Paying My Experience Forward

Daisy WinnerBlog, Medicine, Uganda

I recently completed a year of service as a physician educator, teaching medical students and faculty. As I reflect on my time spent as a Visiting Lecturer at Busitema University’s Faculty of Health Sciences, I think back to my own experiences as a student, and how those moments from the elementary school classroom to the bedside during medical school shaped my own future.

As a kid in Austin, Texas, I remember fondly the field trips we would take in school.  I remember the visits to ButterKrust Bakery in elementary school.  Middle school and high school field trips exposed us to the theater. In college, an undergraduate university class in Texas Politics culminated in a meeting with the Chief Justice of the Texas Supreme Court. Field trips were a fun break from the usual daily schedule used to highlight real world experiences that apply what we learned in classroom teachings.

While I was preparing a lecture on Onchocerciasis, a neglected tropical disease with which I have had little exposure (also known as “river blindness”), I was connected to a rare remaining case in a village in our region. I thought this would be a great opportunity for some experiential learning.

The fourth-year medical students heard a lecture on the topic at 8 a.m. and then in the afternoon it was field trip time! Our contact with the National Onchocerciasis Control Program with the Ministry of Health at our local District Health Office led our two mini-vans full of Busitema University medical students. When we arrived, our host told us a brief history of the black fly vector, Onchocerciasis case-finding, and Ivermectin mass drug administration in the area. Then, we were escorted by the local teacher (who is also the Onchocerciasis elimination program contact in the area) to meet the gentleman. The elderly man was gracious with his time, explaining his decades-long history with Onchocerciasis and revealing some remaining physical findings of the disfiguring disease.

On the ride back to Mbale town, I sought approval from my van. “Was that interesting – did y’all learning something?” As they gave nods and thumbs-up of approval, one of my students responded: “Doctor, we have never been on a trip like this!”

This is just one example of a learning experience introduced by our cohort that creates a fulfilling intermingling of educational styles. Sharing this field trip with them gave me a deeper appreciation for my own educational and career course that brought me to this exact point.

I am a Family Medicine physician, fully educated and trained in Texas. While shorter prior exposures to healthcare delivery in East Africa created my interest in practicing and teaching medicine in Sub-Saharan Africa, Seed’s innovative model cleared the path for effective service.

But the educational debt burden amongst American medical graduates is growing. The average medical student from a public medical school graduates with over $180,000 of student debt.  For many, that rules out the ability to help shape global health through volunteer service such as mine. Yet thanks to debt repayment support from Seed Global Health, and partners like Bank of America, significant portions of debt are forgiven for each year of service, effectively removing some common financial barriers to working in underserved areas. For many of us, it’s the difference that allows us to teach medicine internationally, advancing global health and American diplomacy through volunteer service.

Busitema University’s Faculty of Health Sciences is currently in its fourth year. Last year we had one physician volunteer here and this year I was able to be one of four US physicians that helped graduate Busitema’s first class of 52 young physicians by 2018. Our partnership was so successful, that Busitema started a Bachelor of Nursing Science program in 2015-2016, and this year there are two US nursing educators building capacity in nursing as well.

Currently there are about 250 doctors for every 100,000 people in the United States. Uganda has only 4 doctors for every 100,000 people. The number of medical schools in Uganda is growing rapidly to help tackle this physician shortage, but more faculty are required. Serving as guest faculty at a public school of medicine, I was able to work and teach alongside professional peers for one academic year. This year long service allowed me to support and amplify the efforts of locally-based colleagues towards a sustainable scale-up of this critically needed next generation of health workers.

I know physicians are highly likely to practice in the geographic region in which they complete their medical training, and by serving as an educator in this remote medical school, I am hopefully able to improve the number of well-trained physicians who stay in Mbale to provide care and teach.

 

 

Seed’s debt repayment program has been able to provide millions of dollars in debt relief rewards to Physician and Nurse Educators. With support from partners like Bank of America, the Debt Repayment programs enables the financial freedom necessary for these highly-qualified professionals to serve.