department of medicine

Internal Medicine Residency Program

Global Health Opportunities

Internal Medicine residents at Temple University have long had the opportunity to be involved in Global Health electives. Up to two elective blocks during residency (one each in the 2nd and 3rd years) may be potentially used for these valuable medical experiences. We are currently developing a Global Health/Underserved Medicine track, to begin in 2010 and headed by Dr. Tom Comerci of the Section of General Internal Medicine, which will partially comprise opportunities for residents to travel abroad, as well as to gain a better understanding of the social disparities and complexities of care of the underserved patient here in the United States. This track will be voluntary and will additionally be comprised of night time seminars, community and home visit experiences, and teaching medical students and fellow residents.

We have developed a system which allows residents who meet criteria to develop their own rotations internationally, while others can go somewhere that has been organized for them. In the summer of 2009, we formalized a relationship with a rural hospital in Panama and plan to send our first set of residents to rotate there in early 2010. We also have experiences planned in Uganda, as well as India and other countries yet to be finalized. Through the past experiences of many residents, the program has nurtured many additional contacts in Africa, Central and South America, as well as the Indian Health Service in the United States. Additionally, Temple School of Medicine has developed formal relationships with many medical schools throughout the world which our residents can rotate through. If you are interested in participating in these unique opportunities, please let us know and all efforts will be made to assist you in finding the experience that best meets your needs. Additional information and resources are available by examining our Global Health Handbook. Below are some examples of the many places our past residents have traveled to in recent years.

• Honduras
• Indonesia
• Ethiopia
• India
• Zambia
• Additional Resources

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“I went to Honduras with some other residents from my church. It was a big group that went together - we had around 15 MDs and 15 staff/pharmacists/dietitians. The trip was organized by CMDA (Christian Medical and Dental Association) and GHO (Global Health Outreach). We went to this little town called El Paraiso (about 2 hours from Tegucigalpa). There we provided medical, dental and some light surgical care as we had a bus (MMU-medical mobile unit) that has an OR built in. We also had an portable US machine as one of the ER resident from another state borrowed it from her hospital. Besides seeing patients for their medical complaints, we also gave out anti-parasitics and vitamins to everyone who came in.”

Willy Chuang, El Paraiso, Honduras

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“I volunteered to involve myself with this Christian clinic named Waluyo Jati in Surabaya, East Java, in Indonesia. They provide medical care with a nominal fee (50 cents US) to the poor in the city. During the day, I would see patients with doctors in the clinic, functioning more like a consultant, giving them advice on tougher cases (the more impressive cases were severe iron deficiency with a hemoglobin of 4, sepsis from bad gangrene, and very badly decompensated CHF). If the patient declined admission due to cost or other reasons like commonly tainted blood product in the hospital which leads to many cases of HIV infection, I had to try to manage them as outpatients by seeing them everyday. I gave 2 hour lectures on topics like HTN, CHF, DM, joint pain, dyspepsia, diarrhea, etc. every afternoon to the doctors there. I also tried to correct their misconceptions such as using antibiotics for viral URI treatment, etc. For the rest of the time, I just ate, ate and ate and visited an active volcano, Mt. Bromo, and Bali.”

Willy Chuang, Waluyo Jati Clinic

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“I worked with Ethiopia HIV/AIDS Mission in Addis Ababa.  The project provides social work support through home visits and support groups for 250 HIV positive patients in one of Addis's districts. We saw bed bound end-stage AIDS, as well as many patients benefitting from HAART through the President's Fund meds instituted in 2005: the project had gone from seeing 30 deaths a year in 2004 to 3 last year. We also staffed a couple outpatient clinics, diagnosing everything from nematodes to HIV neuropathy alongside other docs.

Matthew Megill, Ethiopia

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“Patiala is a city in the state of Punjab tucked away in the northwest corner of India, sharing a border with Pakistan. My time was spent mostly in an outpatient clinic where I assisted a former Professor of Medicine at Government Medical College of Patiala, which is one of the oldest educational institutions in the state. Our day was divided into two sessions. The morning session was from 8 a.m. till 12 noon, and was devoted to seeing patients who were follow up patients for chronic medical conditions including but not limited to diabetes, hypertension and COPD. Quite a few patients were from neighboring smaller cities and even villages. I want to mention two things that I found to be very unique are the degree of faith people have in their physicians (some of them had made the trip from over 100 miles, even across state lines, to be seen and with the condition of some of the roads in India, that is a pretty arduous task). Even more interesting is the fact that some the patients had been seen by the same doctor for over 40 years. The second session was from 2 p.m. to 5 p.m. and included what may be called walk-ins. Most patients were not scheduled and were there for conditions ranging from colds and pneumonia to malaria. Among other infectious diseases a notable mention to bone tuberculosis and asymptomatic unilateral large pleural effusions and ascites, which were also tubercular.”

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“I spent a block in Lusaka, Zambia seeing patients in the HIV clinics at the University Teaching Hospital (UTH) and other sites in Lusaka like Chreso clinic. I spent most of my days in the department of medicine attending ward rounds with the senior registrar and taking call with the residents there.” A presentation of some of the interesting cases Dalila encountered is shown below.

Dalila Zachary, University Teaching Hospital, Lusaka, Zambia

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American Medical Association (AMA)
Volunteer opportunities overseas for physicians.

International Healthcare Opportunities Clearinghouse
The International Healthcare Opportunities Clearinghouse (IHOC) web site is designed for health-care professionals and students who are interested in volunteer work with underserved communities at home or abroad. The IHOC web site was begun in 1996 by a small group of faculty members and students from the University of Massachusetts Medical School, Worcester, Massachusetts. IHOC is an ongoing project maintained by the Lamar Soutter Medical Library, University of Massachusetts Medical School.

Diversion Magazine Volunteer Opportunities
A directory of organizations that offer volunteer opportunities at home and abroad.

Library of Congress Country Studies
The Country Studies Series presents a description and analysis of the historical setting and the social, economic, political, and national security systems and institutions of countries throughout the world.

U.S. Department of State
U.S. Department of State: Passport Services and Travel Warnings and Consular Information Sheets for specific countries.

International Medical Volunteers Association
Profiles of dozens of organizations that require medical or medical support personnel to help carry out their humanitarian missions.

Doctors for Global Health
DGH works with marginalized communities around the world to "promote health and human rights with those who have difficulty making their voices heard."

International Center for Equal Healthcare Access
A non-profit organization of healthcare professionals who volunteer to transfer their expertise on HIV care and infectious diseases to clinics in developing countries.

Indian Health Service
The federal health program for American Indians and Alaska natives.

U.S. Department of State History, Education and Culture

CDC Travelers Health
The most used resource for travel health and vaccine information.

International Society of Travel Medicine

WHO International Travel and Health

Minnesota International Health Volunteers

Minnesota International Health Volunteers (MIHV) is a non-profit organization headquarted in Minneapolis, MN that works to improve the health of women and children. They currently have community health projects in the United States, Uganda, and Tanzania on topics including: Reproductive Health, Safe Motherhood, Access to Healthcare, Training of Community Health Workers, Malaria Prevention, Chronic Diseases, Child Survival, Nutrition and Exercise, HIV/AIDS, Breast and Cervical Cancer, and Tobacco Use.

Philadelphia International Medicine

Works with medical schools and hospitals to arrange for visiting physician programs, CME events, short-term observer fellowships and other programs geared to the international physician.  Temple University Hospital is a participating member of this organization.

Health Volunteers Overseas

Health Volunteers Overseas is a private non-profit organization dedicated to improving the availability and quality of health care in developing countries through the training and education of local health care providers. Opportunities for IM physicians exist in Peru, Uganda, India and Cambodia.

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