Objectives

The participants will develop a basic understanding of medical practice and public health in Latin America, as well as develop a feel for the medical system in the context of political, socio-economic and cultural differences. The participant will also gain a better command of medical and conversational Spanish, as well as a deeper understanding of Mexican culture.

Ultimately, the experience will enhance the participant's capacity to treat the growing Hispanic patient population in U.S. medical facilities by providing a meaningful cultural exchange.

PROCESSESS AND EXPECTATIONS

Students will take a pre-test and a post-test. They will also be given cultural literacy materials to read during their stay in San Miguel de Allende.

The participants fall into a few categories and therefore may have different experiences. In addition to Mexican health care personnel, the participants will interact with other U.S. students and residents doing electives from their institutions, as well as attendings who are obtaining CME Credit. The program also involves the participation in various activities within the PACEMD Program (www.pacemd.org) if they are interested.

The MedSpanish experience is roughly divided into HOSPITAL BASED and CLINIC BASED settings. All particiapants are expected to attend morning teaching rounds on Tuesdays and Thursdays at the Hospital. In addition, hospital based rotators are expected to attend the teaching rounds on Monday, Wednesdays, and Fridays.

MEDICAL STUDENTS and others who's Spanish is very limited, typically go to the Clinics. Also, people who are in the program for a limited amount of time are likely to go to the clinics as well. The Clinic based rotators spend 35 hours a week at the community based clinic and the mobile rural health "brigadas," but may also include some limited experience at the Hospital or in Red Cross ambulances.         

RESIDENTS AND ATTENDINGS who are higher functioning in Spanish and who have hospital based skills, will spend most of their time at the hospital (but will also have some "off service" experience). They will have a physician at the hospital, who the rotator can expect to be their primary resource. There may also be a language facilitator/translator in the mornings to help. The hospital training director will also be a resource for the hospital based rotators.

They will typically be assigned to the Emergency Department, or to the inpatient Med or Peds service. They are encouraged to spend time where the most activity is in the hospital, regardless of department. We expect approximately 35 clinical hours a week, 12 hours of which may be "on call" for complicated or interesting cases that the Hospital may need help with.

THE WRITING COMPONENT includes a short essay, due the end of the first week and a more comprehensive essay/evaluation at the end of the experience, which should reflect understanding of the Cultural Literacy materials distributed in the original orientation. On middle weeks (non first or last week), the student-resident is expected to provide one case write up each week. Write ups will be done on center computers or provided on disc by the rotator prior to rotation end.

NON CLINICAL ROTATORS: We also have programs that are oriented to non-medical spouses or to those who do not need or want the international medicine experience. Medical Students and Residents who are in the program as a Medical School or Residency Program elective are not typically able to take this option, since there are clinical requirements which need to be met in undergraduate and graduate medical education.

INSTRUCTOR TRAINING: Occasionally, we have clinical instructors who wish to refine their teaching in Spanish and we build a program around them such that they review specific medical material, and are given opportunities to present it in various forums (hospital, the Red Cross, the Medical School, etc.) We have developed a few durable courses in this way for the PACEMD Program, including Ultrasound/FAST, Advanced Airway, Trauma Nursing, and Neonatal resuscitation. We work the clinical experiences around these busy schedules, if the clinical experience is requested.  

Medical School and Residency evaluation will be returned to the respective program, along with pre and post scores, as well as selected write ups and essays. Input will be sought from the Mexican medical contacts to evaluate performance at those sites. CME diplomas will be issued by the University of New Mexico if appropriate.

N.B. CEU for nurses must be arranged prior to arrival with their respective nursing board!

The program is expanding to Guanajuato City (Red Cross) and to the Medical School (in Leon) and may be configured differently in those environments, and may target different types of participants (i.e. non clinical medical students, between their 1st and 2nd years of Medical School or Medical School professors).

Weekends are typically free for traveling and enjoying the culture. We arrange one 3 day week end per month. These trips, in the past, have included the Pyramids, Guanajauto City, Patzcuaro, the Anthropology museum in Mexico City, hiking, hot springs, etc.  There is a 1.2 million acre tropical jungle ecological preserve 4 hours from San Miguel and eco tours can be arranged.