Rotations at Bugando Medical Center

 Megan McGeehan spent eight weeks in Mwanza, Tanzania. 

"This summer, I completed an eight week elective rotation at Bugando Medical Center in Mwanza, Tanzania with three other Cornell medical students. We rotated through the ICU, Internal Medicine, Surgery, and Obstetrics/Gynecology. Having just finished my first year of medical school, I looked forward to applying what I learned in lecture to a clinical setting for the first time. Days before leaving the United States, we were memorizing microorganisms and learning the characteristics ofClostridium tetani. A week later, on our first day in the ICU at Bugando, we saw two patients with tetanus in different stages of the disease, and we assessed their clinical presentation firsthand, from lockjaw to muscle spasms. At the hospital, we worked closely with medical students and interns, who taught us about diseases that they commonly see in their setting as well as clinical skills. While we haven't learned the physical exam yet in New York, in Mwanza we practiced listening to heart and lung sounds as well as learned the basics of the CNS exam. Learning these skills at Bugando was especially useful since diagnoses often depend on physical exam findings when lab investigations and imaging studies are not available.

We were also able to rotate in Surgery for two weeks with Dr. Katrina Mitchell, a surgeon at NYP. Since surgery is such a visual field, this rotation in particular revealed the challenges of doing medicine with limited resources, and it was valuable to see how the surgeons adapt to having materials out of stock or a shortage in staffing. During our rotation, we also saw several surgeries that are no longer done in the States, such as prostatectomies. This spurred several interesting discussions about the different procedures that are done in different settings for the same diagnosis.

In addition to clinical rotations, I participated in field work weekly. Dr. Jen Downs' study team, comprised of Tanzanian medical students, nurses, and parasitologists, traveled to nearby villages and set up two-day clinics for the men living nearby. We tested the villagers for schistosomiasis, HIV, and syphilis, as well as screened for additional STDs. Our field work was unique in that it combined clinical research, centering on the association between schistosomiasis and HIV infection, with patient care, as we provided treatment to the men and their partners for any STD that we diagnosed. This provided a great example of how academic and clinical medicine can be merged.

My time in Tanzania has been a great learning experience, both medically and culturally. As a first year medical student, I feel lucky to be able to participate in global health in such a hands-on context, especially so early in my training. I would recommend this rotation to anyone looking for a clinically focused global health experience that spans a variety of specialities."

-Megan McGeehan, WCMC, MD Class of 2017