The Tidelands Health MUSC Family Medicine Residency Program Has Gone International

For the first time since the program’s inception in 2017, physician residents have traveled overseas through a Tidelands Health-sponsored rotation -- gaining firsthand experience treating patients in other parts of the world and forging a new path of educational opportunities for the residency program.

In April, Dr. Katherine Gagan and Dr. Erinn Afflick spent 21 days in Uganda through One World Health. The pair worked alongside local physicians at One World Health’s Masindi Kitara Medical Center in a variety of settings, including surgery, labor and delivery and pediatrics, as well as in outreach clinics in nearby villages.

“This really helps your diagnostic skills because, obviously, here in the States we have access to every tool at our fingertips. There, it really forced you to think on your feet and stretch your knowledge base,” Dr. Afflick said. “It makes you a better clinician overall.”

A global health trip was always intended to be part of the experience for physicians in the Tidelands Health residency program, but – as with so many other things in recent years – the opportunity was put on hold amid the COVID-19 pandemic. A medical trip to other parts of the world provides valuable experience for physicians early in their careers, helping them broaden their medical knowledge and introducing them to other cultures.

“There is so much to be gained by experiencing the delivery of medical care in another part of the world,” said Dr. Michael Malone, director of the Tidelands Health MUSC Family Medicine Residency Program. “Being there – immersed in the medical centers and clinics – offers a new perspective that these physician residents will carry with them throughout their careers. We’ve all learned from the stories Dr. Gagan and Dr. Afflick brought back with them. We are excited to build on the foundation they’ve helped create for us to continue these global health training trips for future residents.”

Didn’t know what to expect

Drs. Gagan and Afflick were happy to help chart the residency program’s path for global health training. Through the program’s affiliation with MUSC Health, the physicians joined a trip organized by Charleston-based One World Health, a non-profit that develops sustainable health care centers in developing countries.

The pair didn’t know what to expect, but that was part of the adventure.

After a day of traveling to reach Masindi, the physicians quickly got to work. They arrived at the medical center by 7:30 a.m. for daily devotion, then worked alongside local physicians throughout the day. Every few days, they would travel to nearby villages to see patients in outreach clinics, offering care at no cost. In just four hours at the clinic one day, the physicians treated 50 patients.

“It was really great to be part of that outreach,” Dr. Afflick said.

Malaria, HIV and gastrointestinal conditions were common in the outreach clinics.

“We had to shift our differential diagnosis to the tropical diseases like malaria, typhoid,” Dr. Gagan said. “That is what we became most familiar with while we were there.”

The doctors navigated language barriers, metric system conversions and more without the convenience of the internet at their fingertips. As for advanced technologies like CT or MRI? Those were only offered at larger medical centers four hours away. Doctors instead relied on X-rays, ultrasounds and their medical knowledge.

“A lot of times, they would just have to treat based on symptoms without knowing the exact diagnosis, which is kind of tricky,” Dr. Gagan said. “That’s really all they could do without the resources.”

Already planning the next trip

For Drs. Gagan and Afflick, the experience outside the medical center walls was just as valuable, allowing the physicians to experience the culture of the area.

In addition to the incredible clinical and cultural learning experience, the physicians were constantly thinking of next year – making mental notes for developing a more formal curriculum, schedules, rotations and preparations to make future residency trips even better. They spent time with local physicians and community leaders creating ongoing connections and learning if there are additional ways the residents could support the local medical efforts.

“We really didn’t know what we were walking into,” Dr. Afflick said. “Now that I’ve been there, I will know how to guide people to prepare better.”

Drs. Afflick and Gagan already are working on the curriculum, schedule and other details for a residency trip to Uganda next year. Dr. Afflick is planning to go again, while Dr. Gagan just wrapped up her residency but will be involved in the planning for the residents who go next year.

“It was a really great experience overall,” Dr. Gagan said. “I hope that future residents become interested in going on a trip and continuing to provide that long-term relationship with our friends in Uganda.”

About Tidelands Health

Tidelands Health is the region’s largest health care provider and MUSC Health affiliate, serving the Carolinas at four hospitals and more than 70 outpatient locations. More than 2,500 employee, physician and volunteer partners work side by side with our communities to transform the health of our region – promoting wellness, preventing illness, encouraging recovery and restoring health.