Medical education needs to get a passport

by  | in EDUCATION http://www.kevinmd.com/blog/2012/07/medical-education-passport.html

I participated in a medical mission to Haiti with the Hope for Tomorrow Foundation. The trip only lasted a week, but the impression it made will stay with me forever. I experienced a culture shock stepping off the plane: “tent cities” sprawled the streets, sewage and garbage piled up to no end, and the people had nowhere to go.

Upon arriving to the hospital in Les Cayes, there were hundreds of people waiting there for days for our surgical group. The first day of patient screening was hectic and dysfunctional — there was a mad rush to see a physician, women were handing me their children without apprehension hoping that I would cure them, and the line of patients had no end in sight. I was seen as a doctor to them because I was wearing a pair of scrubs. They did not know any better. They only wanted help.

There was a consistent theme: routine and vital services were unavailable to these people. Their conditions progressed much further than medically appropriate. They were suffering from disorders that became complex due to years of not receiving care, and now they could not be resolved with conventional protocols. Sadly, we were only able to help so many. We were limited in the supplies that we packed and the resources that were provided by the hospital, which were bare minimum at best. We were only able to perform procedures that did not require follow-up, and turning those away that did not qualify never got any easier. We needed to triage, and we needed to move onward by performing the procedures.

In the operating room, the surgeons faced a whole different animal. There were only three tables, much of the equipment did not work, and there was minimal help with organizing the rooms. However, due to innovation and personal drive, the surgeons were able to perform about one-hundred surgeries in their short stay. I was able to assist in several procedures ranging from hernia repair, removal of masses, to even an orchiectomy. Many of the extensive surgeries I assisted in consisted of procedures performed in combination that are usually performed individually, and all of these operations could have been prevented if the patients had been treated earlier. I feel that I did more during this week than I have done my whole life.

This experience is one that I do not believe many medical students have encountered, and I think that is a shame for the US medical educational system. Not only would medical students be able to serve indigent and needy populations in remote and isolated areas around the world, but I think they would be able to participate more extensively in medical care than they would otherwise. When I was assisting in the operating room, I had not even stepped foot into medical school. Regardless, I was using scissors, retractors, and even the scalpel — I sliced living, breathing tissue (under the supervision of an experienced surgeon, of course).

I can only imagine the possibilities for actual medical students as they will be able to use their current education and continue to learn more as they work with what seemed like an endless line of patients. Furthermore, the patients I encountered had not received any sort of care in years. In fact, the hospital we worked at had not performed a surgical procedure for four years prior to our arrival. The educational opportunities, along with the ability to enact great change, are endless in underserved countries. The US medical education system needs to get a passport.

Michael Mank is a medical student.

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