Barriers to patient care in the United States are sometimes metaphorical. But in places such as the mountainous rural areas of Ecuador, they can be literal.
Medical student Zach Solomon discovered this during his participation in the 2017 AMA Global Health Challenge. As a member of A New Pear-spective, the team that won the competition that year, he and four of his peers spent a week helping to care for underserved patients in Guangaje, Ecuador.
“Doctors in certain fields in Ecuador do a year of training in underserved areas, like Guangaje, during their residency,” said Solomon, now a fourth-year medical student at Baylor College of Medicine in Texas.
“They showed us a huge map that had pins scattered all over it representing the patients who were pregnant, along with their gestational age and other information. They told us that many days they walked upwards of eight hours to do house calls and routine prenatal care. I think that experience stuck with all of us, because it really hit home—many of the challenges that physicians and patients can face simply due to the topography of Guangaje.”
A worldly view of disparities in care
The AMA Global Health Challenge invites teams of between two and five pre-med students, medical students, residents and students in allied health fields to submit an essay of 500 words or less in response to a prompt. For instance, this past year the question was: “How can a deeper understanding of the social determinants of health help you, as an aspiring global health professional, to learn and grow?”
At the time that Solomon and his peers submitted their entry to the 2017 competition, they were just entering the clinical phase of their medical school training.
“Having learned the foundations [of medicine] and reflecting on what I saw the first time in Ecuador made me realize how much I had failed to appreciate in the clinical setting,” he said. “I would compare it to the first time someone discovers that they need glasses and suddenly realizes new details and intricacies in their surroundings, or like watching a children’s show as an adult and realizing all the subtle humor that is woven in.
“We felt that our preclinical education had unlocked new potential and opportunities for growth in a setting we were already comfortable in, which I think was a big inspiration for us to come together and really knock out the project,” Solomon said.
The group went on their trip to Ecuador in summer 2018. The team’s name— A New Pear-spective—may have originated as a pun, but it also speaks to what the students gained in the seven days they spent working in a rural, international clinical setting.
“I think the growth in Ecuador for me really came from working with patients in their own communities, as opposed to seeing them in a clinic whose walls obscured my views of their lives,” said Solomon.
“This trip really honed my ability to focus on the social history component of patients’ presentation, and to try to adapt my counseling to fit their situations. In terms of career path and specialty, my experiences in Ecuador only crystalized my desire to continue to seek new challenges in clinical medicine, particularly in the global health setting, in order to continue to improve as a doctor.”
A challenge renewed
A team of medical students from California Northstate University, College of Medicine was selected as the winner of the 2018 AMA Global Health Challenge. Based on their essay and video submissions, the five-member team has won the opportunity to work with underserved patient populations abroad.
“The winning team from California Northstate University, College of Medicine embodies the ideals we most sought in this contest: empathy, a desire to learn and grow, and deep compassion for patients,” said Timmy Global Health’s Executive Director Kristina Graff. “We are grateful to the AMA for sponsoring this contest and for supporting this team of future health care providers. We are excited to have them join forces with Timmy Global Health, partnering in pursuit of a healthier and more equitable world.”
The winning group is slated to make a trip to Ecuador, Guatemala or the Dominican Republic in early 2020.
The AMA Global Health Challenge was created by the AMA Insurance Agency’s MedPlus Advantage Program. The Med Plus Advantage program partners with International Medical Group to promote the contest as well as offer international medical insurance tailored for physicians and other health professionals for as little as $2 a day for those traveling abroad.