The Repeated Themes of MSIH Clinical Rotation Blogs


For 17 years of the 21 years of MSIH’s existence, as part of the Global Health curriculum, the school has been sending 4th years students to partner institutions in resource-scarce medical settings. Eight-week clinical rotations range from rural African villages to South-East Asian clinics. These clinical rotations give students a first-hand experience of life as a physician in very challenging circumstances.

Anyone wishing for more information about the clerkships and their effectiveness can see this article.

Six Hundred Graduates

As these words are being written, students are doing clinical rotations in India, Nepal, Sri Lanka, Peru, Ghana, and a remote community in Canada. More than 600 of MSIH’s graduates have participated in such an experience over the years and they unanimously agree that it’s the most meaningful global health activity of their medical education.

One of the students’ academic obligations during the clerkship is to write a weekly blog post – accessible only to their classmates and course coordinators. Privacy is maintained so that students are free to express their feelings and perceptions only among those with whom they feel comfortable.

The blog posts – which already number well into the thousands – are an incredible source of observations and data. For years MSIH has been pondering how to base academic research on this reservoir of fascinating information, while at the same time preserving student anonymity.

Recurring Themes

While reading this year’s blogs, readers are struck by an overriding theme that arises year, after year. It’s something prominent, yet rendered mundane by its constant repetition. It hides a profound reality that deserves deep consideration.

Each and every student mentions that despite the lack of resources available to them, the local physicians do an exceptional job of treating patients and keeping up to date with modern medical developments. Without MRI machines, PET scanners and in many cases, even a simple ultrasound machine; these doctors perform daily miracles just with a stethoscope, bare hands, honed medical skills, local knowledge, and dedication to their communities.

The best way to describe the students’ awe at the local physicians’ skill level is to show some quotes from previous blog posts:

  • “While I believe there have been many advances which made the USA leaders in the field, it doesn’t mean the other way is the wrong way.”
  • I’ve come to understand that many of the things we see here both culturally and clinically are not wrong, just different.”

Other telling quotes that highlight the conditions under which resource-scarce countries operate are:

  • “They do not have the resources to do what they know to be best for their patients.”
  • “The diagnosis is “most likely” instead of “definitely” because the final test is too expensive.”

Fostering Partnerships

MSIH is hugely proud of its Global Health clerkships. True collegial friendships with clerkship sites have evolved over the years and the school has been fortunate to host visiting students and physicians from almost every site.

“This exchange of ideas and knowledge is immensely useful to our students and teaching staff and we thank our partner institutions for all their hard work and dedication,” says Prof. Alan Jotkowitz, Director of MSIH.

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