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department of medicine

Internal Medicine Residency Program

Global Health Program

 

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 headed by Dr. Gina Simoncini, 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 consist 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 to a site 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 the near future. We also have experiences planned in Uganda, as well as India and other countries. 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.

 

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Willy Chuang (Class of 2007), Honduras

 

“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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Willy Chuang (Class of 2007), Indonesia

 

“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, sepsis from bad gangrene, and very badly decompensated congestive heart failure). 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 hypertension, congestive heart failure, diabetes, joint pain, and dyspepsia every afternoon to the doctors there. I also tried to correct their misconceptions such as using antibiotics for viral infections 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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Matthew Megill (Class of 2008), Ethiopia

 

“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 patients, as well as many patients who benefited from HIV medication through the President's Fund in 2005. The project had gone from seeing 30 deaths a year in 2004 to 3 last year. We also staffed a couple of outpatient clinics alongside other docs, and diagnosed everything from nematode infections to HIV neuropathy.

 

Matthew Megill, Ethiopia HIV/AIDS Mission in Addis Ababa

Matthew Megill, Ethiopia

 

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Sanjeet Khangura (Class of 2008), India

 

“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. Notably, we also saw tuberculosis that affected the bones and the liver.”

 

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Dalila Zachary (Class of 2008). Zambia


“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.”

 

Delila Zachary at University Teaching Hospital.

Dalila Zachary, University Teaching Hospital, Lusaka, Zambia

 

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Alan Sun (Class of 2010), Nepal

 

"I spent a month in Chitwan, Nepal at Jay Buddha Hospital where I spent much of my time with the attending physician in clinic and hospital rounds. The hospital is privately owned but it is affiliated with both the Government hospital and the Teaching Hospital at Chitwan College. This experience provided me with a fairly good perspective on how healthcare is delivered in Nepal. Jay Buddha hospital is in the middle of establishing a program to provide healthcare to the indigent population of Chitwan. In Chitwan and the surrounding areas there are approximately 1000 villages governed by a Village Development Committee where most of the inhabitants don't have money to provide for basic healthcare. Jay Buddha hospital and its director would like other residents and medical students to spend 1-2 days a week in these villages in the Himalayas and 3-4 days in the hospital or clinic. They provide housing and plan excursions on the days you are not working.”

 

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Nicholas Cavallaro (Class of 2011), Peru

 

Nicholas Cavallaro"Overall, my elective in Lima was a great learning experience. I was at Cayetano, a 420 bed, academic hospital in Lima. Many of the patients are underserved and impoverished. In a lot of ways the care for the patients and the education was similar to Temple, but the differences really made me appreciate some of the conveniences we have here. I was able to work on my Spanish, as well as improve my management of patients when resources are limited. I felt what I learned was valuable for not only doing future international work, but also for taking care of patients in general. It definitely ended up being the most educational elective I’ve done."

 

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Roxana Samimi (Class of 2011), Haiti

 

"After the earthquake that devastated Haiti in January 2010, I knew I wanted to help. After much searching, I came across Project Medishare, a non-profit organization which had partnered with the University of Miami Global Institute in order to establish a 300-bed temporary field hospital at the Port-Au-Prince airport. The patients I met in Haiti demonstrated amazing strength, warmth, and compassion.  Many evenings the entire med-surg tent would rise up in song and prayer. During international electives, you go to help people; to make a change no matter how small. And, before you realize it, the experience has changed you.”

 

Roxana Samimi with patients at a temporary field hospital at the Port-Au-Prince airport

Roxana Samimi with patients at a temporary field hospital at the Port-Au-Prince airport

 

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Vishnu Kulasekaran (Class of 2011), South India

 

"I spent my month working in Bangalore, a large and rapidly growing city in South India. The majority of my time was at Columbia Asia Hospital, which is one of six hospitals in India founded by businessmen from the US. Columbia Asia features the same modern technology as in the U.S. I spent time in various departments including the ICU, Infectious Diseases, and Gastroenterology. Tropical medicine was a unique aspect of the experience; cases of tuberculosis, dengue fever, and malaria were particularly interesting. I was also able to work in the outpatient setting at AnaSwami Mudhaliar, a new hospital with limited resources that provided significant educational value."

 

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Regina Jacob (Class of 2010), Kenya

 

"I went to a little town called Bumwalukani on the east side of Uganda (very close to Kenya). My daily activities consisted of teaching health classes to 3-5th grade children in the morning and then in the afternoons, I would see patients in the walk-in clinic.  I had the opportunity to go to the local city and work in the hospital there for one day and I also had the chance to work at The AIDS Society Organization which was really a treat. I definitely recommend a global health rotation!!"

 

Regina Jabob, MD (Class of 2010)

Regina Jabob, MD (Class of 2010)

 

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Lalitha Parameswaran (Class of 2010), Bangalore, India

 

I completed a one month rotation in the Asha Foundation in my hometown, Bangalore. The foundation provided a multitude of services related to HIV/ AIDS care:

 

  • Helpline manned by trained counselors to provide answers to urgent questions
  • Bi weekly outpatient clinic staffed by a pediatrician, HIV practitioner, a financial expert and a counselor to provide primary and antenatal care in addition to HIV care
  • Training the counselors program
  • Training nurses, physicians and residents in HIV/AIDS at various sites across Southern India
  • Training volunteer groups to disseminate HIV/AIDS awareness
  • Adolescent health education
  • Vocational training for indigent women
  • Research activities

My time was divided in attending the outpatient clinic and participating in research activities. I also enjoyed a wonderful rapport with the staff and we had yummy food most times as an added benefit. Dr. Glory Alexander, my supervisor and director of the Asha Foundation was very helpful in coordinating my activities. As I went through my rotation, I was struck by the social stigma prevalent and how the disease went years without diagnosis due to the lack of awareness. Also their method of financial screening for free ART treatment eligibility was very interesting and included facilities we often take for granted in the USA, such as availability of electricity, clean water, cement housing etc. Many of the women were widows and their spirit was remarkable- they contracted the virus from their husbands who often passed away due to AIDS leaving these women with no support and children to take care of- yet these women were so competent, efficient and fairly devoted to the memory of their husbands.

 

Overall, my mind got a good introduction to the HIV/AIDS situation in an urban center of Southern India and some of the challenges prevalent there. I also worked with some wonderful and dedicated individuals and was able to help them in return by creating a research database for them. I would love to go back and contribute more in future.

 

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Additional Useful Web Links

 

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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