Jessica Schmidt, MD
Jessica Schmidt, MD
Emergency Medicine · Madison, WI

POCUS in Rwanda and Uganda

February 4th
Kampala and Mbale, Uganda; Kigali, Rwanda

Project Description

Point of care ultrasound (POCUS) is becoming increasingly important in the management of acute medical conditions across Africa; however, a lack of training stands as one of the most significant barriers. My project will be to increased POCUS training in Rwanda and Uganda, both sites where I have worked previously.

On the first leg of my trip, I will travel to Kigali, Rwanda. Here I will collaborate with a multidisciplinary team working on POCUS medical student education. This group, from King Faisal Hospital, is designing a longitudinal ultrasound educational program for medical students in their final year, integrated across clinical rotations. My role in the project will be as a content expert in the educational software platform. I will be meeting with key stakeholders to finalize protocols and test pilot educational platforms.

For the second part of the trip, I will travel to Uganda to as the lead instructor for two POCUS workshops. The workshops will be held for physicians in the capital, Kampala, and in the Eastern region of Mbale. The workshops will cover basic and advanced ultrasound applications used in common clinical practice. Agendas and recruitment were conducted in collaboration with leadership at both sites and address the educational needs of both of these unique clinical practices. In Kampala, the target audience for the workshops will be emergency medicine residents working at Mulago Hospital. In Mbale, a smaller town six-hours east of Kampala, the target audience will be pediatrics and internal medicine physicians.

Population Served

Rwanda: King Faisal Hospital is a large quaternary hospital in Kigali with several specialties including cardiothoracic surgery, emergency medicine and critical care. The hospital has 160 beds and around 8300 admissions per year. The hospital boasts many specialized facilitates and is working toward development of a kidney transplant center. Medical students

Uganda: In Kampala, Mulago Hospital is one of two public national referral hospitals serving the urban population of Kampala as well as referred patients. Mulago hospital has the only 24-hour public emergency unit for trauma. In Mbale, Mbale Regional Referral Hospital, is one of fourteen public regional hospitals in Uganda. The hospital serves a large catchment of approximately 4.5 million people from 16 districts and is one of the busiest regional hospitals in Uganda.

Expected Impact

This goal of both of these trips is to expand access to ultrasound training. In Rwanda, we hope to build and strengthen a younger generation of POCUS enthusiastic. As hand-held devices are becoming more accessible, medical students will be gravitating more to the use of POCUS in their medical decision making. Our goal is to develop and evaluate a training program that will position Rwandan medical students to be able to acquire and attain knowledge and skills to use in clinical practice as they move into practicing physicians.

In Uganda, the goal is to increase POCUS knowledge for physicians already in practice in order to improve clinical care. POCUS has been shown to decrease length of stay, improve diagnostic certainty and even improve provider job satisfaction. The Uganda POCUS workshops are part of a larger project with continued ultrasound medical education which will be conducted remotely and with site visits.

Trip Photos & Recap

We brought a group of five emergency physicians to implement two highly successful POCUS Bootcamps for physicians in Mbale and Kampala. We trained 46 participants total including residents (senior house officers) in Emergency Medicine, IM, peds, anesthesia, OBGYN and surgery. In addition, we partnered with local champions to create ongoing quality assurance with image review.

Residents at the training were engaged, inquisitive and exceptionally quick learners. It was energizing to see the enthusiasm they brought to learning this new skill. Immediately after the course, residents were able to implement POCSU skills in the inpatient wards for ultrasound-guided procedures and diagnoses. One of our physicians was able to stay in Mbale for ongoing hands-on education in the clinical wards where POCUS had an immediate impact on acute resuscitation and patient care.
I am thankful for my team from the US and my Ugandan partners for making this course successful. We look forward to our sustained partnership and ongoing collaboration in education, clinical care and research!