Jessica Tarleton, MD, MPH, PGY4, is the most recent resident to participate in the Global Health Residency Scholars Program. This international elective is a four-week rotation in Ethiopia. Here are some of Dr. Tarleton’s reflections:
One of the biggest areas of need I saw was in having enough teachers for medical students since the country has dramatically increased the number of medical students in response to the shortage of physicians. With only a few faculty physicians at each hospital, the residents do a lot more of the formalized teaching that in the US is usually done by faculty. I decided to participate in teaching the medical students quite a bit while I was there to help relieve the burden on others. Most days – after morning report, when the activities of the previous day and night were summarized and critiqued – I would go with students to do bedside teaching rounds or a small group discussion of a bread-and-butter gynecology topic.
Because the training hospitals for Addis Ababa University (AAU) are public referral hospitals, and many healthy or benign women’s health issues are managed by non-physicians (or more likely, no one), the patients that are served by AAU have a lot of pathology—a lot of preeclampsia and other serious pregnancy complications, and very large uteri, adnexal masses, and advanced gynecologic cancer. Open surgery is practiced widely and well, but no laparoscopic or hysteroscopic surgery is available, and there is very limited access to chemotherapy and radiation therapy. These are things we take for granted every day the US.