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Medical Student Perspectives: Medical School in the Jungle: A Personal Reflection on International Rotations

I'm sitting at the beach on the last night of my international rotation and I can't help but reflect on this wild experience. For the past four weeks, I have been in Costa Rica studying medical Spanish and having the time of my life. Over the past month I have transformed into an almost-fluent Spanish speaker, and I am so excited that I will be better able to communicate with my Spanish-speaking patients when I return to the States.

I was fortunate to have various clinical experiences while here in the jungle. I visited a hospital in a small city where the wards consisted of two large rooms full of hospital beds, one room for men and the other for women. In these wards, there were no concerns of Health Insurance Portability and Accountability Act (HIPAA) violations and no thoughts toward maintaining patient privacy.

Labor and delivery room

The patients in these shared wards, in beds just 3 feet apart from each other, had conditions ranging from pneumonia to dehydration to post-op recovery. The maternity ward was another large, open room filled with a mixture of women in labor and new moms who had recently delivered in the separate, sterile delivery room. Downstairs in the emergency department, patients with IVs in their arms lined the hallways, waiting to be seen by a doctor. The equipment in the emergency department was run-down, to say the least—I was shocked to find they stored iodine in an old Gatorade bottle!

Trauma area and emergency room

We went to a lactation clinic to assist new mothers in caring for and feeding their new babies. We visited an orphanage where we attended to the various medical needs of the children. Finally, I spent multiple afternoons working with an internist in a small clinic. There, I relearned the importance of recording a complete medical history and determining a patient’s diagnosis on the basis of signs and symptoms instead of expensive laboratory tests. In Costa Rica, I had the opportunity to practice medicine with a rural, underserved population minus the technology on which we rely so heavily in the United States.

Sure, hopping on a plane and heading to a faraway country on your own can be intimidating, but the medical and life experiences are truly invaluable. After years of extremely hard work, exam taking, and sleep deprivation, it is possible to find yourself asking, “Why am I putting myself through all of this?” I found my answer in Costa Rica, where my passion for medicine was reignited. For me, this has been the most valuable souvenir I can bring home with me. I now feel refreshed and ready to take on the world once I get back to the States. In a study I came across recently, an estimated 55% of medical students complete an international elective during or before medical school. I hope that many other students are lucky enough to have a similar experience. No matter where you choose to spend your time, I don't believe you can go wrong, but be prepared for adventure, in the form of potentially finding a snake in your bathroom or even stepping on a stingray in the ocean!

After reading about my enticing international adventure you're probably wondering how you can have your own! Most medical colleges have established international rotation Web sites or departments, so be sure to check with your school first. This can make the selection and the process of getting your rotation approved significantly easier. If your school does not offer these resources, here is some information that will be helpful. First, decide what type of experience you would like to have. Are you interested in a certain part of the world? I narrowed my search to Spanish-speaking countries. Is there a certain population with which you would like to work? Many programs abroad work with specific populations, so choose what interests you most. Once you've narrowed it down, you can start researching a program that fits your needs. Here is a list of Web resources to get you started. Good luck!

• AMSA International Heath Opportunities
• Global Medicine Network
• Medical Internships Abroad
• Electives Compendium
• Adventure Education Center—Medical Spanish

Back to April 2012 Issue of IMpact

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