Mid-way through dragging myself through the “Covid semester," I found myself lacking meaningful academic experiences. I remember sitting in my room thinking of ways I could be more involved, considering the circumstances of the global pandemic. I felt stagnant in my professional endeavors not knowing when things were going to return to normal as Covid cases fluctuated unpredictably. Volunteering organizations were not taking new applicants, hospitals and clinics were not allowing students to shadow, many places were on a hiring freeze, and studying abroad seemed impossible considering the social distancing, lock-down orders, and travel bans due to the pandemic… or so I thought. My advisor sent me a link to a winter session virtual study abroad class. I thought this was a joke, a study abroad class that’s virtual? Doesn't that defeat the whole point of studying abroad? I had some reluctance but I decided to keep an open mind and applied.
“To my knowledge, a medical virtual study abroad of this kind had never been done before at the University of Iowa, this whole experience seemed like uncharted territory, nevertheless, it was the most rewarding cultural experience that I have had in college.”
When I joined the first zoom meeting, I was met with eager student faces and enthusiasm from everyone involved in making the experience possible. We quickly started the course with a series of briefings on the Dominican healthcare system: We learned about the healthcare structure, insurance systems, access to healthcare, and the Covid-19 response system. The next week we were “on the ground” and immersed in an enormous amount of medical exposure. The days were filled with live sessions of medical observations, patient interactions, and discussions. In addition to interacting with patients, we were given the opportunity to speak to various healthcare professionals including medical interns, an epidemiologist, gynecologists, general physicians, dermatologists, and hospital staff/administration. In between the sessions we were able to practice our patient interaction skills with a computer-based medical simulator, we learned about the body and its diseases, and we read many articles and watched documentaries.
"We’d end the days with learning about the rich culture of the DR. We learned about food and music, we went on virtual drone tours, we learned and practiced Spanish, we even learned how to dance bachata, merengue, and salsa!"
Some days we were up at 6:30 a.m., and some days we would end at 6:30 p.m. There’s a saying in the DR: “We don’t know what the plan for the day is until the day is over." Learning to adapt to newly arising situations and realizing that you are able to fluidly influence your experience. This is the advantage of participating in such a new virtual study abroad course during these times.
The most prominent experience for me was the clinical experience. Over the duration of the course, collectively, the class had gotten the opportunity to observe/interact with almost 200 patients! We saw many things, from the common flu, tummy aches, and skin problems - to surgical implant removals, post-Covid complications, and injuries. We were able to ask the patients about their symptoms, and we were able to ask the doctors about their reasoning behind diagnoses and treatment plans. Although learning about symptoms, diagnoses, and treatments was important, I think the most important thing about this clinical experience was learning to be cognizant of context. During our times of reflection, Jonathan (our medical intern facilitator) stressed the importance of context - taking into consideration social culture, health care policies, and unique circumstances. It's education and training that allows us to be efficient medical professionals, but it's the understanding of the context that allows us to be empathetic and compassionate providers.
"For a healthcare provider, it is especially important to see the world from different lenses, and it’s important to understand the context. It has been extremely enriching to experience a culture different from my own and I am forever grateful for this eye-opening experience."
We saw women uncomfortably discussing the specifics of a hysterectomy because of her husband's wishes. We saw a mother and child breaking out in rashes because she tried to save money by purchasing cheaper shampoo. We saw a man that had refused to go to the doctor for years for his painful (extremely large) inguinal hernia because of machismo culture and not wanting to appear weak. We saw high rates of comorbidities such as hypertension/diabetes that can be partly attributed to diet, and we saw hospitals with lack of medications and resources - affecting the quality of care they are able to provide. In a way, the clinic beautifully acted as a central convergence point for the blending of many components that contribute to the individual's unique situation. We saw how components such as “gender-based” power dynamics, financial situations, food and diet, and ideas of health care structure all have roles in contributing to an individual's unique situation and how it could manifest itself as medical symptoms. It’s important to realize that we live our daily lives in a bubble, whether that bubble is our friend group, our home state, the University of Iowa, or the United States. We need to be aware that there are different people in uniquely different situations. For a healthcare provider, it is especially important to see the world from different lenses, and it’s important to understand the context. It has been extremely enriching to experience a culture different from my own and I am forever grateful for this eye-opening experience.
On a broader scale, I think it really puts things into perspective, it made me realize that there's a lot of people that need help and that I, one day, will be capable of helping. It’s hard being a student, it’s easy to lose sight of the bigger picture. This experience was refreshing, it made me remember why I’m doing what I’m doing.”
Tuan Truong, a third-year human physiology and neuroscience major from Des Moines, Iowa, participated in the Virtual International Medicine program during the winter of 2020.