I am currently a pediatric emergency medicine fellow and a prospective pediatric simulation fellow who will be spending 15 days among two Rwandan cities, Kigali and Butaro, helping expand medical education and simulation for medical students at the University of Global Health Equity (UGHE). UGHE is a global university in rural northern Rwanda that aims to train the next generation of Rwandan and East African leaders in global health and medicine. Its inaugural class started in 2019 and is currently gaining clinical clerkship experience. The university recently partnered with two major safety net hospitals that aspire to develop further as teaching hospitals. While I am there, I will work with a cohort of students undergoing their pediatric clerkships by leading daily morning reports, pediatric inpatient rounds, problem-based sessions, and simulations. The program emphasizes delivering education in novel ways, so I plan to have many “chalk talks”, case discussions, and “flipping the classroom” sessions to effectively communicate lessons that cater to various learning styles. My pediatric emergency medicine background also allows me to share my interest in pediatric resuscitation through teaching Pediatric Advanced Life Support (PALS) and Emergency Triage Assessment and Treatment (ETAT) during this time. Additionally, I look forward to expanding the simulation space at UGHE by running and debriefing simulations covering a broad range of pediatric topics.
I hope to make a difference in this actively expanding international program by sharing my passion for teaching and treating children with acute illnesses. I also hope to cultivate a deeper relationship with an international community so I may visit annually and make a lasting mark with didactic curriculum and simulation development for future generations of students.
My direct work will involve the medical students at UGHE, but I hope my participation also creates ripple effects for members of the Rwandan community. This community can benefit significantly from restructuring healthcare delivery to be more equitable; the university specifically aims to retain Rwandan and East African doctors who will be inspired to stay and re-invest locally as leaders in this movement. I have always wanted to take part in the empowerment of global communities through passionate education, and I look forward to contributing on an individual level to that larger goal.
The benefit will certainly be mutual. I will inevitably see different attitudes, resource utilization, and practice variations that will help me gain a refreshing insight into the way things are done in other corners of the world. I can bring those fresh perspectives back home to my community of pediatric emergency medicine doctors in New York.
The impact of my time in Rwanda will be two-fold on multiple levels. First, by sharing my experiences in pediatric emergency medicine, the medical community I work with in Kigali and Butaro will directly have glimpses into common problems, practices, and solutions within my community, and I into theirs. The exchange of resource allocation, hospital flow, location-based differential diagnoses and differing schools of thought will be valuable to take back home. Upon my return to New York, I plan to formally share such lessons through grand rounds and hands-on sessions for my pediatric emergency medicine and emergency medicine colleagues. Second, the roots I create during this visit will help expand our global medical community in so many potential ways that extend far beyond one visit. The team at UGHE and my network (both medical and simulation) will forever have each other as allies for collective growth opportunities. Lastly, I hope the most profound impact lies within the community members of Rwanda. By crossing paths with a young, inspiring group of to-be doctors who are ripe to re-enter their communities as changemakers, I hope my contributions will propel them forward with passion and energy.
Rwanda has experienced significant upward economic change over the last 25 years, rebuilding itself after traumatic historic events like the genocide of 1994. One way it paved the road forward was in efforts to address access to health. Statistically, the vast majority of Rwandans live in rural areas of the country, with limited access to healthcare. In partnership with Partners in Health and the Bill and Melinda Gates Foundation, envisioned with the help of Paul Farmer, a new medical school called UGHE was created. The University of Global Health Equity is focused on recruiting local future doctors and establishing a curriculum built on health equity to promote creating the social changemakers of tomorrow.
I came to the main campus of UGHE in the Butaro district as visiting faculty. I helped teach various topics in a “Welcome to Pediatrics” bootcamp. During this week, I taught the basics of pediatric assessment triangles, ETAT (emergency triage assessment and treatment), respiratory distress, seizure management, hyperbilirubinemia, and more. Some of these topics were more in a lecture format, while others were in small group sessions in a flipped-classroom model. During the second week, we hosted a daily morning report led by the medical students, followed by a full day of rounding in the pediatric inpatient wards at the Butaro Hospital.
My experience serving as an educator abroad was equally as challenging as it was rewarding. I often found myself thinking about how I could challenge our students to think beyond the textbooks and lectures. Doing so required observational skills on my part, so that I could really get to know each of the 18 students’ personalities, strengths, and weaknesses and tailor feedback to each of them personally. What warmed my heart the most these two weeks was how kind and open the students were to learning and growing.
I have just returned and I already look forward to future annual visits to a team of students, doctors, and patients who have opened their arms to all of us who visit their beautiful country. I am in awe of this incredible movement to nurture and retain doctors who feel empowered to keep rebuilding their communities centered on equity.
