1. Who is the rotation open to?

It is open to all medical personnel (including medical students) who are interested in improving their ability to communicate with their patients in Spanish. We offer one to two month electives for Medical Residents, and customize rotations for as little as a week for community physicians, nurses or paramedics. Flexibility is the key. We will work around your schedule.

2. Do I need a special license or visa to do this rotation?

You must bring either a passport or drivers license and a birth certificate. Passports are increasingly required for international travel. If you are bringing a child, without both parents present, you need a notarized, written permission from the other parent, or legal papers indicating that you have sole custody. You will be in Mexico on a tourist visa, which will be issued to you at the port of entry.

3. What are the liability issues?
   
   For good reason, health care workers in the United States are concerned with malpractice and liability issues. We do not issue malpractice insurance in Mexico, nor is any available from a third party. Here are the reasons that your activity in Mexico is "low risk":
   
   Technically, this is an "observational" rotation. You have no license to practice. You sign nothing and document nothing. (As they say in the U.S., if you did not document it, it did not happen). The Attending at the Health Ministry hospital signs off on everything. Your work in the Health Ministry Hospitals, clinics, and program is affiliated with the University of Guanajuato. Unlike in the U.S., public organizations such as these are almost impossible to sue in Mexico.
   
   Defamation in Mexico is a criminal offense, especially if you need your good character in order to work (i.e., physicians). This means that an accusation that cannot be proven leaves the initiator with the possibility of a criminal defamation counter suit. The loser pays all and faces a criminal counter suit. Also, the society is rather deterministic. This means that not even doctors can change "God's will" and cannot be held responsible for bad outcomes. Thus, it all adds up to extremely low risk.
   
   Of course, nobody can guarantee that there would be no risk at all. Despite the above information, you may get legal counsel in the U.S. suggesting that you would need malpractice insurance wherever you go, even in a refugee camp. If this continues to be a major concern, we would recommend "Option 2" which limits clinical time.

4.   What do I wear?

Guanajuato is high desert (about 6-7,000 feet). This means that even in the summer, it is often cool in the evenings. You should bring a light jacket or sweater. It seldom gets higher than 90 degrees, and it is a dry heat, so it is quite comfortable. In the winter it can get quite cold (although it almost never snows), so you should dress in layers.

In the winter, daytime temperatures range from an average high of 70 degrees to a chilly 50 degrees. Almost all construction is masonry, so it can feel colder than what is registered. House slippers are a great idea. The rainy season starts in June, and pretty much stops by October or so. The rains typically come as refreshing afternoon showers.  Even at its worst, it is almost always more pleasant than where you are now!

5.Can I bring my family or significant other?

 Please do! We encourage you to bring family and/or significant other. There are generally additional expenses in bringing a family to San Miguel. For rotators having other specialized housing requirements,  we will assist you in renting a house or an apartment during your stay.

There is plenty for non-medical adults and children to do in San Miguel, and we can often arrange for babysitting. If you are a single parent bringing a child, DO NOT FORGET, you must bring custody papers or permission (notorized) from the non-accompanying parent!

7. Should I convert currency before I go?

You might bring a few hundred pesos ($50) but it is not needed; there are plenty of ATM machines.  Keep in mind that airports tend to give a poor exchange rate.

Many places do not accept credit cards, and even fewer accept American Express, so cash is your best bet. There are several ATM machines throughout the city, and this is probably the easiest and most economical way to get pesos. Stores that accept dollars as payments usually give you a lower exchange rate.

One thing to consider if you plan to pay in cash or make a large purchase, ATMs generally only allow an advance of about $300 U.S. per day. In addition, each transaction will charge your account approximately $2, unless you can find your own bank's ATM here (rather unlikely). You may want to plan ahead for this. It is also wise to tell your bank that you are traveling out of the country so that they don't inactivate your card for your own protection (!!)

You can change dollars in "casas de cambio" for a decent rate and travelers checks in banks, but in general, ATMs are the way to go.

8. How do I get there by air?

Leon, Guanajuato is about 1 1/2 hours away with an international airport (code: BJX - El Bajio International Airport). It is serviced directly from Dallas, (American), Houston (Continental) Chicago (AeroMexico) and a few other cities (try Expedia and Priceline).  

Mexico City (MEX) is another option. You may save $200-300 but it is then a 4+ hour bus ride (about $50).

Queretaro (QRO) is a new, even closer airport, but seems more expensive.  It is services by Continental Airlines, United Airlines, US Airways, Northwest and most of the international Mexican air carriers.

9. Do I need a car?

 No. San Miguel is a walking town. Sometimes, a car is good for touring outside of the city, but it is easiest to take taxis or buses for non-local travel.

10. Can I bring a car?

Yes, if you were a truck driver in your last life. Please contact us at least 1 month ahead of time so that we can explain to you the process. Driving in Mexico, you may have heard, can be challenging (i.e. dangerous), especially at night. This has as much to do with road hazards as anything else. There are some great toll roads, however.

11.  Are there any additional requirements for residents in this rotation?

Residents are expected to read the Cultural Literacy materials, to write an essay the first week´s impressions and to write a shortpaper in the last week which addresses some of the cultural issues.  They are expected to provide a limited number of case write ups or do a presentation at the clinical setting. They are expected to make a presentation on their experience when they return to their program.

12. Do I need an electricity converter?
    
    No. U.S. electric cords work here, but if you have a three-prong plug, (for example, for your laptop) get an extension cord that will plug into a two-prong socket.
13. What do I wear to work?
    
    Scrubs are most appropriate for the hospital setting. (Please change into your scrubs at the hospital and back to your street clothes before leaving.) Bring your own scrubs - at least two pairs. Be sure to bring your white coat, as it is required in the hospital. The 2 pieces of equipment you’ll use most are your stethoscope and eye protection. If you are interested in doing Cruz Roja ride-alongs (ambulance), please bring field pants or khakis, as you will be responding to calls in the field. Shorts are not appropriate. Scrubs do not typically provide enough debris protection from such things as automobile collisions and fires.
14. What is the clinical experience like?
    
    This is an evolving rotation. The hospital experience is initially observational. We work with the various interns who staff the ED and the rest of the 35-bed hospital in San Miguel. While we have no clinical responsibilities per se, we often make suggestions about patient care and assist with suturing, deliveries or anything else that comes up (sometimes this is very exciting!) .We also have experiences available in a community clinic and in mobile clinics (rural medicine). The idea is to be in a setting where you can learn Spanish and learn about Latin American health care. It is fairly low key.