Advice for Rotations:
Medicine: As far as what I’ve heard from the other students and seen around the hospital, the medicine department is pretty welcoming and tries to promote a good learning environment. Go to morning report on Monday (well, every day really) and introduce yourself to Dr. Allain (Theresa) and Dr. Bailey (Peter). They’re both approachable. Dr. Allain is the dept. chair and Dr. Bailey is in charge of elective rotations. I spent most of my time on 3b (adult male medicine ward) and had 2-8 patients most days. After morning report in the Medicine Annex, go to 3b and approach one of the interns or registrars (equivalent to residents here). Ask them if there are a few patients you could follow. They’ll likely show you ¼ of one bay that will be “yours,” or you may end up sharing with another student. Your role for your patients will be managing their day-to-day care, drawing/tracking down labs, ordering studies, etc. I had a tremendous amount of autonomy, but seemed like a good idea to touch base with the intern or registrar in the bay before making any major changes, just so they’re in the loop. You’ll round with a larger group on Tuesday and Friday and those will be the only days that attendings see patients on 3b. Any difficult cases/major changes in care are best addressed on those days.
Where to find lab results if they don’t show up:
Obs and Gynae: Can do as much or as little as you want. Try and hook up with an intern or a fifth-year student and do what they do. Midwives do most of the deliveries here, but you can do them too if you’d like. The department is very short-staffed on consultants and don’t be put off by Dr. Taulo. His bark is worse than his bite, but if you work with him in the OR apparently he’s nicer.
The smells and heat make this dept. pretty intense. If you can get past it, you’ll have a good time.
Ryan Shepherd, Kim Earle, Stephanie Maczka, Steven Kreis, Hilary Schmid, Lisa Siebert, Jim Snyder
I decided I didn’t want to climb Mt. Mulanje so found a weekend trip I would enjoy much more. I spend the weekend covering 30 miles on horseback on the Zomba Plateau. If you’re interested in riding horses, they are prepared for the most experienced rider or someone who hasn’t riddn and needs to be led by a groom. The stable’s website is www.plateaustables.com.
If you’re not into horses, you can tour the mountain via jeep, bike or foot, which can be set up through any hotel you stay at. I stayed at the Ku Chawe Sunbird Inn, most notably the nicest but priciest place.
The plateau was absolutely gorgeous.
Steve Kneis (Groups I and II)
The conditions you will see here will no doubt shock you and it’s good that they do. I hope they disgust you and scare you and effect in you a change to try and make a difference. There are still imitations on what you can do whilst here as a student, but as physicians we will have the authority and responsibility to better the lives of those around us, wherever that may be.
So take everything to heart, even if you don’t go on to practice international medicine. Remember your time here and value all that you have at your disposal at home.
Catherine Burger, James Goldsmith
Dr. Peter Wait organizes the rotation and will assign you to a bay on one of the wards, but feel free to reassign yourself I you think you’ll work well with an attending/intern. Do things yourself — draw blood, start IVs, LPs, take patients to X-ray or HIV testing and counseling. If a patient’s HIV status is unknown, get HTC or order “diagnostic HIV test” and make sure it gets done. If negative get date of last test, if positive, know last CD4, WHO stage and where patient gets meds. Do not trust the admit forms, “investigations” may be listed by not done, recheck physical exams.
A great rotation. Most consultants are expats and are fantastic teachers. Did not like Paeds Nursery at all. I liked Paeds Special Care, Chathinka and Malaria Research the best. Enjoy your time with the kids; they are so cute!
When I look back on this experience in 30 years, I probably won’t remember how I was practically stung/bitten/eaten ALIVE by every insect in Africa. I probably won’t remember that four of us lost our bags for a week and had to wear the same outfit every day. Probably won’t remember my doxy sunburn or that my camera card corrupted itself and now I can’t access any of my pics. I would like to say that I probably won’t remember my near urinary incontinence on safari and had to jump out of the Jeep to relieve myself … but I’ll probably never be able to live that one down. (Beware the Zambian beer!) I WILL remember the laughs, the amazing weekend excursions, the animals. I WILL remember the people – the children smiling and waving and calling “azungu”! These Malawians are some of the most genuine, caring people I’ve ever met. I WILL remember how this country has touched me in a way that few things have. I’ve learned so much about life … and death. I am so luck to have been a part of this. Thank you Terrie for making this possible. You are one of my true heroes and someone I’ll always look up to. I’m anxiously awaiting your book!
Terrie, you are amazing. I really don’t know how you do it, but I aspire to be as motivated and dedicated to my work as you are. I hope we didn’t distract/bother you with our nighttime giggle parties.
I loved this adventure and hope it’s the first of many. When you can, sit on the back porch for as long as you can and talk about life with your colleagues. Never again will you have such a wonderful group of people in one area having such an experience.
Some of my favorites:
For the past six weeks, I have been in the tertiary care “centre” of the 13-million-people-strong nation of Malawi. I think on Surgery you see things other services won’t, e.g., mob justics, wood screws used in Sx. That gives yet another of the many perspectives you’ll develop here.
This is an exceptional rotation, especially if you’re entering a surgical or procedural field. Dr. Thumbs (“tooms”) will set you up the first day. Plastics/Burns was my favorite service and I was allowed to assist and operate as much as I wanted. My advice would be to try and get on a service you think you’ll like early and do a few more weeks if you do. They’re very flexible.
Molly and Necole’s Top 10 ways to enjoy OB
Necole Koliba and Molly Veale