The Pros and Cons of Global Healthcare Experiences

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Session 318

Lawson is the executive director at Atlantis, a leading global healthcare experience fellowship that gives you the chance to explore other healthcare systems.

Today, we cover what you should be looking for, what you should be avoiding, and much more!

Based in Washington, D.C., Atlantis does international programs for premed students. Lawson has been working with the company for over three years.

[03:03] Is it Worth the Experience?

What is the value of this is a question they commonly get. Whether it’s a good fit for them or not or how do medical schools look at these types of experiences. Lawson thinks the answer basically depends on the student.

'Like any good premed student preparing for medical school, be very thoughtful about the story that you're crafting.'Click To Tweet

Assuming that you have a strong GPA and MCAT, beyond that, medical schools are looking for what is the story of this person they’re seeing on the resume or in the interview.

With this being said, global experiences can be a big part of that story for some candidates. You certainly don’t want it to come across as manufactured or fake and this is the fear that some students have. They fear it’s not real or it’s not as valuable in the medical school process.

But Lawson believes that properly done and understood, this can be a really significant part of the student’s application.

[05:12] How It Can Come Across as Manufactured

Sometimes, you need to ask good questions. Sometimes global experiences or global programs in health are not done responsibly or where the incentive structure is going to be helpful for the education of the student. Lawson says there are two sides to this.

On one hand, for instance, the program may make a big payment to a physician and maybe the student to physician ratio is not very good. Sometimes, the program itself could seem like a high priority but when you get there on the ground, in a foreign country, you meet the healthcare partner and realize the priority is not really towards the student’s education or experience.

The other side is that as a premed student when you’re thinking about crafting your narrative in your story, students often think that everyone else has global experience so they have to have it to be competitive. But that’s not true.

'You definitely don't need to have global experiences to get into a great medical school.'Click To Tweet

As a result, sometimes students would rush into just checking off the box and go abroad to volunteer. However, Lawson points out this is not a thoughtful way to approach this either.

[06:58] Volunteering in the U.S. and Abroad

Over 90% of the programs of Atlantis are in first-world European hospitals. Lawson says there’s a conflation in the U.S. premed community of this idea of global health in more developing or under-resourced areas. That said, there are so many opportunities to do that in the U.S. and there is so much need. Not to mention that you don’t need to deal with some strange ethical situations or some of the cross-cultural things as much if you did this in the U.S.

Students don’t often look at rural healthcare or urban poverty as much as they should when thinking of volunteering programs but if you’re bent on going abroad, it is particularly challenging to find a professional and ethical global health program for premed students if you’re going to under-resourced environments. It’s just harder. Lawson warns there are lots of shady volunteer programs. As a premed student, you can get into situations that you might not want to talk about in your medical school application.

[10:05] A Backlash of Shadowing Abroad Among Medical Schools

It saddens Lawson that many students are wary about global experiences because he thinks there’s so much that can be learned from a good global health experience. But there’s been pressure both from the inside of medical schools as well as influencers and thought leaders outside of medical schools that have been pushing this.

Some admissions committees are very concerned and very particular about this while others don’t care quite as much. And the very thing they’re concerned about is this general principle that a person should not be practicing medicine in an unlicensed way. So you should not do things you’re not trained to do.

Lawson explains that it’s miscommunication and the need among underserved communities that have led to students being put into positions where they’re asked to help with things like delivering babies or stitching someone up. The local healthcare practitioners are pushing them and they may not understand that they’re not trained. Plus, there could be language barriers. So it’s a very difficult situation.

'Premed students don't really realize that doing any sort of practical medicine without training is really not smart and not ethical.'Click To Tweet

Many premed students don’t realize that doing practical medicine without training is not ethical so they sometimes like to brag about this on their application. And this is when you start to get into trouble if you talk about it and if you talk about it extensively in a personal statement or an interview.

There are extremes of this and a lot of times are the minor things like takinga physical or taking blood pressure, denoting grey area on some of these practices. What some admissions committees might look at badly upon is when they’re taking a patient’s blood pressure even if they don’t have the qualifications to do that even if they’re supervised.

'I don't think you should treat global health experiences as a venture where you can try out things on foreign patients.'Click To Tweet

[15:50] Why Shadow Abroad

Lawson reveals that only about 15% of students they surveyed said it’s easy to get shadowing experiences in the U.S. While the vast majority of 55% said it’s hard to get shadowing opportunities but they can figure it out. Then about 28%-30% of students say it’s very hard to find quality shadowing. And students, who have found a quality global health program that does things in an ethical way, say it’s easier. The way hospitals work and their incentive structure in Europe for instance, are more open to training and observation. They even have extra capacity that sometimes U.S. hospitals don’t have. And the physicians have a different mindset on compensation and the value of time than U.S. physicians do.

Another reason is the comparative health care aspect. Europe’s health care system is a single-payer health care system. But the U.S. has struggled with this internally although there are parts of our policy now that’s headed in that direction. But it’s helpful for students to really live in and understand the pros and cons of the single-payer system especially if you want to have any sort of activity or voice in policy health care.

That said, Lawson doesn’t think everyone needs to go abroad to shadow. At the end of the day, it has to be the quality of shadowing you’re getting.  A lot of students look at shadowing as to check off for clinical experience in general.

At Atlantis, they educate students on the idea that shadowing is not a check off that you can put on your resume. Instead, look at t as an opportunity to understand medicine and to understand the life of the doctor because this is what you want to do for your whole life. So they want to give their students extensive and varied exposure to real medicine.

'Look at it as an opportunity to understand medicine and to understand the life of the doctor because this is what you want to do for your whole life.'Click To Tweet

Additionally, they could get very important takeaways from shadowing abroad. But if you can do it in the U.S. then by all means. Lawson says that while there’s a degree to it where students really struggle to find clinical experiences in the U.S. so they go to Atlantis for the clinical experience. But that can be rare. He says it’s typically someone who has an interest in global things and global health experience.

[22:35] Financing Global Health Experiences

Their programs are not cheap and there isn’t a super easy way to go abroad in general without spending thousands of dollars. On their end, pay attention to financial aid, scholarships, fundraising, etc. There are organizations that give financial aids. Don’t think of going shadowing abroad as a luxury and only rich people can do. A majority of their students don’t come from wealthy families but a lot of them are contributing a lot financially themselves from their savings, work, and fundraising, etc. With that said, they get more experience at the end of the day since they do take these more seriously.

Moreover, Lawson points out that education is usually not free. even if you get unpaid internship, that’s costing the hospital or the intern provider something. Everyone is used to spending money on tuition. And people are spending all this money on their GPA or their brand of college. But they’re not willing to spend even $5,000 on great MCAT prep or interview prep, which are other things that are extremely important for getting into medical school. Although this makes sense since these are going to be out of pocket, which is an upfront cost.

When you spend your dollars on education, you should be thoughtful about what really do you need in order to move to the next step. It’s not only the GPA that’s important but other things too.

'It's really smart to invest early on in your education because of the compounding returns on that.'Click To Tweet

[28:27] An Overview of Atlantis Programs

They try to keep the focus of the program on the hospital. They partner with public hospitals in Europe and with the National Ministry of Health in Italy, considered as the best public university hospital in Italy, regional services in Spain, and private and public hospitals in Portugal and Greece. That said, they’re more focused on hospital experiences. They spend a lot of time preparing departments, doctors, the hospital administration for their student groups every summer.

Mondays through Thursdays would be hospital focused. So students spend the majority of the day in the department doing one to one shadowing or sometimes with one other student. By 3 pm, doctors would be wrapping up their day and students would already be coming back to their housing to relax. There are group meals but Mon-Thurs is mostly hospital-focused. Friday, they do a full day excursion so they take students to something cultural or local, going to a historic or cultural site or some outdoor activity like hiking, kayaking, etc. So they try to have some fun activities on a Friday. Then weekends are free. They used to do a lot of scheduled programming but they realized a lot of students weren’t showing up because they wanted the free time.

'Shadowing is more exhausting than students usually realize. You're on your feet most of the day.'Click To Tweet

[31:00] Basic Logistics When Going Abroad: Safety

A lot of people are concerned about safety and the actual international travel (cost, etc.). For the first time international traveler, safety and the travel aspect can be daunting. Flight costs can vary a lot depending on different factors like dates, times, etc. So be willing to invest a good bit of time comparing flight prices and different options. Research on the best flight because you could literally save hundreds of dollars just by tweaking little variables like departure airport, return date, etc. And a lot of students don’t realize that so they can get intimidated by the cost of the trip to Europe. Students on the east coast should be able to find a flight if they’re booking 3-4 weeks ahead of time in the 600-700$ range. This is way less expensive than students think it would cost.

On the safety side, you can use the U.S. Department State’s safety ratings. There happen to be some attacks in Europe in the past few years but as a whole, most cities that students reside or stay in the U.S. are more dangerous than any place where they operate in Europe. They have more challenges with students in alcohol, than anything else, but no violent crimes whatsoever.

Check out Atlantis’ website to learn more about them and the programs they offer. Call them and they’d be happy to help you understand what’s a good fit for you.

[36:00] Should You Really Shadow Abroad?

Don’t use this thinking this is going to put you over the top of your medical school application or going to get you into medical school. Don’t think of this as something that would stand out in your application.

If you can afford to go on one of these experiences without going into debt, then it’s something to look into. But if you can’t, that’s okay. Not going to one of these isn’t going to put you behind any other students who are going on them.

What these experiences will do is give you the experience of traveling around the world, exploring other cultures, seeing other healthcare systems, and meeting a group of students in a different setting and really bonding and forming relationships with those people.



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