Session 178

Your questions are taken directly from the Nontrad Premed Forum. Be sure to register for an account if you haven’t yet, and join a collaborative community of like-minded students.

This week, we tackle a question about global health and volunteering abroad.

Meanwhile, be sure to check out all our other resources on the Meded Media along with a host of podcasts to help you along your path.

[00:52] OldPreMeds Question of the Week

“I am hoping to get feedback about whether I should put my global health experience on my med school application or not.

I have what I feel is great global health experience. However, I have been getting more and more concerning feedback on what that experience will look like on my med school application.

Recently, my adviser at school told me that the experience does not count as healthcare experience, it only counts as a cultural experience.

Additionally, I have heard that some med schools are starting to reject applications with any global health experience at all to discourage students from doing short term medical “missions” that can be damaging to local communities.

Lastly, I had posted something in the Premed Hangout Facebook group about my experience and how much I enjoyed being in the OR shadowing cataract surgeries.

I posted a picture of myself with one of the ophthalmic nurses I had become friends with over the duration of my experience. I was really surprised by the amount of negative feedback I got from the Facebook group.

People began privately messaging me and commenting that what I did was unethical, I didn’t deserve to get into medical school, and making comments that it looked really bad for a white woman to go to a third world country to participate in one of these programs that takes advantage of under-served and under-represented populations.

I ended up deleting the post and leaving the Facebook group.

It was really disheartening because I had put a lot of research into making sure I chose a program that really emphasized responsible global health practices that provide long term and follow up care to patients. I am now very concerned about the experience of having a really negative impact on my application.

I have several years of experience working as an optometric technician and grew very passionate about eye care.

One day at work, a pharmaceutical rep told me about her experience volunteering abroad on an eye care trip and I thought it sounded like a great opportunity to give back to the world for something I was passionate about.

I began researching programs and learned about the differences between doing a program that focuses on providing sustainable global health and doing a short term eye care “mission” trip. After understanding that the short term trips, even if well-intended, can actually have a really negative impact on the communities they are trying to help, I found a really great program called Unite For Sight.

Unite For Sight partners with local native ophthalmologists in Ghana, India, and Honduras to provide them with funding to run outreach programs through their private clinics. With the funding from Unite For Sight, these private clinics are able to hire a local outreach team.

The outreach team has a designated region. And each day, they travel 1-4 hours to different outreach locations to provide eye screenings by local optometrists and ophthalmic nurses hired for the outreach program.

They are then able to dispense reading glasses and medications for conditions like glaucoma etc. When a patient needs surgical treatment for something like cataracts or glaucoma, arrangements are then made to transport the patient to the main clinic for further testing or treatment.

The patient usually stays near the clinic for a few days for follow up care and then the ophthalmologist will travel to designated areas to provide further follow up post-op care around the 3, 6. and 12-week mark. At the last post op, once everything is healed, they are given a new glasses prescription.

The outreach team also partners with local community leaders in the towns they travel to in order to spread awareness of the program and gain good trust with the community in addition to training local community volunteers.

What I really love about this program is that each outreach point is visited on a regular basis to provide long term and follow up care.

Patients are able to be monitored and given medication refills to last until the next visit. Where the volunteer work comes in is with assisting the outreach team with the eye screenings.

As a volunteer, you are required to go through a training program 30 days before your departure date that educates you about global health, cultural diversity and cultural competence, and of course, eye care.

Once at the location, volunteers are trained on how to check visual acuity and take patient history working with a local translator.

Volunteers also assist with cataloging data so that the program can track patient outcomes so that Unite For Sight can measure the impact they are having in each local community in order to develop the most effective practices for long term success.

Lastly, another thing that attracted me to the program was that there are over 25 medical schools. And many optometry schools who have affiliations with Unite For Sight will give their students academic credit for doing one of their clinical rotations in the program.

After finding a program that provided sustainable health care to local communities, I was excited to see the school affiliations because to me, it seemed to validate that the program was truly having a positive impact on the communities they are in.

I now feel like I am almost instantly attacked by mentioning that I did volunteer work abroad to anyone without being given a chance to explain the program that I did or why I chose it.

I truly believe that the program is having an amazing impact on underserved communities and wholeheartedly support it. However, I am concerned that by putting it on my application it will automatically give a negative view of me just by having the words “Global Health”.

Has anyone else had a similar experience? What are your thoughts or opinions? I really appreciate any and everyone who took the time to this long post! Thank you for your input and advice!”

[06:50] Global Medical Volunteerism

Global medical volunteerism has been controversial. It has been on the news, with some discussions about its impact on the communities. It sounds that Unite for Sight is an organization that is doing a lot of good.

Where students go wrong is they find some program that was started randomly maybe at a university and they don’t have the infrastructure. They don’t have the support of the community where they’re going. They don’t have the long-lasting impact that some programs have.

And that’s where a lot of the negativity comes from. They come. They do things. They leave. And then people in the community are worse-off for it.

[08:00] Where the Negativity Comes From

The Dunning-Kruger effect is a type of bias wherein when somebody reads the headline once, they assume all of it is bad because they read one headline. You have to completely ignore that.

What is happening is a premed goes overseas to a third world country to assist in surgeries. They would do things to patients that they would absolutely not be able to do with patients here in the United States based on their level of training.

That’s where the biggest negativity comes from. It’s not the medical tourism, specifically. But it’s going abroad and doing things to patients that you wouldn’t be allowed to do here.

[09:15] Should You Put This on Your Application?

You have experience working as a technician in an optometry office. So you have the training and the skills to do a lot of this stuff. For you, this is less of a concern.

This depends on what you’re going to be talking about in your application in terms of what you’re doing to the patients. If you’re just talking about interacting with the patients and doing some visual acuity and taking histories, then that’s great! You’re not doing anything “to” the patient.

So it’s really up to you on whether you should put that on your application or not. But I don’t see why you shouldn’t put that on your application.

There could potentially be one person at one medical school that may see and screen that. You can’t prevent that from happening.

[10:42] Always Understand First

Lastly, for everyone listening to this podcast, don’t attack other people for what they’re doing. Try to understand first.

As a physician, a colleague, as a patient, as a friend – always come from a perspective of understanding things first before handing out advice.

And for the most part, people don’t want your advice, so keep it to yourself.

Links:

Nontrad Premed Forum

Meded Media