Faculty Coordinator: Anna McDonald, MD, anna.mcdonald@swedish.org
Elective available to 2nd or 3rd year Family Medicine residents and fellows from Swedish Family Medicine programs (First Hill and Cherry Hill) and from Family Medicine programs affiliated with UW WWAMI network.
Please see Separate tab on the website "Malawi global health rotation."
https://swedish-fh.squarespace.com/malawi-program-info/
SCHEDULE:
One full block away. Minimum of 3 weeks in country. Travel 3 days total)
You may use vacation to extend your rotation.
ROTATION PREPARATION:
One year before the rotation:
Notify Elizabeth Hutchinson, Liz Stahl and the chiefs of your interest and elective blocks available.
6 months before your rotation:
Talk with your adviser, chiefs of your intention to be away.
1 month before rotation: meet with Elizabeth Hutchinson to discuss expectations during away rotation
TIMING OF TRAVEL:
Specific times of travel to be determined by the faculty in Malawi (Dr. Anna McDonald).
Rotation goals:
GOALS:
Swedish residents will work within the current government health system in Malawi to:
Model Family Medicine presence in the government health system Demonstrate full spectrum, patient centered integrated care while working within the structure of health care providers at Mangochi District Hospital.Help to create teamwork within the hospitalWhen appropriate, teach medical students and residents who are studying family medicine
Objectives:
At the completion of a 4 week rotation in Malawi, a family medicine resident will:
Discuss the issues of social determinants of health, health equity, social justice, and governmental policy in terms of their impact on the distribution of health services in low-resource settingsIdentify sociocultural and psychological factors influencing health literacy and interaction with the local health systemMake appropriate evidence-based decisions within a limited resource settingTailor clinical interventions by taking into consideration local socioeconomics, politics, health disparities, and cultural influencesDemonstrate the ability to communicate effectively and collaborate with the patient, family, and caregivers with sensitivity to sociocultural and health literacy issues so that the diagnosis and plan of care are clearly understood and pertinent to their specific situationRecognize his or her own practice limitations and seek consultation when appropriateRecognize his or her own biases and stereotypes related to health care delivery in International settingsDemonstrate a commitment to sustainable interventions of health care delivery in MalawiAssess availability and safety of medications and other treatments in Malawian contextCite non-medical issues (e.g., political, safety, environmental, and climate factors) unique to practicing in Malawi.Cite specific safety factors, legal considerations, and personal freedoms that might be handled differently when taking part in health care delivery in Malawi
(adapted from AAFP global health curriculum)
RESIDENT ROLES:
Clinical:
* Clinical roles will be determined by the onsite faculty depending on the current vacancies and needs:
Seeing outpatients, inpatients and OB
Procedures such as manual vacuum aspiration, paricentesis, thoracentesis, IV placements, blood draws, skin, endometrial and cervical biopsies
OB ultrasounds
Overnight call one night per week (paired with a Malawian provider)
Residents will be expected to be at the hospital from 8-4:30 M-F with the exception of their post call day. The schedule will be finalized by the onsite faculty
Community orientated care
When available, participate in the weekly travel to rural health posts
Teaching: Based on the direction of the onsite faculty
· Support clinical oversight, teaching, logbook support, and evaluation of:
medical students ("undergraduate students) who are on their family medicine rotation
clinical officer students
medical officer students
nursing students
· Giving lectures, case presentations, other formal teaching
· Mentoring
· Organizing or participating in group teaching for patients
System development:
Work within the health care team to improve patient care, team work and patient care delivery.
Professionalism:
Residents are:
· Expected to be flexible, open-mined, and patient understanding that: Family Medicine is a new concept in Malawi and not well understood. Having physicians practicing medicine in the district health centers is foreign and not always accepted.
· Expected to be respectful, unobtrusive and unpretentious. There are nuances about the health care system, cultural structures and policies that cannot be understood in a month’s time. It is better to be an assistant than a leader in this setting.
· To use personal discretion regarding travel during the rotation. When not working on the weekends, travel within the country is permitted; traveling outside the country should be done with great caution
· Not to use illicit substances, participate in risky activities, drive or participate in medical care that is outside of their scope of training.
Blogs:
Resident blog: http://thebadhumors.com/malawe/
Hutchinson blog: http://malawimusing.blogspot.com
* A FULL ORIENTATION DOCUMENT IS AVAILABLE ON THE website
WWAMI Family Medicine Global Health Rotation Orientation Guide
GENERAL OVERVIEW:
Background:
The Ministry of Health of Malawi (MOH) had recognized the need and value of training family physicians to meet the medical needs of their population. The MOH desires a primary care based system based on a cadre of well-trained family physicians at multiple sites around the country. The Swedish Family Medicine Residency program, as part of the University of Washington Family Medicine Network (Washington, Wyoming, Alaska, Montana, Idaho-WWAMI Network), has initiated a program to support the training of Malawian physicians to become family physicians with a broad skills set spanning maternity care, pediatrics, adult medicine, geriatrics and limited surgical care.
Dr. Martha Makwero, a Malawian family physician trained in South Africa, is working to create training sites that will accommodate the first family medicine trainees in this country. The scale of the project exceeds available resources to create a family medicine training network over the next 10 years. Partnering with WWAMI to model the largest family medicine training network in the United States will bring in expertise in program and faculty development that will enhance the implementation of the new Malawi family medicine programs. The goal is to support the development of 3 residency training hubs in Malawi that will provide the needed infrastructure for their future health system. The residents role is to help teach generalist health care delivery to address medical, psychological and social needs of patients within their communities.
Beginning September 2014 a partnership between Swedish Family Medicine (SFM), College of Medicine in Malawi (COM) and SEED global health formed to increase the academic presence of family medicine in Malawi. This partnership involves a long-term commitment of both faculty and senior residents. The goals of this partnership are to improve the training environment for Malawian students and residents, support the health system’s efforts to deliver comprehensive, integrated care, and to provide US residents an opportunity to develop new knowledge and skills and to advocate for individual and community health in resource-poor settings.
This model--of a US academic institution partnering with a developing family medicine program partnering with SEED Global Health as a backbone--has potential to be repeatable in other countries with other programs. Combining the wealth of interest in global health among US residency programs with the human resource shortages in developing programs in a structured way could have profound implications for global family medicine development.
Updated 7/1/17
Effective 7/1/17-7/1/18