issues are where the roots of problems in third world nations come from. And in medicine, lack of medical supplies plays a huge role too.

that's why the recent g8 summit is soooooossoooooooooooooooo important.
does anyone what happened in scotland??????

 

[burton117]

Well that's just the thing, with the Haiti example...

There is sooooo much political turmoil that most Haitians I talk to are tooooooo scared to go back and often fear for their life. One of my premed Haitian friends was of the ligher skinned african american haitians. They drove her and other ligher skinned haitians out of the country and told them never to come back. They made threats to that particular friend's family. So with that kind of stuff going on, I can see why people are afraid to go back to a place like Haiti.

But I agree with your other post.........

That the root of the problem with both third world countries, and rural areas in our own country are.......

That the distribution or number of doctors and medical supplies are lacking. The same thing can be said with food distribution in African countries. A lot of African countries have enough crops to feed all the citizens but don't distribute it enough. Distribution and other government caused issues are where the roots of problems in third world nations come from. And in medicine, lack of medical supplies plays a huge role too.

Brain drain as well as producing food are both significant issues.

First of all, if you had the opportunity, would you leave? Doctors in other countires often have this opportunity, and many take it.

In Sierra Leone, for instance, they produced large quantities of rice for export. However, this made up a significant portion of the economy and often many locals went to bed hungry as food was tagged for export.

Good discussion all around...

 

[burton117]

Anybody else out there have experience with working in developing countries and is willing to share their stories?

Alternatively, if anyone has read any good books about medical / dental work overseas - that would be great to hear about too!

 

[LavaG]

....

 

[dbhvt]

Burton,
No stories about working in developing countries here, but you had some questions about ID earlier, and I thought I'd try and add to the answers. Theoretically, ID is a really broad 'subspecialty'. Think of a disease. Is it infectious? Then treating it is an ID docs job.

On the ground in the US, ID docs treat mostly HIV, then hospital acquired infections (involving nasty resistant bugs), and then things immigrants/refugees have when they get here or things americans pick up while travelling. This is because these particular infectious diseases are fairly complicated and make primary care docs uncomfortable. Sometimes those diagnoses listed in the ICD-9 book under 'ill-defined conditions" end up in clinic because none of the other specialists know what to do, so they ask the ID doc to take a crack at it.

In developing countries ID docs treat the infections that are prevelant in those particular areas. HIV, Malaria, SARS, TB, schistosomiasis, typhoid fever, all of these are the responsibility of the ID doc. Bioterrorism is also an ID concern (anthrax, smallpox, etc.). Several of the US ID docs I've met travel intermittantly to Africa or SE Asia to lend their weight to the cause.

 

[Anastasis]

I just wanted to thank everyone for their book suggestions. I think I'm going to pick some of those up.

Also I just wanted to say that after reading the thread I wish I could change my vote. I voted for EM just because I thought they would see a broad spectrum of illnesses but I think I would have to say either surgery (because, as someone said, they're hard to come by) or family practice who isn't afraid of doing a bit of OB/GYN and just about anything that needs done.

I don't have any experience in the third world but I have some in grassroots community groups and the truth about that kind of work is you pretty much need to do a bit of everything because the little things are what keep the place running. I would think the same thing would hold true for a clinic in the 3rd world - you need Orthos who will lance a boil, you need a dermatologist to diagnose a cold, you need an internist to deliver a baby, you need everyone to get out of their comfort zone and get what needs to be done, done.

sorry if that was a bit rambling and incoherent... just my $.02

 

[burton117]

LavaG,

Sounds like you have had some experiences that were pretty powerful. It would be hard for me to imagine that. Resources are definitely in short supply. It is good to remind us that doctors are limited when they don't have drugs, vaccines, gauze, sterile water, and medical supplies. A valid point, indeed.


Dbhvt,

Thanks for that comparision of ID in the US vs Other Countries.. That was helpful and exactly what I was asking about in that earlier post.

Have you observed that the focus of training is different here in the US so that when ID specialists go to other parts of the world - the experience is limited in dealing with these issues? Obviously the training in the U.S. (exposure during residences, etc...) is going to focus on problems specific to the U.S., but how much attention is really given to Infectious Disease issues from a global perspective? Or is this more of the arena of Public Health? I am just curious as to the focus of the training.

 

[54578]

I posted this question before, and no one provided an adequate response.

I won't go into the long details of my committment to internatinal health and serving the poor; however, I will say I have been living and working in poor communities across Latin America and India for the past 7 years (during my summers in college), implementing anti-poverty and public health projects. I have also worked as a Health Policy Analyst at the United Nations for two years, advising organizations like the WHO, World Bank, and IMF on health policy initiatives impacting the poor.

My question is this:

How does everyone here - who's passion for international health work I find so refreshing and commendable - attempt to pursue this career in the near future? I am currently applying to medical schools, and I find this hard to convey. I could say now (at my age) that I want to live in India, serving the poor in a rural clinic; but realistically, I want to live here in the US; I want to be by my family; I want to have my own family; and I don't know many spouses that would sympathize with this cause.

With that said, my reconciliation: Graduate medical school, finish a residency (for me, general surgery), perhaps do a fellowship, then join an academic institution, where one could devote a few months out of each year to serve on medical missions with MSF or Physicians for Human Rights, etc. Or option two: Join the WHO, United Nations, etc (though such aspirations, though legitmate, may come off as arrogent).

Does anyone else have difficulty conveying their career ambitions? How do YOU intend to serve the international community? And realistically is the point I'm driving at (unless you truly want to give up your life, your family, and the US to live in poverty somewhere in the third world).

 

[burton117]

I just wanted to thank everyone for their book suggestions. I think I'm going to pick some of those up.

Also I just wanted to say that after reading the thread I wish I could change my vote. I voted for EM just because I thought they would see a broad spectrum of illnesses but I think I would have to say either surgery (because, as someone said, they're hard to come by) or family practice who isn't afraid of doing a bit of OB/GYN and just about anything that needs done.

I don't have any experience in the third world but I have some in grassroots community groups and the truth about that kind of work is you pretty much need to do a bit of everything because the little things are what keep the place running. I would think the same thing would hold true for a clinic in the 3rd world - you need Orthos who will lance a boil, you need a dermatologist to diagnose a cold, you need an internist to deliver a baby, you need everyone to get out of their comfort zone and get what needs to be done, done.

sorry if that was a bit rambling and incoherent... just my $.02

Anastasis:

Cool name... Anastasis is the name of the Mercy Ship that visited Freetown, Sierra Leone when I was interning there with World Relief..

Right on! We just need a willingness to help out - no matter who you are..

 

[dbhvt]

Have you observed that the focus of training is different here in the US so that when ID specialists go to other parts of the world - the experience is limited in dealing with these issues? Obviously the training in the U.S. (exposure during residences, etc...) is going to focus on problems specific to the U.S., but how much attention is really given to Infectious Disease issues from a global perspective? Or is this more of the arena of Public Health? I am just curious as to the focus of the training.

I'm not particularly familiar with the training focus for ID fellowships abroad vs in the US. As you say, the real bulk of the training is going to be based on the patients you see. Rare case presentations or other seminars aren't going to substitute for clinical experience. The fellowship program I am familiar with is limited to US patient exposure, though many of the fellows have had earlier clinical experiences in underdeveloped areas of the world. I would speculate that different programs in the US may incorporate time spent abroad. UCSF and Hopkins are two biggies in this field. As far as graduate medical education outside the US, I can't help you there.

If you're considering a carreer as an ID specialist, I wish you good luck. It can be a very difficult specialty with a high pain/income ratio... and (this scared me when I found out) it can be difficult to find a position after finishing your training. But it carries some extraordinarily powerful rewards. My advice to you would be to keep your mind open, but if ID is a good fit, go for it!

 

[54578]

I posted this question before, and no one provided an adequate response.

I won't go into the long details of my committment to internatinal health and serving the poor; however, I will say I have been living and working in poor communities across Latin America and India for the past 7 years (during my summers in college), implementing anti-poverty and public health projects. I have also worked as a Health Policy Analyst at the United Nations for two years, advising organizations like the WHO, World Bank, and IMF on health policy initiatives impacting the poor.

My question is this:

How does everyone here - who's passion for international health work I find so refreshing and commendable - attempt to pursue this career in the near future? I am currently applying to medical schools, and I find this hard to convey. I could say now (at my age) that I want to live in India, serving the poor in a rural clinic; but realistically, I want to live here in the US; I want to be by my family; I want to have my own family; and I don't know many spouses that would sympathize with this cause.

With that said, my reconciliation: Graduate medical school, finish a residency (for me, general surgery), perhaps do a fellowship, then join an academic institution, where one could devote a few months out of each year to serve on medical missions with MSF or Physicians for Human Rights, etc. Or option two: Join the WHO, United Nations, etc (though such aspirations, though legitmate, may come off as arrogent).

Does anyone else have difficulty conveying their career ambitions? How do YOU intend to serve the international community? And realistically is the point I'm driving at (unless you truly want to give up your life, your family, and the US to live in poverty somewhere in the third world).

bump; anyone?

 

[anystream]

in CA, a family friend of mine drives to Mexico for long weekends and performs free eye surgery (I think he works at a private practice during the week). international work doesn't have to span several months for it to be helpful.

 

[anystream]

Burton,
No stories about working in developing countries here, but you had some questions about ID earlier, and I thought I'd try and add to the answers. Theoretically, ID is a really broad 'subspecialty'. Think of a disease. Is it infectious? Then treating it is an ID docs job.

On the ground in the US, ID docs treat mostly HIV, then hospital acquired infections (involving nasty resistant bugs), and then things immigrants/refugees have when they get here or things americans pick up while travelling. This is because these particular infectious diseases are fairly complicated and make primary care docs uncomfortable. Sometimes those diagnoses listed in the ICD-9 book under 'ill-defined conditions" end up in clinic because none of the other specialists know what to do, so they ask the ID doc to take a crack at it.

In developing countries ID docs treat the infections that are prevelant in those particular areas. HIV, Malaria, SARS, TB, schistosomiasis, typhoid fever, all of these are the responsibility of the ID doc. Bioterrorism is also an ID concern (anthrax, smallpox, etc.). Several of the US ID docs I've met travel intermittantly to Africa or SE Asia to lend their weight to the cause.

a book if you're interested in learning more about ID: "The Woman with a Worm in Her Head"-- it chronicles the cases seen by an ID doctor

 

[oldbearprofessor]

bump; anyone?

Dear Meso - I wrote the paragraphs below in the pedi forum some time back. Hopefully you will find it helpful.

regards

OBP

International Pediatrics

There are several ways to go about doing international work in pediatrics. I think the most common way is to do primary care in indigent communities. Often, people go with a group of 5-20 doctors, nurses, etc and will spend 1-3 weeks caring for children in isolated community settings. The doctors can come from any specialty or general pedi. Often these groups have a religious group connection, or a medical school connection and often include non-medical components to the mission. Often they will return annually to the same area. This is a great way for people who are primarily US based with limited time to travel to do a wonderful job of helping some of the world’s poorest kids. The doctors usually pay their way from personal expenses and don’t always need to speak the language of where they go. Usually these groups will bring medical supplies, especially basic medicines with them.

A similar, more academic version of this is to go on a specialty lecture tour to other countries. International pediatric symposiums are common in most countries and they usually welcome academic lecturers, especially if they pay their own way! This type of thing often includes visiting hospitals as well and sometimes some direct bedside teaching, although usually this is limited.

Both of these modes are open to anyone who is interested and require relatively little time commitment. They make a tremendous contribution both in terms of exchange of ideas and providing medical care and medicines. There are no data of course, but I would guess than >95% of international pediatric visits by Americans to developing countries are of these two types.

For those who have more time, more resources and more desire to spend more than 1-2 weeks/yr abroad, there are also several opportunities, but each has its own challenges.

There are a few Americans who operate medical clinics in developing countries. In my experience nearly all of these are people who themselves or their family came from the country in which they are operating the clinic. There are however some amazing examples of doctors who have moved from the US to work in other countries virtually without salary. Most doctors however, will maintain their practice in the US. They may staff the clinics with local doctors, with guests doctors form other countries (including the US), or go themselves for several months each year. Such clinics usually require a substantial level of financial commitment and support either by the US doctor or by a foundation.

The academic version of this is the one that is closest to what I do. Based on support related to nutrition research I do, I will take a team of doctors, nurses and dietitians to other countries and put on a lecture and bedside teaching session for several days. This has varied from country to country but has focused on clinical neonatology. This means everything from teaching how to resuscitate babies without anything in terms of modern neonatology in villages in Africa, to teaching the use of modern ventilator methods in Latin America. I think the team approach is critical as one of the major issues in many countries is nursing care of premature and sick babies, not basic medical knowledge in neonatology.

Finally, I note that we really like to go back to the same place as often as we can. We have found that one visit to a hospital can give some ideas to them, but not really change things the way we would like in terms especially of enhancing nursing care. At each visit we see more improvement and that has been gratifying. We have worked in one hospital for about 5 yrs now in South America and developed a close relationship with them.

 

[54578]

Dear Meso - I wrote the paragraphs below in the pedi forum some time back. Hopefully you will find it helpful.

regards

OBP

International Pediatrics

There are several ways to go about doing international work in pediatrics. I think the most common way is to do primary care in indigent communities. Often, people go with a group of 5-20 doctors, nurses, etc and will spend 1-3 weeks caring for children in isolated community settings. The doctors can come from any specialty or general pedi. Often these groups have a religious group connection, or a medical school connection and often include non-medical components to the mission. Often they will return annually to the same area. This is a great way for people who are primarily US based with limited time to travel to do a wonderful job of helping some of the world’s poorest kids. The doctors usually pay their way from personal expenses and don’t always need to speak the language of where they go. Usually these groups will bring medical supplies, especially basic medicines with them.

A similar, more academic version of this is to go on a specialty lecture tour to other countries. International pediatric symposiums are common in most countries and they usually welcome academic lecturers, especially if they pay their own way! This type of thing often includes visiting hospitals as well and sometimes some direct bedside teaching, although usually this is limited.

Both of these modes are open to anyone who is interested and require relatively little time commitment. They make a tremendous contribution both in terms of exchange of ideas and providing medical care and medicines. There are no data of course, but I would guess than >95% of international pediatric visits by Americans to developing countries are of these two types.

For those who have more time, more resources and more desire to spend more than 1-2 weeks/yr abroad, there are also several opportunities, but each has its own challenges.

There are a few Americans who operate medical clinics in developing countries. In my experience nearly all of these are people who themselves or their family came from the country in which they are operating the clinic. There are however some amazing examples of doctors who have moved from the US to work in other countries virtually without salary. Most doctors however, will maintain their practice in the US. They may staff the clinics with local doctors, with guests doctors form other countries (including the US), or go themselves for several months each year. Such clinics usually require a substantial level of financial commitment and support either by the US doctor or by a foundation.

The academic version of this is the one that is closest to what I do. Based on support related to nutrition research I do, I will take a team of doctors, nurses and dietitians to other countries and put on a lecture and bedside teaching session for several days. This has varied from country to country but has focused on clinical neonatology. This means everything from teaching how to resuscitate babies without anything in terms of modern neonatology in villages in Africa, to teaching the use of modern ventilator methods in Latin America. I think the team approach is critical as one of the major issues in many countries is nursing care of premature and sick babies, not basic medical knowledge in neonatology.

Finally, I note that we really like to go back to the same place as often as we can. We have found that one visit to a hospital can give some ideas to them, but not really change things the way we would like in terms especially of enhancing nursing care. At each visit we see more improvement and that has been gratifying. We have worked in one hospital for about 5 yrs now in South America and developed a close relationship with them.

unbelievably helpful; thank you so much!

Do you find it realistic that one can gain a professorship at an academic institution to teach (like surgery), and that the hospital allows you to spend 6-8 weeks of each year working alongside organizations like Doctors without Borders, the Internatinoal Rescue Committee, etc?

 

[oldbearprofessor]

unbelievably helpful; thank you so much!

Do you find it realistic that one can gain a professorship at an academic institution to teach (like surgery), and that the hospital allows you to spend 6-8 weeks of each year working alongside organizations like Doctors without Borders, the Internatinoal Rescue Committee, etc?

thanks - from an academic perspective, it would be difficult, but not impossible, to arrange 6-8 weeks/year. Doing this consecutively would pose problems in terms of call schedules, etc. Doing 2-3 blocks of a couple weeks is more practical. The farther you go up the academic food chain, the easier this would be to arrange.

Regards

OBP

 

[burton117]

Dear Meso - I wrote the paragraphs below in the pedi forum some time back. Hopefully you will find it helpful.

regards

OBP

International Pediatrics

There are several ways to go about doing international work in pediatrics. I think the most common way is to do primary care in indigent communities. Often, people go with a group of 5-20 doctors, nurses, etc and will spend 1-3 weeks caring for children in isolated community settings. The doctors can come from any specialty or general pedi. Often these groups have a religious group connection, or a medical school connection and often include non-medical components to the mission. Often they will return annually to the same area. This is a great way for people who are primarily US based with limited time to travel to do a wonderful job of helping some of the world’s poorest kids. The doctors usually pay their way from personal expenses and don’t always need to speak the language of where they go. Usually these groups will bring medical supplies, especially basic medicines with them.

A similar, more academic version of this is to go on a specialty lecture tour to other countries. International pediatric symposiums are common in most countries and they usually welcome academic lecturers, especially if they pay their own way! This type of thing often includes visiting hospitals as well and sometimes some direct bedside teaching, although usually this is limited.

Both of these modes are open to anyone who is interested and require relatively little time commitment. They make a tremendous contribution both in terms of exchange of ideas and providing medical care and medicines. There are no data of course, but I would guess than >95% of international pediatric visits by Americans to developing countries are of these two types.

For those who have more time, more resources and more desire to spend more than 1-2 weeks/yr abroad, there are also several opportunities, but each has its own challenges.

There are a few Americans who operate medical clinics in developing countries. In my experience nearly all of these are people who themselves or their family came from the country in which they are operating the clinic. There are however some amazing examples of doctors who have moved from the US to work in other countries virtually without salary. Most doctors however, will maintain their practice in the US. They may staff the clinics with local doctors, with guests doctors form other countries (including the US), or go themselves for several months each year. Such clinics usually require a substantial level of financial commitment and support either by the US doctor or by a foundation.

The academic version of this is the one that is closest to what I do. Based on support related to nutrition research I do, I will take a team of doctors, nurses and dietitians to other countries and put on a lecture and bedside teaching session for several days. This has varied from country to country but has focused on clinical neonatology. This means everything from teaching how to resuscitate babies without anything in terms of modern neonatology in villages in Africa, to teaching the use of modern ventilator methods in Latin America. I think the team approach is critical as one of the major issues in many countries is nursing care of premature and sick babies, not basic medical knowledge in neonatology.

Finally, I note that we really like to go back to the same place as often as we can. We have found that one visit to a hospital can give some ideas to them, but not really change things the way we would like in terms especially of enhancing nursing care. At each visit we see more improvement and that has been gratifying. We have worked in one hospital for about 5 yrs now in South America and developed a close relationship with them.

Good Post!! Very helpful!

 

[burton117]

a book if you're interested in learning more about ID: "The Woman with a Worm in Her Head"-- it chronicles the cases seen by an ID doctor

Amazon.com Website:

The Woman with a Worm in Her Head: And Other True Stories of Infectious Disease

 

[Anastasis]

Anastasis:

Cool name... Anastasis is the name of the Mercy Ship that visited Freetown, Sierra Leone when I was interning there with World Relief..

Right on! We just need a willingness to help out - no matter who you are..

Hey I know someone who served on that ship, she said it was a fantastic experience - not why I picked this name.

It means "Resurrection" in Ancient Greek.

 

[lemonlite]

Internal med / ID

 

[tank you]

i would say peds. think of all the kids in india, china (most populous nations), all of africa, and the other third-world countries. so sad

 

[LadyBulldog]

wait, so i'm confused....i thought that doctors can only practice in the country where they earned their degree unless they take some exams/re-do residencies..... so with a degree from the US, would we even be allowed to practice in third world countries w/o re-doing much of our training?

 

[travelbug73]

Great posts and discussions guys and gals! I'm going to ramble, so please bear with me.

I would like to become a doc sometime in the near future and I battle with questions such as "how can I be of help in the poorest of poor parts of the world" and "will I do justice to my family" everyday?

I think the most important thing that is required is a change in policies, and abolition or reduction in bureaucracy, red tape and corruption at the grass roots levels. In addition, in countries like India, there is also population expansion. Ofcourse, population expansion goes hand in glove with illiteracy!

I have gone from thinking ID to Ob-Gyn to Opthalmology to ER to healthcare MBA to becoming a politician to whatever as the most useful career move, but at the end of the day, I'm more confused than the previous Anybody else as confused as I?

On a separate note, can anybody, who has volunteered previously, lead me to good organizations that have overseas health care volunteer opportunities?

Thanks for all your insights, great posts, keep them coming!

 

[burton117]

wait, so i'm confused....i thought that doctors can only practice in the country where they earned their degree unless they take some exams/re-do residencies..... so with a degree from the US, would we even be allowed to practice in third world countries w/o re-doing much of our training?

Someone at the D.O. school near me (Midwestern University - IL) said that the D.O. licensing exam is for only the united states, where as the M.D. licensing exam gives you the right to practice internationally. I don't know if this is correct or not as this is hearsay - but as DO's can sit for the MD licensing exam around the same time as their licensing exam, this may not be an issue. Please correct me if I am wrong...

 

[LadyBulldog]

uh, i'm pretty sure that's wrong