Student Reflection by Evelyn Dunn

My Final Rotation in Medical School: An Experience in Kenya

When I set out to do this elective I had a number of goals that I wanted to accomplish: to improve my communication skills with both patients and members of the inter-professional health team, to continue to develop my clinical skills, to challenge myself to adapt to working in a new culture and environment wholly different from that of my previous experiences, to learn about how resource limitation and also allocation affect management plans in resource-poor countries, and so on. One of my more personal objectives was to explore a new part of the world, and through this to improve my understanding of what the human experience can be for different people. I believe through this elective that I achieved all of these goals, and also grew as an individual more than I could have anticipated.

I have no doubt this experience has improved my ability as a new resident and future practicing physician to deliver compassionate, patient-centered care. Learning to adapt my skills, techniques, and plans of care for patients in resource-constrained settings will also prove to be an invaluable experience in my future training and practice. The patient encounters I had in Kenya will stay with me in my memory – in the initial visit to the Gynecology ward I met approximately 10 women, all younger than myself, who were suffering from late stage cervical cancers. This is unheard of in Canada, but is a hugely devastating disease of women throughout Africa. While the presentation and stage of disease was generally far worse than I have observed in Canada, there are such great gains that can be made in the care of women in Kenya. The potential to make dramatic impacts on both morbidity and mortality is very exciting as a young professional in healthcare. It is remarkable and inspiring to have observed and participated in this.

Learning about the importance of teaching and working within the system there, as opposed to attempting to transplant our system overseas to a place without the resources to do so is something one must realize when participating in these types of exchanges. Giving them the skills and useful materials to stand on their own and to function without continual support from overseas faculty is key for these partnerships to flourish. Another obvious but important realization for myself was that what might never be considered an appropriate option in Canada could be a feasible option in other settings where disease, resources, and beliefs are wholly different. This elective challenged and changed my beliefs of what I consider compassionate and appropriate care, and I believe I will be a better physician because of this.

These 5 weeks in Kenya acted to reinforce my commitment to women’s health from a global perspective and my desire to continue to participate in learning opportunities and clinical experiences outside of North America. Partnerships such as this one with the Moi Teaching and Referral Hospital provide exceptional opportunities for students like myself, as well as staff persons to be part of something that will make great impacts on the lives of many.