Tuesday, November 29, 2011

It's really happening!

It's off to Asia I go!!! Why you ask? Well, let me start at the beginning...

One of the most attractive features of the Duke Physician Assistant Program is the opportunity to expand our medical education to include global health. As someone who is interested in international relief efforts and medical missions, this is an elective that I just couldn't pass up! There are many organizations to oversee medical doctors and nurses in international health programs and disaster relief efforts, however, there are few that utilize physician assistants. Fortunately this is changing and the presence and utilization of physician assistants abroad is increasing. I'm thankful for the many PA's who have promoted our profession and paved the way for future practitioners like myself. After I graduate next year (August 3rd to be exact... not that I'm counting down), I anticipate finding a position which will allow me to participate in international medical aid. Ideally I would like to become part of an organization like the National Disaster Medical System (NDMS) International Medical Surgical Response Team (IMSuRT). IMSuRT is a team of medical specialists who provide surgical and critical care during a disaster or public health emergency both domestically and internationally. I first found out about this specific branch of the Department of Health and Human Services while working at Children's Hospital Boston. Several of our pediatric trauma surgeons, plastic surgeons, pharmacists, nurses and OR techs went to Haiti to set up a make-shift operating room in a tent to help many sick and injured children in Port au prince. In addition to disaster response teams, I am also interested in medical mission trips. If my job affords me the opportunity to escape for a week or two every year, I would love the opportunity to provide medical care to those with limited resources and poor access to adequate care. Even basic medical care can be life changing to those who are living in underdeveloped nations.

I digress...Fortunately, my application was approved and I was accepted into the global health elective. Starting December 28th, I will begin a 4-week rotation in Sri Lanka--a perfect in-depth introduction to international healthcare! My time will be spent assisting in surgery, treating patients on the wards of Karapitiya Hospital, administering immunizations in community clinics, and perhaps even assisting in childbirth while shadowing Public Health Midwives making rounds in rural villages. These experiences will allow me to develop a comprehensive understanding of the Sri Lankan public health system, learn how culture and religion influence medical practice, and assess the penetration of the public health system into the smallest of rural villages.

Learning about health care systems outside the U.S. will not only help me anticipate the challenges I might face working globally, but will enrich my medical education. Patients will present with diseases that I may never see in the U.S. because of vaccinations. Furthermore, with limited access to preventative care, Sri Lankans often present much later in the course of their disease, giving me a better understanding of the physical manifestations of the untreated disease. And unlike the U.S., I won't be able to order an MRI or a CT with a simple click in e-Browser and I certainly won't have blood work done on a 'stat' basis. I will have to rely on my physical exam skills and critical thinking to problem solve and treat patients- and I couldn't be more excited. This will be an incredible test of my history taking (via a Sinhalese translator) and physical exam skills as I strive to come up with a differential and ultimately a diagnoses. I am looking forward to enhancing my diagnostic skill set and supplementing my medical education with the training and mentoring of Sri Lankan physicians on staff at the University of Rhuana. Striving to determine feasible treatments while preserving the cultural and religious customs of patients will invariably mold me into a versatile and effective global health provider.

I hope this blog can provide some insight into my educational adventures in medicine, as well as the fun I intend to have along the way. Did I mention that I will be spending some time exploring Thailand beforehand??? I will trek for several days through the teak forests and bamboo jungles in northern Thailand (outside of Chiang Mai), visiting remote hill-tribe villages and learning about the lifestyles of these hardy people. Then I will hop on a bike to explore the countryside and continue south to the Sri Lanna National Forest where I'll kayak before heading much farther south to paddle and rock climb in Phuket. Don't worry, I'll make sure to squeeze in a cooking class and some play time with the elephants!

Now that I've read both the Sri Lanka and Thailand travel books cover to cover, the dates are officially set and the plane ticket has been purchased, I am eager to get going... as soon as I figure out how to pack 7 weeks worth of stuff into my 65L pack!

I hope to blog as often as I can, but I hope to be busy having fun and learning! Stay tuned!