Georgetown Medical Students Explore Global Health

Dr. Irma Frank, associate dean for international programs, calls them Georgetown’s “ambassadors for health.” They are the medical students who choose to serve and study abroad in developing countries—in Uganda, in the Dominican Republic, in rural Australia, in India, and in more than 20 countries all over the world.

It’s the Jesuit ideal of “care of the whole person” with a cultural twist: “Georgetown medicine is based on cura personalis, both here and abroad,” says S. Ray Mitchell, MD, dean for medical education. “This is care of the whole person in their world—not ours.”

As part of Georgetown’s medical school curriculum, first and fourth-year students are given the opportunity to study internationally through the Office of International Programs. Currently, according to Dr. Mitchell, about 40 percent of Georgetown medical students will spend 6-8 weeks overseas in developing countries, compared with about 15-20 percent on average for Georgetown’s peers.

First-year students are matched with local mentors in a developing country and then are guided through a health promotion program for that part of the country. They are exposed not only to different health systems, but different cultural and societal norms.

Allison Linden (M’08), now a surgery resident at Georgetown University Hospital, spent time in India and Uganda during her first and fourth years of medical school, respectively, where she witnessed a health system that primarily catered to patients who sought medical care at the worst point of an illness. Preventive care was almost non-existent. She says her international experience also prepared her for GUH’s diverse patient population.

“At Georgetown University Hospital, there is a large and multicultural patient pool, so my experience abroad helps me understand how to treat patients more effectively,” she says.

“We focus on culturally competent medicine and connection,” says Mitchell. “Contrary to most medical schools, which send western physicians as faculty to precept, our programs teach ‘immersion medicine.’” In one Georgetown program, students live in the homes of Dominican families, where they connect with local physicians and work with the local patient population.

Not surprisingly, most students go with an intention to serve, Frank says. But what they don’t expect, she adds, is that they end up receiving much more than they give. “The experience changes the students’ view of how medicine functions around the world, and opens their eyes to an underdeveloped part of the world. These students are incorporating the Jesuit traditions of academics and service and bringing them together globally,” Frank says.

In GUMC’s School of Nursing & Health Studies, undergraduate students in the Department of International Health are required to spend 12 weeks abroad doing field research in epidemiology and disease management. Bernard Liese, MD, who chairs the department, says that more than something to add to a resume, the curriculum is designed to expose students to the reality of working in a different cultural environment. He finds that when students engage in international service they have a more emotional reaction to what is happening and says “they tend to come back as advocates for change.”

Darwin Young (NHS ‘08) spent a semester in underserved rural Uganda participating in an internship with the Ministry of Health where he designed a study analyzing the impact of public sector capacity on the distribution of insecticide-treated bed nets, a key tool in the global fight against malaria. “By having to live and work in a different culture, and vastly different from the classroom,” he said, “I had the opportunity to grow and mature—not only intellectually, but personally.”

Shawn Corcoran, (M’07) also went to Uganda in 2007 to help set up a clinic in Fort Portal, at the foot of the Rwenzori Mountain Range in the western part of the country. There he witnessed the heartbreaking health consequences of poverty, patients coming to the clinic only after diseases have become untreatable. His fondest memory is Stephen, a young boy he was able to successfully treat for chronic osteomeylitis. “Like most meaningful experiences in life,” he said, “It was the people of Uganda that made my visit there so enriching. Dozens of patients brought forward the quality of my education and training at Georgetown as I managed to evaluate and sometimes treat them on my own.”

A common experience is the spirit of hope alive in those who endure the harshest existence imaginable, with only the most rudimentary access to health care. Mitchell, who went in 2006 to visit Kibera, one of Africa’s largest and poorest slums, reflected on how this visit altered his perspective. “We all become creatures of habit,” he said. “We live within our neighborhood. We live graciously and generously. We think we understand problems elsewhere. We have compassion. We may even pray for what we see in the news. Then you go and see suffering on a scale too hard to conceive.” He contrasted this dismal reality to the dignity and spirit of the people who seemed “unaware of how bleak we might consider the situation.”

Then he added, “I knew my Western standards were irrelevant. Their human spirit is just absolutely inspiring. There is a Haitian proverb that ‘the mind cannot know what the eye has not seen.’ This eye-opening experience opens our students’ minds and hearts to international health.”

By Carolyn Saour, GUMC Communications