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Christiana Care Medical Center Opens its Doors to International ACP Members and Physicians

Rodrigo Cruz

Rodrigo Cruz from Chile with Dr. Collier and ACP Past President, Dr. Dale

Virginia Collier, MD, FACP, Hugh R. Sharp, Jr. Chair of Medicine at Christiana Care Health System in Newark, Delaware and ACP Regent, has welcomed many ACP international guests into her medical center over the years. Two International Fellowship Exchange Program Awardees, Dr. Angela Castro Lopes from Portugal and Dr. Yomi Okunola from Nigeria, completed their rotations at Christiana Care under the guidance of Dr. Collier and her executive assistant, Marykay Ennis. Recently, Christiana Care also hosted Rodrigo Cruz Navea, ACP Medical Student Member from Chile and President of the Council of Student Members of Chile for a 4 week rotation. Christiana Care will also host Dr. Beat Frauchiger, a Chair of Medicine at a mid-size medical center in Switzerland, in May. We talked to Dr. Collier and Ms. Ennis to find out why they welcome international physicians to Christiana Care.

Dr. Collier has been an avid traveler for most of her life. When she and her husband finished their fellowship training in 1980, they packed up everything they owned and traveled the world for six months. This opportunity provided her with an understanding of how broadening it is to be exposed to different cultures and individuals from these cultures. It is an experience that she has often drawn on throughout the years.

Dr. Collier has regularly developed friendships with people in other countries and with people in the U.S. who come from other countries. She notes that each time she makes an international friend, it changes her perception of the country she is visiting and gives her a more in-depth understanding of the culture. She has carried these experiences with her while a residency training program director and now as Chair of a Department of Medicine.

This international outlook was the basis of an ACP Evergreen Award presented to the Delaware Chapter recently. Developed initially while Dr. Collier was Governor, the Delaware Chapter formed a program that funds Associates for 4-6 week international fellowships to provide medical care in underserved areas. When they return, these Associates make presentations to the DE Chapter on what they have learned during the rotations.

With respect to hosting international physicians and medical students, according to Dr. Collier, “These activities are not difficult to do and mean so much to the individuals who come to the United States. Hosting international visitors allows Department of Medicine residents and physicians to learn how medicine is practiced in other countries.” Through this international outreach and personal one-on-one contact, Christiana Care has also developed long term relationships with international physicians. Dr. Collier and Ms. Ennis have stayed in touch with their guests long after their experiences are over.

“In the future, if I have a resident who wants to go to Nigeria, we now have a friend in Nigeria whom we know is a good doctor, and we know that our residents can work with him and have a good experience,” notes Dr. Collier, who adds, “There is nothing but good that comes of this.”

Residents at Christiana Care have benefited significantly from the international interaction. During his rotation Dr. Okunola gave an eye-opening talk to residents about medical care in Nigeria. They learned how physicians are trained and about resource allocation in Nigeria, both of which differ significantly from what occurs in the United States. Dr. Castro Lopes also gave a talk on Portuguese medicine during her tenure at Christiana Care.

Christiana Care has been very generous to its international guests and has even been able to provide housing. While Dr. Collier highly recommends that other Chairs of Medicine take on the opportunity to host international physicians, she knows that this kind of generosity may not always be possible.

Of course, such an experience is not without challenges. Initially, Dr. Collier had difficulty determining which visa to recommend for the international physicians and brought in the first international guest under a complicated training visa which was time consuming to obtain. Eventually, they found a type of visa that was easier to obtain which made the process go much more smoothly.

Housing can be another challenge, especially in areas like New York City. While this was not a particular obstacle for Christiana Care, transportation was somewhat challenging. In suburban or rural areas like Delaware, where public transportation is not as widely available or reliable, it can be difficult to get around without a car; however, rental cars are expensive, and some international visitors may not have international drivers’ licenses. Both Dr. Collier and Ms. Ennis noted how adept their international visitors were at figuring out ways to get around. Ms. Ennis found the resourcefulness of international individuals particularly refreshing.

Dr. Collier noted that language barriers have not been an issue to date. Most of the international doctors who have visited Christiana Care have spoken excellent English. For those who were not as proficient in the language, it was not difficult to find other residents who were eager to explain or act as interpreters at lectures and classes.

One particularly rewarding experience for Dr. Collier was helping Dr. Okunola, a nephrologist, attend the American Society of Nephrology (ASN) annual meeting in Philadelphia during his fellowship at Christiana Care. Dr. Collier was able to get in touch with Tom DuBose, MD a former president of ASN who is also active in the ACP, who arranged for Dr. Okunola to receive complimentary registration to the meeting.

“It takes a relatively small amount of effort on the donating end, so to speak, to make a major difference,” Dr. Collier remarked.

Both Dr. Collier and Ms. Ennis noted that more than the two of them have made these experiences possible – the contribution of residents, medical students, other administrative assistants, supervisors, and other faculty have been critical.

“It’s always gratifying to see that everyone opens their arms to international visitors,” says Dr. Collier. “It has been a team effort, and everyone has enjoyed all of the visits. But it didn’t feel like an effort. Everyone pitched in and made it happen.”

Dr. Collier also commented on the importance of ACP to these initiatives. “If it weren’t for ACP, we wouldn’t have had any of these international visitors. The ACP is the center of all of this.”

It is a mutual admiration, as ACP depends on people like Dr. Collier and the staff at Christiana Care to make these visits a success.

Nigerian Oluyomi Okunola, MD, a visiting American College of Physicians Fellow (second from right), with mentors (from left) Claudine Jurkovitz, MD, Stephanie Gilibert, MD, Virginia U. Collier, MD, and Skip Kuhn, MD

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