Why every doctor should experience medicine abroad
Key Takeaways
I have had the privilege to work abroad in developing countries as a medical student and as a physician.
What I saw: India, Tanzania, and more
Ahmedabad, India, was my home for 4 months after I graduated from medical school. I volunteered in a women’s hospital on weekdays and at a community medicine camp on the weekends. I worked closely with many brilliant physicians who mentored me and taught me how to diagnose and treat a vast array of illnesses without the high technology that is used in the Western world.
Young women with pelvic inflammatory disease, older men with colon cancer, and children stricken with kwashiorkor were just some of the many patients I saw and helped treat.
During my first week in India, I delivered a 25-week-old baby boy whom I watched for an hour struggling to take his last breaths of air because the family could not afford to pay for ICU care.
I learned that episiotomies are India's standard of care for vaginal deliveries. I have seen my fair share of malaria and other infectious diseases in Tanzania. I have seen overwhelming oppression of women in developing countries to the point that female patients would rather see me, a white foreign woman, as a healthcare provider than a male provider of their own culture.
By the same token, I have had my fair share of patients in other countries shun me because I was unaware of their customs; after all, “How can a white female American doctor understand my background?”
I have worked in big international hospitals and makeshift clinics in villages, and I’ve walked to homes in remote villages as part of a medical triage team.
I have assisted with a cesarean section in an operating room without electricity, and so much more. Working abroad in medicine has made me a better physician and helped define who I am as a person.
A different perspective
Many patients and physician employers contend that physicians who spend time practicing abroad make some of the best physicians because they are quick on their feet, adaptable, culturally sensitive, problem-solvers, and effective communicators.
Working abroad in medicine not only challenges you as a person, but it challenges you as a doctor while broadening your cultural horizons. It gives you:
Insight into the pitfalls and positives of the US healthcare system
A different perspective on how to practice medicine
A different understanding of how patients in other countries live
"The experience of working abroad, and the lessons learned, can have a lasting effect on one’s approach to being a doctor."
— Kristen Fuller, MD
Regional infectious diseases
Regardless of which foreign country you choose to work in, you will be exposed to new illnesses and infectious diseases you may never (or rarely) see in the United States.
Seeing diseases common in other countries and understanding how various environments contribute to their prevalence can make you more knowledgeable about global infectious diseases when you return home.
Back in the United States, you may be more aware of malaria, tuberculosis, and different types of intestinal parasites. As a result, you may keep these diseases in mind when you see patients who have traveled or lived outside the country.
Our medical colleagues may miss many of these diseases because they haven't seen them first hand.
Coping with fewer resources
As practicing physicians in the United States, we often lose the “art of medicine” when it comes time to the physical examination, particularly the skills we once learned and practiced at the early stages of medical school.
Palpating the liver and gallbladder, percussing the lungs, and looking for Murphy’s sign are often physical exam skills we learned, were tested on, and quickly forgot the more our careers progressed. Nowadays, we often rely on diagnostic imaging and laboratory results to help us with the diagnosis.
Many developing countries, however, do not have these state-of-the-art technologies, so practitioners in those regions rely heavily on physical examination skills.
"Working abroad in medicine in facilities with limited resources opens your eyes to the abundance of resources in the United States."
— Kristen Fuller, MD
It may also help sharpen the physical examination techniques you learned in medical school
Getting out of your comfort zone
Being in a different country with a different culture, an unfamiliar language, and customs much different from those in your home country, you begin to realize that you are an outsider. You no longer have the familiar feeling of being at home, having your familiar office staff around you, seeing familiar patients, and having access to familiar technology, procedures, and medications. As a result, you are most likely out of your comfort zone.
Practicing medicine in a different country makes you realize you are an outsider looking in. But it teaches you what it’s like to not understand and to not be understood. Ultimately, this experience can give you empathy and compassion toward your patients back home who come from all walks of life and are often misunderstood by their own health professionals.
You become culturally sensitive
Often, practicing medicine abroad means that you must adapt to how different people think and live.
Many underserved populations in developing countries have their own unique way of living, and working in their country as a physician quickly teaches you that you are the one who must adapt to them, not the other way around.
You quickly learn which customs are appropriate, which phrases and words should be avoided, and how to adjust to another culture. In addition, you learn to pick up on the more subtle aspects of culture: mannerisms, conversational etiquette, and relationship building.
Learning to be culturally sensitive while working abroad can give you an advantage when you return to the United States. Whether you return to your previous job or take a new job in your home country, you have acquired the ability to be more cognizant of different cultures within your patient population.
With this heightened awareness, you see the special characteristics of such individuals as seasonal tourists, Native Americans, rural community members, inner-city youth, and others, and you know how to approach patients in a culturally sensitive manner.