Lunch Talk: 4th Year International Electives

Introduction by Bonnie Bissonette, Associate Director for Student Center for Global Education

• Office is on 3rd floor of SMC if you are interested in contacting her! 
• Services and opportunities: 
• 1-on-1 student advising 
• Logistical support for what you want to do 
• Holding Global Forums - six times a year, on global health topics (next one on Tuesday, April 23rd)
• Developing interprofessional programs (such as the Malawi program) 
• Helping with 4th year electives 
• Check out GHLOs - Global Health Learning Opportunities (by AAMC) 

Bonnie introducing the lunch talk. 

Dr. Neda Frayha, Office of Student Affairs - about the application process

• You will be interacting with OSA a LOT as you plan your 4th year, in general. 
• Currently 2 international electives formally in the student handbook:
• Pediatrics Elective (Doris Duke) in Mali (currently on hold due to political unrest)
• Elective with Dr. Nelson Goldberg in Department of Plastic Surgery - mission-based trip to do reconstructive surgeries on children (and often adults) - country varies by year (Guatemala often) 
• 4-6 months
• Usually for students who are interested in a specific field (surgery, gynecology recently) 
• Other opportunities:
• Often self-designed by student
• Working with faculty members met in 3rd year
• Working through other medical schools that offer a desired elective
• Fill out forms on the OSA Academic Handbook website. 
• If you are interested in Women's Health, Dr. Jowla is doing stuff in Africa.
• You can always extend your international elective by additional subsequent free months. 
• Remember that you want to be in Baltimore for:
• Interview season (November through January) 
• March - for Match Day (in case you don't match and need to do SOAP) 

Sarah Schaffer and Student Panel

• Identifying a site for an international rotation 
• Aparna: I lived in Peru for a year for research between 3rd and 4th year, so I already had my 4th year site identified (Lima's maternity hospital) 
• Joel and Adam: both interested in Emergency Medicine
• We reached out to EM faculty here at UMMC, who referred them to a colleague who set them up in South Africa. 
• May be hard to find a program that the OSA will give credit for - so find faculty members that can vouch for the program. 
• Takes around 1 year to identify and plan a 4th year rotation, so start early. 
• Responsibilities while abroad ("typical day")
• Joel: I worked at a primary care clinic, which basically functioned as the local ER in the area - so got a lot of hands on experience (seizures, lines, LPs, etc.) 
• Adam: A plus for doing an international elective is that you can basically function as a resident, with a lot less red tape than in the US. While I was in Cape Town, I got to do a lot of procedures that residents would have been doing, had he been in the US. 
• Aparna: I was at a Spanish-speaking high-volume maternity hospital. You have a lot more responsibilities, and often the attending doesn't check your work, so you have to be confident and accurate in your work. 
• Biggest change you will see is when you are writing out your notes in a different language. If you aren't fluent, you will have a hard time and not appreciate the rotation fully. 
• Best and worst part of the trip
• Joel: The best part was meeting medical students from around the world, also on rotation at your site. No worst part. 
• Adam: The best part was doing all the procedures on stabbed and shot people in South Africa. There was no worst part, but the financial aspect was a little daunting.
• Also was great for the interviews, especially for EM! 
• Aparna: The best part was learning about healthcare and doctor-patient relationship in another culture and country. This was also the worst part - sometimes, you will see patients getting treated badly because they were poor or because the doctors have a lot of power in that culture. 
• Definitely looks great for your resume. 
• Administrative hurdles and other advice
• Joel: Programs are often very unorganized. Finding housing was fine. 
• Aparna: I had free housing by staying with a Hopkins student in Peru. Programs will make you pay to do the elective, so you should definitely ask if housing/transportation is provided. 
• Adam: In the Mali Doris Duke fellowship, everything was provided. When you have to do find housing yourself, like in South Africa, it can be kind of frustrating - so start a year in advance! Definitely look for places that have provided housing, or that have people you know that you can stay with - these sites can be dangerous! 
• Don't forget about transportation. 
• Also, try to see if you can make the elective count for a required rotation. 
• Finances
• Aparna: My mentor paid for everything except food and minor expenses - because I was going back to do research, as well as my rotation.
• If you want to go to a tropical country, there is a Trop Med program that may help fund you. 
• CDC - Kenya
• Joel: My overall extra cost was around $4,000 - including flights, housing, tuition at the foreign hospital, etc. It was hard for us to find a research program to fund us. 
• Adam: Realize this is an expensive process, and be creative. 
• You need to spend time finding a research mentor and program - this can be hard in 3rd year, when everyone is so busy. But there is definitely  funding out there!
• Google non-profit organizations/NGOs that may help pay for a portion of your work ("international medical mission") 
• Time of 4th year for trip
• Aparna: February, after interview season and before Match Day
• Adam: Avoid November through January. We went from October to mid-November to catch the summer in South Africa, but had to shift my interview schedule. 
• You must have internet access to schedule your interviews! 
• The best time is probably spring (February) - because you have free time that you can choose to add on to your rotation. 
• Other Q&A  
• Joel: Make sure you bring a mask if there is rampant TB in that country. 

Malawi - Summer 2013

Click here for information about the Malawi summer opportunity!

Students in Malawi, summer 2012

Summer Research Opportunities Abroad

Main Points from the Summer Research Opportunities Abroad lunch talk, co-hosted with SALUD on 11/19/2012

Click here for the powerpoint used in the lunch talk.

Identifying a Mentor

• Start early! I did malaria research in Burma and first contacted my mentor in December and first met with them in March. (Christian Larsen). 
• I didn't have a mentor - I did it all on my own. (Mike Robbins)

• It was helpful to talk to Dr. Warnick (who handled research for our year) and also to go on a UMB-sponsored trip, so I didn't have a specific mentor. Keep inquiring and expressing interest. (Kristin Lohr). 

• I also did not have a mentor, but I found OSR to be a good resource. I went to Chile. (Alexi Pappas)

• I continued prior clinical research that I had been working on with a colleague from  Barcelona, Spain.   Remember that UMB is full of researchers that work with people around the globe, so don't feel restrained to OSR. (Michael Atlas) 

Identifying a Project

• Figure out where you want to go, and then narrow down projects or opportunities from there. (Mike Atlas). 

• Take advantage of the Global Education Center here at UM, newly opened this year! (Kristin Lohr)

• Don't be too picky about the project you do. We both did lots of random projects but still had a great experience (Mike Atlas, Alexi Pappas) 

• rewriting training courses and manuscripts 

• scrubbing in to the OR

• helping in research labs 

• Be sure you know your own interests, since a mentor will likely ask you, "What do YOU want to do?" (Sarah Schaeffer) 

Funding

Many projects are self-driven, requires lots of persistence in finding a mentor, identifying a project, and finding funding. More success is probably found in established programs, but you can do your own if you work hard enough at it. Some possible funding sources include:

• UM - look for fully funding programs (ex. SRTP) 

• Your future mentor

• You - yes, you may be forced to decide if you want to foot some or all the bill yourself - of course, as a last resort! #YOLO. 

Overall Lessons: 

• Don't give up! (Christian) 

• It is nice if you either know what you want to do, OR where you want to go. Don’t necessarily need to know both – but will help focus the project. (Alexi)

• Don’t stress about funding. Just decide where you stand on paying the bill yourself early-on. (Mike Atlas)

• Do something that inspires you (Mike Robbins) 

• If you want to do international work, actually doing it in the summer is the best motivator to come back to 2nd year and work hard. (Kristin) 
• Remember that you will have only completed 1 year of medical school, so you will not have as many skills as if you went in a 4th year elective. But the experience is still very valuable. 
• A note about language barriers: Being somewhere where you do not understand the language can be mentally taxing for both you and other people around you. It can be difficult and exhausting. If you do not speak many languages, try to choose a country where more people speak English. It shouldn’t inhibit you from going anywhere, but definitely consider it. Also consider cultural barriers, in addition to language barriers. 

Resources:

• Center for Vaccine Development - great place to find a mentor 

• Institute of Human Virology - esp if you are interested in HIV work

• Global  Health Interprofessional Council 

• Student Center for Global Education & Bonnie Bissonette