I will be volunteering in April/May at the National Referral Hospital in Bhutan. This will be through HVO and specifically be to help train local physicians in Emergency Medicine. This will include: case presentations, clinical training, continuing education, didactic instruction, faculty/staff training, formal lecturing, grand rounds, and mentoring.
The project directly benefits the people of Bhutan. Because of the small size of the country and small population (less than 1 million) there is a lack of resources, especially when it comes to more advanced medicine. There are only 3 hospitals in Bhutan, and the National Referral Hospital is the only one with specialists. The population in Bhutan is generally underserved and poor. A new Emergency Medicine program has recently been started there to help train local Bhutanese doctors in Emergency Medicine. I will be volunteering to help with this program.
One of the main reasons that I elected to volunteer with this program is because it directly helps the local population. The Emergency Medicine Program will be helping to teach local physicians to become trained in Emergency Medicine. The hope is that by teaching local physicians, they will then, eventually, be able to continue the program and teach subsequent generations of Emergency Medicine Physicians.
Photo #1: 45 y/o F with a large epidural hemorrrhage. Pt actually came in neurologically intact but after about 3 hours, had a significant change in mental status, she was re-scanned and this is one image from her CT. Ultimately she had a great recovery, and was walking and talking about 5 days later. She did require operative management after being stabilized in the ED, got a burr hole and evacuation of hemorrhage.
Photo #2: Triage training for entire ED staff that myself and 2 of the other ED consultants did. We taught them a new and much improved system for triaging all patients presenting to the ED, with the hope to expedite the evaluation and treatment of the sickest patients and overall improve ED flow.
Photo #3: This is the group of Emergency Medical Response students. They will become the countries first paramedics. While there are some people operating ambulances at the moment, most are minimally trained. These students will be well trained and able to provide many more services and much improved treatment in the field.
Overall, the trip was amazing! I had an incredible experience and I am very appreciate for the grant from Doximity to pay for my travel to get there.
I spent most of my time, in the Emergency Department, working with the local medical officers and the 2 ED residents. Helping to train them in Emergency Medicine, including in seeing and evaluating patients. Appropriate workups and evaluations, as well as helping to improve their procedural skills. They are a very dedicated group of medical officers and very eager to learn and improve.
I was also fortunate to be able to help do some of the training of the first paramedic class in the country. They have one more year, mostly of clinical training, but will become the country’s first true paramedics. Given the often very long transport times in the country, this will be a huge improvement.
Along with the two other American ED consultants that are there working for the Bhutan government, I helped in a 3 day training seminar for the entire ED department. We taught a new model for triage, developed in part by the WHO. The hope is that this new system, will improve the throughput of patients in the ED as well as help facilitate and speed the evaluation of the most critical patients.
Outside of the ED, I was enamored with the country and its people on a whole. The parts of the country that I was able to see was beautiful. The Bhutanese people must be the kindest, most gentle population in the world, certainly from what I have encountered.
I am very much hoping to return some day, hopefully in the not too distant future. I really enjoyed my time there and no doubt gained a much better understanding of their culture and life there.
Thanks again to Doximity and the Dox Foundation for the help and support.