Global health is a passion of mine that first developed in college. I continued to find global health opportunities in medical school, and was happy match at a program that supports my global health pursuits as a resident.
I got started straight away as an intern with the RIGHT program. The Resident Initiative in Global Health at Tulane (RIGHT) is a program that brings together residents from all specialties to facilitate collaboration on global health projects and offer mentorship. Monthly seminars offer a forum for residents interested in global health to converse and share experiences, while learning new tools and knowledge to aid them in future careers in global health. The program has some limited funding for resident projects, and external funding opportunities are consistently advertised and promoted at monthly meetings.
My trip to Ecuador during CA-1 year featured early mornings and late evenings in the operating room. Fundacion La Vida is a two-operating room, outpatient orthopedic clinic and surgery center in Portoviejo, Ecuador.Although local physicians and staff operate the clinic for routine orthopedic care, the clinic relies on volunteer specialists for more specialized surgeries, such as hip and knee replacements. During our trip, we performed 16 hip replacements, and 15 additional lower extremity cases. The new, unsettling environment forces adaptation and flexibility, which I find invaluable in anesthesia training. We used a multimodal, opioid sparing pain management approach that was in many ways more robust than our pathway at home. We used a nerve stimulator alone to perform nerve blocks, as no ultrasound was available. But other than lacking an ultrasound, the clinic offered high quality care to its patients and outcomes were excellent. The most rewarding part of the trip was being able to offer real solutions for patients with congenital deformities.
During CA-2 year, I completed a one-week CME course in global health and medical missions in Bocas del Toro, Panama. The course was organized by Dr. Ben LaBrot of Floating Doctors, and course topics included ultrasound in austere environments, tropical medicine, cultural competency, and medical mission logistics and execution. The most unique aspect of the course was its multidisciplinary nature. There were pediatricians, dentists, family medicine physicians, nurse midwives, and emergency medicine physicians. I was able to quickly teach everyone about an ankle block that would be relevant for some of the “sea-urchin-spines-in-foot” removal procedures. I was also reminded of post-partum hemorrhage management and neonatal resuscitation from the other specialists. So how did this course help prepare me for my future career as an anesthesiologist? I think it is incredibly important to remember that anesthesiologists are indeed physicians. Even though primary care may not be our favorite use of time, it is undeniably vital to patient care and not outside our scope of practice. A surprising majority of patient presentations in Panama (and likely in other parts of the developing world) are musculoskeletal pain, headache, and pregnancy - all of which have direct relevance to an anesthesiology practice. I also got direct hands on experience with point of care ultrasound and saw its diagnostic impact firsthand.
Christopher Busack, MD