GLOBAL HEALTH EXPERIENCE
STUDENT SITE EVALUATION
General Information
Which level of student are you?
Answer Options
MS1
MS2
MS3
MS4
Country & City/Town/Community of Elective Site:
La Descubierta, Dominican Republic
Name of Host Organization/Institution:
International Medical Alliance, Project Hispaniola
Department/Focus of Work:
Clinical Outreach
Name of Preceptor:
Dr. Ruth Berggren
Dates of Rotation:
17/12/11-24/12/11
10/03/2012-18/03/2012
Total cost of elective:
1400
Did you receive a scholarship for this elective?
Response
Percent
78.6%
21.4%
0.0%
0.0%
Answer Options
No scholarship
Paul Brand Scholarship
Dean's Scholarship
Other (please specify)
Other: Dean’s Travel Scholarship
Response
Percent
71.4%
0.0%
28.6%
Response
Count
11
3
0
0
Response
Count
10
0
4
10

Pre-Travel
Please rate how well prepared you were for this elective site?
Answer Options
Poor
Fair
Fine
Good
Excellent
Which Global Health elective were/are you enrolled in?
Response
Percent
0.0%
0.0%
21.4%
64.3%
14.3%
Answer Options
Global Health Enrichment Elective - ELEC 5047
Preparing for Global Health Work - INTD 4030
International Medicine - MEDI 7003
None
Other (please specify)
Response
Percent
100.0%
0.0%
0.0%
0.0%
Response
Count
0
0
3
9
2
Response
Count
14
0
0
0
0
What session(s) were most useful/helpful?
1 Vector Born Diseases
2 Dermatology, travel medicine, vaccines
3 Any lecture related to diseases commonly seen in global settings
4 Infectious Diseases
5 Infectious disease lectures and brief language lessons given by Project Hispaniola members
6 WASH session, and infectious diseases lecture from Dr. Berggren
7 Infectious Diseases, Dermatological conditions, previous trip presentations
8 Any information on tropical infectious disease and differential diagnoses.
9
It was important to hear stories from other global health trip like those from the Ethiopia session.
10 Informative sessions about the diseases.
11 The travel medicine lecture was helpful
12 Skin diseases, vaccination
13 Infectious Disease
What could have been provided that would have been of benefit for your elective site?
1 Basic medical Spanish, basic clinical skills
2 More case studies of common illnesses
3
I would have liked to have seen a lecture on evidence for the benefits of small fee-for-service care versus free clinics.
4 Medical Spanish Workbooks (similar to those they print for the Spanish electives)
5 Had a better orientation of day to day logistics. A mock clinic would have been helpful.
6 Knowing any bit of basic Spanish.
7 Information should have been passed along from previous trip participants
8 Additional practice with physical exam skills--distinguishing types of tympanic membranes,

heart murmur sounds, lung sounds.
9
The biggest obstacle for me was the language barrier even though we had adequate translators. It still would have benefited if I knew more Spanish.
10 More patient history and basic Spanish.
11 How to do a focused history
12 An overview of what diseases/ problems are most prevalent in different countries
What suggestions do you have to improve student preparation for international electives?
1 Focus more on language skills, so the language barrier won't be as significant
2 None- we had a great trip!
3
4
As this trip leader I will do our trip manual and insure that the next trip leaders are not only prepared to leave but also prepared for the first day of clinic with check lists etc.
Meetings with previous and past trip participants to pass along knowledge of successful strategies and what to expect
5
6
Provide some brief sample heart or lung sounds, or pictures of different physical exam characteristics to look for in differential diagnoses. Do this within a team setting for each trip instead of in a class session so that learning will be more engaged and interactive, as well as time-saving.
In addition to the global health courses, I found it helpful that Project Hispaniola meets on weekly basis to talk about the specifics of our upcoming trip. For instance, we had a lecture on commonly prescribed medications and how to work the pharmacy.
7 Practice your Spanish more!
8 A pharmaceutical lecture
Accommodation, Meals & Travel
What accommodations did you have?
The girls stayed at a house and the boys stayed at a hotel
How would you rate the suitability and comfort of your accommodations?
Answer Options
Poor
Fair
Fine
Good
Excellent
Answer Options
Poor
Fair
Fine
Good
Excellent
Response
Percent
0.0%
0.0%
21.4%
42.9%
35.7%
How would you rate the quality of food while at your elective site?
Response
Percent
0.0%
0.0%
14.3%
50.0%
35.7%
Response
Count
0
0
3
6
5
Response
Count
0
0
2
7
5

What was the source of meals while at your elective site?
Answer Options
Prepared own meals
Cafeteria
Home stay/Meals prepared at accommodation
Restaurants
Other (please specify)
Response
Percent
7.1%
0.0%
100.0%
0.0%
What type(s) of ground transportation did you utilize during your elective?
Response
Count
1
0
14
0
0
Answer Options
Walk
Train
Cab
Car
Motorcycle
Bicycle
Other (please specify)
Other: Bus, Truck
Was the ground transportation safe?
Response
Percent
57.1%
0.0%
0.0%
92.9%
0.0%
0.0%
Response
Count
8
0
0
13
0
0
6
Answer Options
Not Very
Fair
Fine
Good
Very
Response
Percent
0.0%
0.0%
14.3%
42.9%
42.9%
Elective Site
Please describe your duties during your elective rotation?
Response
Count
0
0
2
6
6
1 Triage, patient histories, clinical exams, pharmacy, conducting basic health screenings
2 Took physical exams, worked at pharmacy
3 Setting up mobile health clinics in various sites
4 Assisted doctors and patients at 5 stations: triage, medicine, peds, OB/GYN, and pharmacy
5
Organizing team members and setting up clinics sites. During the day students did different activities (OB/GYN, Internal Med, Pediatrics, Triage, and Pharmacy)
6 Assisting the doctors, and running the pharmacy
7 Pharmacy tech, triage, assistant to doctor in OB/GYN, internal med, or pediatrics
8 We met with patients and provided them with health care and medication
9 HPI, physical exams, urine/glucose/HIV/pregnancy tests, diagnosis and recommendations.
10
My main duty as the trip leader was to coordinate the day to day activities at the clinic sites and to ensure everything runs smoothly.
11 Help with setting up, organizing supplies, rotating through different specialties
12 Assisted physicians by taking history of patients, helped with triage and ran a pharmacy

13 Triage, pharmacy, shadowing, medical care
14 Rotated in different clinical areas within our mobile clinic units
Was your site preceptor helpful?
Answer Options
Not Very
Fair
Fine
Good
Very
Response
Percent
0.0%
0.0%
0.0%
0.0%
100.0%
How would you rate your site preceptor’s/mentor’s knowledge?
Response
Count
0
0
0
0
14
Answer Options
Poor
Fair
Fine
Good
Excellent
Response
Percent
0.0%
0.0%
0.0%
0.0%
100.0%
How would you rate your site preceptor’s/mentor’s teaching abilities?
Response
Count
0
0
0
0
14
Answer Options
Poor
Fair
Fine
Good
Excellent
Response
Percent
0.0%
0.0%
0.0%
0.0%
100.0%
Response
Count
0
0
0
0
14
On average, how much time did your preceptor spend with you during a typical day?
Answer Options
0 - 2 hours
2 - 4 hours
4 - 6 hours
6 - 8 hours
8 hours or more
Response
Percent
0.0%
7.1%
0.0%
28.6%
64.3%
Response
Count
0
1
0
4
9

What types of things did you learn from the health center/hospital staff/program staff with respect to global health, public health, tropical medicine and infectious diseases?
1 The health disparities between the westerns and undeveloped worlds are ridiculous.
2 I learned common clinical findings in areas where public health is not up to health standards.
3 I learned a lot about how to manage a clinic/diseases in a resource poor setting.
4
5
In addition to learning basic medical skills, I also learned about the global health concerns and infectious/chronic diseases unique to Haiti and the Dominican Republic (diabetes, scabies, parasites, etc.).
Infectious diseases are a serious threat to human health. We must remain vigilant in our public health efforts in the US and help other countries to set up a public health infrastructure.
In addition, people of all walks of life suffer from the same diseases as us such as hypertension and diabetes.
6 I learned much about how to treat common sicknesses such as scabies, gastritis, and grippe.
7 I learned about the different challenges for treating people in the Dominican Republic.
8
We brought our own staff to the clinics we set up and thus had little interaction with the health center staff.
A major difference in children's healthcare in this region is the prevalence of parasites.
9
10
Bacterial and fungal infections are also widespread, and some incidence of tropical/thirdworld illness (Malaria, TB) was observed. However, prevalence of other illnesses seems similar to South Texas and the United States overall. Children are just as prone to viral upper respiratory infections, and STD transmission is similarly common. Diabetes and hypertension run rampant among the population, with the major difference of being very poorly controlled due to lack of medical access.
I learned that working in a medically undeserved region requires patience and flexibility. For example, on each clinic day we had to use the materials around us to make an improvised
OB-GYN exam room.
11
12
13
14
Organization, humility, compassion, basics on common diseases. Especially from working on site in neighboring Jimani (sp?).
The best way to be prepared for these experiences is detecting clinical signs and remaining patient.
The importance of befriending the people living in the area, trying to build a sustainable program
There are various ways that medicine and public health are practiced in different countries and each area/person is affected differently. Knowing the basics of public health and medicine however, can help to apply the practices in various places. I think my knowledge of these areas helped me to understand the practices in the DR and also to better serve the communities there.
What awareness of the host country’s health care system did you acquire?
1
2
3
The system was largely inadequate. People had been diagnosed with treatable diseases but could not afford their medications so they went untreated.
There is basically no health system. The minimum amount that is available is too expensive or not accessible to majority of the population.
I learned a lot about the tensions between the Dominican Republic and Haiti and where those tensions stem from.
4 Knowledge of its limited resources and racial prejudice.
5 Mostly that there was a lack of an adequate healthcare system.
6 I think it was interesting to see the lack of resources that the country has.
It was sad to see how much the health care was lacking. Some patients will end up dying
7 from diseases that can be easily treated in the US.
8 Common diseases that affect people of that poverty level
9
There are no doctors in the rural villages, and villagers will often travel from miles away on foot for medication and care. Often the closest thing to a doctor or dentist is a voodoo priest or layman tooth-puller with no medical knowledge. Need is great and access is poor in this area.

10
I learned that the healthcare system especially in the border region between the Dominican
Republic and Haiti is non-existent.
11 Just that, in rural areas, it is sorely lacking.
The host country's health care is in a state where acquiring pain relievers is even difficult for
12 some individuals. The animosity between Haitians and Dominican Republicans also makes it difficult for Haitians to get proper healthcare, resulting in escalation of certain health problems which may have been prevented.
13 People's living condition, water shortages, and latrine system
14 There are many people who have little or no access to health care at all.
Would you recommend this elective site/program to another student?
Answer Options
Not likely
Somewhat unlikely
Not sure
Somewhat likely
Very likely
Response
Percent
0.0%
0.0%
0.0%
0.0%
100.0%
Response
Count
0
0
0
0
14
Please explain:
1
2
3
4
I really enjoyed the people/culture as well as learned a lot of clinical skills. It helped open my eyes to the importance of being an empathetic, respectful physician. I definitely plan to make caring for the underserved a major part of my future practice.
It is a great learning experience and really helps you remember why you want to go into medicine.
I think this site is very well run. I think many of the logistics are worked out well so that students can focus on learning as much as possible on the trip.
Good learning experience, lots of clinical exposure (especially for MS1s). Exposure to infectious diseases and global health disparities.
It was an amazing experience that has strengthened my passion of helping the underserved.
Furthermore, the amount of knowledge you are able to gain in this type of setting is unmatched by any other academic setting. 5
6 I would recommend it.
8
It's a great trip that doesn't require a lot of travel, the doctors are excellent and really facilitate learning.
9
10
The global health program is not just useful to students who are interested in careers working abroad. Rather, the fact that patients abroad experience a spectrum of illness very similar to patients in our own community should signify that these projects are an excellent medium through which medical students can gain relevant firsthand experience. Furthermore, serving communities abroad allows students the chance to bypass many limitations that are imposed within our own healthcare system, so that even early-year students can gain better clinical practice and have a more direct impact on patients. Early exposure and early opportunities to have an impact reinforce the desire to strive for excellence in our learning. The other major benefit of participating in a project abroad rather than at home is the exposure to a new environment, which necessitates new ways of thinking about social and political infrastructure and patient needs. Exposure to an entirely different set of rules and problems challenges students to think beyond what is common to them and fosters both increased analytical thinking and a higher level of sensitivity to cultural diversity. Global health experiences will ultimately help create more broad-minded and empathetic doctors.
The main reason that I've returned on this trip is because of the wonderful doctors that are involved. Dr. Berggren and her husband, Dr. Curiel, are unbelievable physicians, teachers, and advocates of global health. Additionally, the trip really opens your eyes to other aspects of medicine that you may not have considered before.

11 I learned a lot and it was an enriching experience.
12
This was a great experience to get exposure to a new community where the culture gives insight on how healthcare is provided. The mentors are all very knowledgeable about the community and medicine so the educational experience is very well rounded.
13 Would recommend
14
I would highly recommend this experience to any student who is interested in global medicine and in public health as well.
What suggestions do you have to improve this elective site/program?
1
Have a handbook for the next year's group so they can be more prepared with what to expect.
2 More communication between trip leaders and the host organization (IMA).
Continue to improve on process and insure that future Project Hispaniola members will pass
3
4 on the knowledge and passion of this work.
Project Hispaniola is truly a student run organization so it is important that previous trip goers pass on their knowledge to future students in order to preserve continuity. We therefore have made a trip manual which can always be improved upon.
5
6
A little more time to get to know the culture and area, especially local customs, language, and food.
Need to provide specific detail about the daily activities, an example of what each day will be like
Any other comments?
1 none
2 Thank you for providing these opportunities for medical students!
3
Thank you so much for the opportunity for such an experience. I hope that the Global health program continues to grow because it is one of the most valuable things that this school has offered me.
4 None