I will be traveling to Botswana to work on the Medicine wards at Scottish Livingston Hospital (SLH) in Molepolole. At the hospital, I will be taking care of patients on the inpatient General Medicine wards (including the Isolation ward, which treats patients with active tuberculosis infections). I will also be working in the outpatient clinics including the primary care clinic, the HIV clinic, and the tuberculosis clinic. While working at SLH, I will provide formal and informal teaching to interns and Medical Officers at SLH. This includes bedside teaching during rounds as well as morning educational lectures.
The population served will be the residents of the Kweneng District of Botswana, which is home to just under 400,000 individuals. SLH serves as a secondary referral center within Kweneng District, and while I am there I will be part of the team providing general inpatient Internal Medicine, outpatient primary care, and both inpatient and outpatient HIV-related and TB-related healthcare within the Kweneng District. The ratio of doctors to patients in Botswana is much lower than in the United States, increasing care gaps within this population. This is compounded by recent medical supply shortages.
Additionally, I will play a role as a medical educator for interns training within Botswana’s medical education system. Botswana currently has one medical school which was opened in 2009, therefore medical education infrastructure is still relatively young in the country.
Botswana has approximately one tenth the doctors per capita as compared to the United States. Therefore, the most immediate impact will be directly providing healthcare to individuals in a system with significant physician shortages. I also hope to contribute to a sustainable impact by directly training upcoming Batswana medical professionals through medical education, including both bedside teaching with interns from Botswana as well as formal educational presentations during my trip. Many of these doctors will continue to work in Botswana throughout their careers, contributing to the long-term effort to decrease shortages.
Lastly, as I intend to subspecialize in Infectious Disease after residency, this opportunity will help me hone a valuable skillset within ID, particularly in regards to tuberculosis care and HIV care. I anticipate that my exposure to TB and its complications will be much higher in Botswana than while practicing in the USA, which will be critical to my growth as an ID physician. I will be able to transfer these experiences and skills to patients throughout my career.
I had an amazing time in Molepolole. I spent the majority of time working in the medical wards at Scottish Livingston Hospital. I worked with the inpatient Medicine team to treat admitted patients for everything from DKA to disseminated cryptococcus. While on the wards, I had the opportunity to teach the interns, both informally on rounds and formally through morning didactics. I also helped to lead a sim session on response to cardiac arrhythmias.
Outside of the wards, I had the opportunity to work in multiple clinics during my stay. One such clinic was the primary care clinic, where I helped interns develop their plans for patients. Additionally, I had the chance to work alongside a Medical Officer at the Occupational Health Service Clinic, where we saw patients with occupational lung diseases related to gold mining. Due to the correlation between structural lung disease and TB re-activation, we diagnosed and treated a good deal of TB at the clinic.
Overall, this trip was a great experience for me to experience and work in a medical system outside of the United States, as well as to contribute to medical education. I gained experience in diagnosis and treating infectious diseases that are common globally but less commonly seen in the US, primarily TB and complications of untreated HIV. These are experiences that will be important to me as I pursue a fellowship in Infectious Diseases.
