College of Medicine students see medicine through global lens

From left, Rolfy Perez, Olivia Munizza and Ivana Marji join staff at the Hospital Regional de Loreto in Peru during their fourth-year trip.

By Carolyn Kimmel

As she reflects on the past four years at Penn State College of Medicine, Jordan Trubiano points to her participation in the Global Health Scholars Program as a definite asset to her medical training.

“I gained an understanding that there are different strengths and weaknesses in each country’s health system, which will give me a different perspective to offer to future training programs and hospitals where I will work,” said Trubiano, who will do her residency in obstetrics and gynecology at the University of Massachusetts Medical School.

In Ecuador, where she traveled twice—once after her first year of medical school and again last winter—maternal health care is free, and people marvel that health care in America is so expensive and doesn’t cover everyone, she said.

The Global Health Scholars Program appealed to her because it offered two chances to visit the same place. As a first-year student, she worked on nutritional lessons for elementary school students and, during her second trip, she completed medical rotations in reproductive and sexual health.

“We’re the only U.S. medical school doing a longitudinal curriculum built over four years,” said Dr. Ben Fredrick, director of the Penn State College of Medicine Global Health Center. “Our program values relationship with the local community and builds relationship over time.”

The 10-year-old program has become more structured as more students now view cross-cultural experience as a necessary part of their medical education, Fredrick said. To be considered for inclusion, a country must have both a College of Medicine faculty champion and an international partner engaged at the site, and the country must be considered safe.

First-year students participate in a community health project. In Zambia, the focus on malaria and HIV; in Peru, infectious disease; in Ghana, strengthening of the health system; in Australia, indigenous people; and in Japan, nutrition. In their fourth-year trip, students gain clinical experience.

Xavier Candela, a first-year College of Medicine student traveling to Ghana this month with Fredrick, hopes participation will prepare him for a lifetime of global health mission trips.

“I have always thought of health care as something that should defy all political and cultural barriers and I believe, with globalization, there is increasing opportunity to address specific population needs across the globe,” he said.

Candella hopes to learn about the host culture and the nuanced challenges of delivering quality care abroad. “The unique relationship of Penn State Health Milton S. Hershey Medical Center with Eastern Regional Hospital and its faculty allows students to be involved in research and service opportunities,” said Candela, whose past mission trips helped steer him toward a career in medicine. ​​

Olivia Munizza said being a Global Health Scholar set the tone for the rest of her medical training, opening her mind to the biases she had toward patients different from herself. “I really want to react with an open heart and mind and be very patient-focused. We all get stuck in our Hershey bubble,” she said.

See photos of the Global Health Scholars on the Medical Center’s Flickr page.

During her first trip to Peru, Munizza was involved in two research projects focusing on sanitation practices in restaurants and diarrheal sanitation in areas where people regularly washed out diapers and also got their drinking water, she said.

“People there don’t notice the things we pointed out. They thought they were fine,” she said. “It was definitely a challenge. We didn’t know what to expect. I was high on being in medical school and really wanted to ‘save the world.’”

Her second trip last February was again an eye-opener, as she spent each day in a clinical setting in Iquitos.

“I observed that the doctors really used their physical exam skills, and it made me think that maybe U.S. doctors are over-testing, over-ordering and over-prescribing simply because they can, rather than relying on simple exams skills,” said Munizza, who will do her residency at Orlando Health in Florida and wants to be an emergency room physician.

The program, Fredrick said, makes the students better doctors—and better equipped to provide equitable health care.

“Our country is becoming more diverse, and future physicians need to be able to work with people from very different perspectives, both patients and colleagues,” he said.

Students also have the unique opportunity to see serious tropical diseases and advanced cases of cancers and heart disease that they would never see in the U.S.

Patients benefit as well. “Our students model a more humanistic approach to patients that is respectful,” Fredrick said.

In Kenya, one student’s project centered on community health worker training, and the Ministry of Health used her recommendations to make changes to the country’s training protocol, Fredrick noted.

The Global Health Scholars Program sends 25 students per year abroad. Interested first-year students must apply online and be interviewed. Scholarship money is available to ensure cost isn’t prohibitive, Fredrick said.

Penn State College of Medicine Global Health Scholars pose for a photo with one of their host families in Quilapungo, Ecuador. Back row from left are Eustina Kwon, Kyla Halsor, Janie Trinkeller, Connor Carmichael and Jordan Trubiano. Photo courtesy of Rebeca Martin-Billings.

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