We have a long and outstanding tradition in international health for research, education and clinical practice. Interest in overseas medical experiences has been increasing. Admittance into this pathway allows you to be eligible for a certificate in International Health from the American Society for Tropical Medicine and Hygiene (ASTMH). Clinical training in this pathway is similar to the Categorical pathway. We recommend our trainees to use some of the electives for international experiences. Contact: Keith.Armitage@UHhospitals.org
Length of training: 3 years
Setting: University Hospitals Cleveland Medical Center, Louis Stokes Cleveland Veteran Affairs Medical Center, various international health centers
Description and defining characteristics: Many medical concerns transcend the limits of our own society, so it is important to respond to the global challenge to extend the benefits of modern medicine. The Case Western School of Medicine and University Hospitals have a long and outstanding tradition in international health research, education and clinical practice. Interest in overseas medical experiences has been increasing. Many of our residents have taken advantage of our collaborations to spend time in healthcare facilities in a variety of locations across the globe. Some work these experiences into the categorical track while others join our International Health Pathway.
The International Health Pathway has 1-2 slots each year. Admittance into this track allows the candidate to be eligible for a certificate in International Health from the American Society for Tropical Medicine and Hygiene (ASTMH).
Clinical training in the pathway is very similar to the categorical pathway; there are the same number of ward, ICU, and ambulatory months. Although total elective time is the same, it is anticipated that residents in the International Health Pathway will use some of their elective time abroad. Scheduling is flexible and it is possible to use most of elective time consecutively to maximize international experiences.
The Division of Infectious Diseases and HIV Medicine has several projects, primarily based in Uganda. Research efforts include HIV and tuberculosis, and range from bench science to translational projects to clinical trials and epidemiological studies. Projects are done under the auspices of The Case Center for AIDS Research and the Tuberculosis Research Unit. Collaborations in India are under development.
Another important resource in the School of Medicine is the Center for Global Health and Diseases (CGHD). Areas of research in the CGHD include malaria, filariasis, schistosomiasis, and other tropical diseases. Collaborations exist in Kenya, Papua New Guinea, CoteD'Ivoire and Brazil. The Center is also the current home for the editorial offices of the American Journal of Tropical Medicine and Hygiene (AJTMH).
Schedule: The breakdown of the schedule for residents on the International Health pathway is the same as that of our categorical residents. However, there is more flexibility in that elective time can be grouped together to allow a more meaningful experience abroad.
International Health Experience by Brigette Gleason, MD
Our recent International Health graduate, Brigette Gleason, who now works at the Centers for Disease Control and Prevention, discusses her experience.
Every day Dr. Brigette Gleason spent in Sierra Leone this fall helping fight Ebola was filled with tragedy and the specter of death.
Next to the office where she analyzed reports and helped shape local response to the epidemic, burial teams donned protective suits before going to handle the dead.
Gleason, a doctor for the Centers for Disease Control and Prevention who is now the agency's point person in Virginia, found herself blocking out many awful details.
It was the only way to keep working.
"You have to separate yourself from some of the reality sometimes. You can't save everyone. If you get emotionally invested in everyone you care for, it could be devastating. The idea is to focus on the progress you can make and on acting and doing," Gleason said. "I think that being there and knowing that I was helping was one thing that really made it easy to keep going.
My second year of residency I was able to rotate at the national teaching hospital in Laos with a colleague, Katie Linder, MD. Dr. Keith Armitage and Case Western Reserve University have worked with the nonprofit Health Frontiers (started by a pediatrics professor) in the past, and introduced me to their current leaders. Health Frontiers helps support the internal medicine and pediatrics residency program at the only programs of their kind in Laos.
I spent a month working in the national hospital, both in the general wards as well as on the pulmonary wards. We saw some patients with diseases I have never seen in Cleveland (melioidosis) and advanced progression of common worldwide diseases (lung adenocarcinoma). We had the opportunity to work with outstanding young residents, who worked incredibly hard to care for their patients with limited resources. I learned much about the provision of acute medical care in resource poor nations. We took part in resident education activities, and really felt involved in the program for the time we were there. The program directors Gordon and Angie were very helpful and all around great people know. It was an outstanding experience away from University Hospitals Cleveland Medical Center and Dr. Armitage and the chief residents were incredibly helpful in setting up our schedules so that we could use elective time to take part.
I highly recommend this opportunity to future residents, and would be happy to talk more about it with those who are interested.
The Medical Student's Guide to doing Research Abroad
Title: Medical Student's Guide to doing Research Abroad
Authors: Max M. Feinstein and Jessica Ray
Description: This guide is the culmination of the experiences of two medical students who spent a combined total of nearly four years conducting research and pursuing clinical rotations abroad. Topics covered in include identifying host institutions, financing a trip, health and safety concerns, cultural and language considerations, and ideas for taking advantage of time abroad.