Electives - Global Health
Uganda Clinical Medicine
Elective Number: 1525 (International)
Rotation Supervisors: Dr. Christopher Moore
Designated signer: Dr. Moore email@example.com
Available: All Rotations - based on availability at Mbarara
Regional Referral Hospital
Duration: 4 weeks (up to 8 weeks) based on Mbarara availability
Evaluation should be given to: Overseas preceptor - students should
bring evals back and give to Dr. Moore
Prerequisites: Rotation must be arranged with
Dr. Moore at least 4-6 months in advance to allow plenty of time to set things
up in Uganda. As well, at
least a month prior (but best to be 6-8 weeks prior) to beginning the rotation complete
the Elective requirements on the Forms
Report to: Dr. Tony Wilson
Time to Report: 9:00 am
Place to Report: Medicine Ward, Mbarara Regional Referral Hospital
Attendance: Attendance at elective activities is mandatory.
- Anyone who is ill or has a personal or family emergency must contact Student
Affairs and the Attending on Service.
- Students are allowed to take off up to 1 day per week to interview between
November 1 and February 1.
Number of students per rotation: 1-2
- Learn to diagnose and treat unique medical conditions prevalent in Uganda,
but unusual in the patients cared for at the University of Virginia.
- Learn about different healthcare delivery systems in Uganda.
cultural understanding that allows you to work effectively with patients
of different backgrounds and cultures.
- Learn to practice at the level
of one's capacity and not to exceed one's level of training.
The four-week rotation will be offered on a rotating basis throughout the year.
MRRH does occasionally host students and less often students from other institutions,
so availability is based on capacity of MRRH to host a UVA student. Coordination
of the trip should be completed at least six-months before the rotation.
MRRH is an approximately four-hour drive from Kampala. After arrival into
Entebbe/Kampala airport, ground transfer to MRRH can be arranged by public
bus (Swift Safari is recommended) or by private car. Arrangements with reputable
drivers can be coordinated through Dr. Moore and/or the administration at
Clinical Competencies and Objectives
This international student elective rotation is a four-week block designed
to give the visiting student training in all aspects of clinical care
in a resource-limited international setting. The majority of clinical
exposure occurs with inpatients, but the visiting student is expected
to attend at least one of several ambulatory clinics per week as well.
The rotation will provide an introduction to international healthcare
systems in a resource-limited setting in sub-Saharan Africa.
The rotation will provide visiting students with the training required
to diagnose patients with acute and chronic illnesses in a resource-limited
setting. The student will become familiar with common illnesses seen
on the wards including, but not limited to: AIDS associated opportunistic
infections, tuberculosis, cardiovascular diseases, renal failure, gastrointestinal
bleeding, severe anemia, malnutrition, and organophosphate poisoning.
In conjunction with housestaff and faculty, the student will help create
a diagnosis and management plan for each patient on their ward round.
Working in a developing country will expose the student to the difficulties
in medical management encountered by clinicians and patients in resource-limited
Students will be expected to actively participate in ward rounds
and contribute to the management of each patient they encounter. As such,
they will hone their physical exam skills as this is the main diagnostic
intervention available. Radiologic and laboratory studies are scarce
so there is an increased reliance on the physical examination. Students
will also be required to present teaching sessions on topics generated
from patients on the ward round. They will increase their knowledge of
tropical diseases not frequently encountered in the United States such
as parasitic infections, nutritional deficiencies, measles, and tuberculosis,
Students will be expected to investigate and evaluate their care
of patients, appraise and assimilate scientific evidence, and to continuously
improve patient care based on constant self-evaluation and life-long
learning. This international rotation will improve the student’s
evaluation of necessary tests both in resource-limited and resource-privileged
settings. Practicing medicine in a resource-limited setting will expose
the student to diseases not frequently encountered in the US and will
improve physical examination skills.
Students will experience the opportunities and challenges present
in the Ugandan healthcare system. They will participate in the management
of acute and chronic diseases managed by Ugandan physicians. They will
learn how ancillary support, including patient attendants (family members
or friends), augment the capacity of the Ugandan healthcare System.
Interpersonal and Communications Skills
Students will demonstrate effective communication with American
physicians, Ugandan physicians and Ugandan medical students. Students
will improve their cultural awareness and practice effective communication
with Ugandan patients and clinical staff by participating as members
of a multicultural healthcare team.
Students will be expected to respect and work with patients, students and
physicians from a different cultural background. They will learn to adapt
to a different medical system.
Disease Mix & Patient Characteristics
Students will encounter patients with a variety of diseases. Frequently
encountered acute diseases include: myocardial infarction, severe sepsis,
meningitis (bacterial, cryptococcal, or tuberculous), organophosphate
poisoning, and diabetic ketoacidosis. Common chronic diseases include:
diabetes, hypertension, kidney disease, and HIV infection.
Procedures performed will include physical examination. Visiting students
will be advised not to participate in invasive procedures such as thoracentesis
or lumbar puncture.
Dr. L. Anthony Wilson is the Chair of the Department and the onsite supervisor
for visiting students. He is a senior professor of internal medicine
and neurology trained in New Zealand and the United Kingdom where he
had a long and distinguished academic career. The supervising Ugandan
staff includes attending physicians who have completed three years of
post-graduate training in internal medicine (Masters of Medicine) which
is equivalent to a US based residency.
Students will participate on ward rounds on a daily basis with
the housestaff and a supervising attending physician. Students
will be expected to discuss management of patients with the supervising
attending physicians as well as the Ugandan housestaff which generally
includes an intern and a student (a Masters of Medicine candidate). Additionally,
one attending physician is on call each day and rounds with the admitting
team on new admissions in the morning and again in the evening every call
day. Students will be expected to participate in post-call rounds
each morning and at least once per week in the evening. Attending physicians
also supervise housestaff in the ambulatory clinics which visiting students
will be expected to attend at least once per week.
Rotation goals and objectives will be reviewed by Dr. Moore with
students prior to commencement. Students will be given verbal feedback
on their performance as well as a written evaluation using the Oasis
on-line evaluation tool. Students will evaluate their attendings and
the rotation itself, also using Oasis.