University is part of growing trend in global health Global health is an abstract concept. Feeling deeply the compassion and value of unselfishly caring for another human being is not. In fact, it’s tangibly present in the face of Michael Lockwood, D.O., ’81, one of a growing number of faculty and students who have experienced the transformation of providing international medical care firsthand. “Such work requires more than skill,” says Dr. Lockwood, past OMM chair at ATSU’s Kirksville College of Osteopathic Medicine. “It requires an appreciation of life and a notion that all life is valuable and that each person can do something to help.” Consistent with the humanitarian and altruistic ideals that originally motivate many to enter medicine, such work has been formalized into an international health education program at ATSU so that its students are able to do their part.
With the advent of the program, the university is formally bringing to bear a few of its core values and key educational tenets, including caring for the underserved and instilling compassion in its students. Such programs also are in line with the osteopathic mission of promoting primary care physicians, which studies have found global health programs to positively influence. “The art of the possible” Benefits to students, says Edward Cho, D.O., ’01, are many and include higher scores on USMLE boards; an increased awareness of public health, patient education, patient cost issues, and financial barriers; a decreased reliance on diagnostic testing; increased skills in history taking and the physical exam, doctor-patient communication, clinical and language skills, and cultural competence; and a predilection not only for a career in primary care but also in global health and continued secular and faith-based medical missions. In short, says Dr. Cho, assistant director of the New York Institute for Technology’s Center for Global Health, “Not only do we supplement our educational objectives, but we inevitably produce better healthcare professionals.” According to Dr. Cho, who also serves as assistant professsor in emergency medicine at NYIT’s New York College of Osteopathic Medicine (NYCOM), there also exists a competitive reason for offering such programs. Allopathic and osteopathic schools across the country, he says, are finding an increasing number of students choosing schools and residency programs based on the global health opportunities they offer. Dr. Lockwood agrees that such programs are gaining traction. “This generation seems to realize, ‘We are not alone on this planet.’ There is increasing interest in volunteering and being part of something larger than self.” Case in point is Ellie Jensen, D.O., ’09, who is in her intern year of internal medicine at Dartmouth Hitchcock Medical Center in Lebanon, N.H. Dr. Jensen recently completed a medical mission to Guatemala and says, “I absolutely think that incoming students look at what medical schools have to offer in regard to international health and mission trips. These are active students, many of whom traveled out of the country while they were in college. The opportunity to do it again is absolutely appealing for those students. I know that I looked for similar opportunities in my residency program search, and I would love to be able to do further medical mission work. Trips are yet unplanned, but I wouldn’t hesitate if they were to become available.” In 1991, Dr. Cho says, only 22 percent of U.S. medical schools/residencies offered courses in global health. In 2006, nearly all offered some avenue for students to pursue international opportunities, ranging from student-led interest groups, concentrations, travel support, or partnerships with foreign institutions. Medical schools are responding, Dr. Cho says, because “they are finding it teaches essential knowledge and skills that cannot be replicated in classrooms or hospitals.” Students working internationally “gain understanding in how diagnostic skills improve when you don’t have the technology piece at your disposal, but also cultural issues, working in a tough setting and a challenging environment,” Dr. Cho says. “They learn these things in a very short period of time, which is why the idea of having people involved in missions is very attractive to a lot of schools and programs.” It’s a “different kind of learning,” he says, “and the impact of what you do when you work overseas has a different impact than within the U.S., where there’s more of a layered safety net. If you’re in a developing country, you understand the implications of what you do and how you treat your patients and the big impact of their overall health outcome. “A lot of students and residents look at patients as cases, not people. Once you get the understanding of the deeper layer that goes into the socioeconomic reasons of why people are in the situation they’re in, they gain greater insight when they come back.” In such an environment, students learn “the art of the possible,” Dr. Lockwood says. “It’s ‘this is what we have. How can we make a difference?’” Dr. Lockwood joined with World Medical Missions for three mission trips to Afghanistan as well as a five-month trip to Nepal, which he funded personally. He says such missions provide a broad, comprehensive approach to medical care, with an emphasis on cultural and spiritual issues. “My faith commands me to do it,” he says of his international work. “There is such a tremendous need, and you cannot come back unchanged.” Indeed. Alan Barber, D.D.S., director of ATSU’s new international health education program, left his 27-year private dental practice in January 2007 to devote his time to such medical missions because of the life-changing effects they had not only on himself but also on his students. “Almost everyone has come back and raved about what they were able to do to help people who have absolutely no care,” he says. “It really lights them up and reaffirms their dedication to healing and compassion for others.” “Good health is more than just good healthcare” But make no mistake, Barber cautions. “This is hard work, and students are challenged. I think to help people who have so little kind of realigns perceptions,” he says. This, perhaps, is one reason Barber created True North Missions, a non-profit sending organization, after he left private practice. Dr. Barber, who has served as adjunct faculty in the department of family/preventive medicine and community health since 2001, also has been a preceptor for KCOM students on mission trips for nearly 10 years. Whereas in the past he and his students made a yearly trip to Belize, since 2007 impoverished Guatemala is the destination for Barber and his students, who have adopted 15 isolated Mayan Indian villages and two orphanages located along the country’s most famous river, the Rio Dulce, or “Sweet River.” Barber says his job – he’s working pro bono for six months – is to help develop an infrastructure, including clinics, food, lodging, and interpreters, and to coordinate participation of a multidisciplinary group of faculty and students. He anticipates making eight to 10 two-week trips each year, sending 25 to 30 students yearly from KCOM, SOMA, ASHS, and ASDOH. To prepare, his focus now is on fundraising and recruiting preceptors and faculty advisors for the trips. Across the country in New York, KCOM alumnus Dr. Cho and his Center for Global Health team have just returned from a four-week trip to Ghana as part of NYIT’s Certificate in Global Health program, which Dr. Cho helped to create one year ago. The program is a multidisciplinary, problem-based learning format to help students understand the issues involved in global health and includes content and perspectives from faculty and students not only in medicine and the health professions but also in engineering, business, and education. As Dr. Cho says, “good health is more than just good healthcare.” Dr. Cho, who completed his MPH at the Harvard School of Public Health, was recruited by NYCOM Dean Barbara Ross-Lee, D.O., to be part of the program, which includes coursework in health policy, health systems, health finance, and the environment of non-governmental organizations (NGO), as well as coursework in cultural and health disparities, tropical medicine, and infectious disease. Students complete all work on campus before putting the theoretical into practice in Oworobong, Ghana. “You won’t find it on MapQuest or Google Maps,” Dr. Cho jokes. Strategically located, the site covers up to 65,000 people whose nearest hospital is three hours away. In order to have a continuing presence, Dr. Cho is collaborating with a number of faculty and residency programs in the New York area. His job, like Barber’s, is to provide a genuine, quality environment for students that complements what they’re learning in the classroom while providing care to those who desperately need it. “What students learn is most important, but what they’re going to remember the most of their education are these kinds of experiences and how they enhance all the knowledge they accumulate over the years. They give purpose and meaning to what they are studying,” says Dr. Cho. Drs. Barber and Cho also hope to share something a little more intangible with the nation’s future caregivers – compassion. “Can we solve all of a country’s healthcare problems?” asks Dr. Barber. “No. That could take decades. But we’ve helped. We have done all we can as physicians and human beings. We have eased their suffering.”