Resident Physicians serve overseas,
learning the art of care.
Healing with More than Medicine
When residents of the Memorial Family Medicine Residency program take a rotation overseas, they instantly become part of a more than 20-year tradition. The experiences test the physicians’ clinical skills in ways they may not have imagined, often in remote hospitals or clinics with meager equipment and supplies. Along the way – and perhaps most importantly – they learn lessons about the human condition, bringing home a new outlook on what it means to care for others.
Jim Strycker, MD, Memorial Family Medicine Residency Class of 2017
Finding yourself in the middle of nowhere
From an office perched just above the noisy traffic of South Bend’s Michigan Street, Dr. Jim Strycker described his journey to a small hospital in Zimbabwe, Africa, where he spent time as both a medical student and later as a fellow during his training at the Memorial Family Medicine Residency program.
“Towns give way to villages and then to subsistence farms with stick-and-mud huts with thatched roofs,” he said. “People drive donkeys attached to the beds of pickup trucks, like a cart.”
“If it’s the rainy season, you take a 30-minute longer drive to find the bridge,” he continued. “If it’s the dry season, you wade across the river where it’s low. Once you’re there, you’re pretty much in the middle of nowhere at a 150-bed hospital.”
Located three hours northeast of the capital of Harare, Dr. Strycker said the Karanda Mission Hospital serves a catchment area of about 2 million people.
“People would get in line before sunrise and wait until it was their turn. And if they didn’t get seen by dark, they would go back and wait overnight until the clinic opened in the morning.”
“We would work until dark or until there were no more patients which, in my experience, never happened.”
His days were spent caring for patients in the outpatient clinic as well as rounding on the inpatient wards.
“I was doing my obstetrics fellowship at the time so I took the labor and delivery ward and rounded on the moms,” Dr. Strycker said. “They called it a NICU (newborn intensive care unit), but it really wasn’t a NICU. It was really just a room with a heater in it.”
How has Dr. Strycker’s experience in Africa translated to his work today as a family medicine physician?
“I think traveling overseas and learning overseas makes for a more well-rounded person and doctor,” he said. “I think it gives you a lot more perspective on the severity of illness and the incentive to work to find solutions for problems. It forces you to think outside the box and get in that mindset of finding workable solutions that give the best care for the patient.”
A Passion to Serve
“This was the only place I found, in interviewing with 20 places around the country, that said they would not only pay for my trip but also continue my salary and benefits while I was away,” Dr. Jennings said. “That, to me, demonstrated the importance that the international rotation had here and a longstanding tradition of sending residents to multiple places around the world.”
During her second year of residency, after receiving advice and information from Dr. Randall Suttor, associate director of the residency program, Dr. Jennings decided on doing a rotation in a small, rural hospital in Macha, Zambia.
“My experience in Zambia really was the pinnacle of my training,” she said. “And that’s what I hear from residents who go overseas time and time again – it’s just an extraordinarily impactful event.”
Dr. Jennings explored all segments of family medicine, including inpatient medicine, tropical disease management, outpatient medicine and some surgical management, too.
“It’s one of those humbling times in your life where you say, ‘I’m going to go to this place and help!’ and actually you’re the one who is helped so much more. The experience changes your worldview and you learn things that you might not have been able to learn stateside.”
Kristine “Tina” Jennings, MD, Memorial Family Medicine Residency Program Director, in Zambia.
Building on a tradition of service
For more than 20 years, Dr. Randall Suttor has guided residents who want to experience practicing medicine a half a world away. He, too, was once a resident at the Memorial program, and was inspired to travel to Ecuador for six weeks during his third year of residency by then-director Robert Fenstermacher, MD.
Before a resident decides where to travel for his or her international rotation, Dr. Suttor helps tailor the experience based on the resident’s interests in medicine as well as geographic and language preferences and facility type.
“Some residents are content in seeking out a place where they don’t have consistent electricity or running water. Others want to be in a place that has restaurants and a lot of infrastructure,” he said.
Beyond the diseases and conditions a doctor would expect to see in developing countries such as tuberculosis, malaria, parasites, HIV and malnutrition, residents also discover how different social structures can impact care delivery.
“Here in the United States, we’re really focused on the autonomy of the patient,” Dr. Suttor explained. “People have the right to direct their own care. In a lot of cultures, however, those decisions are a family decision, or maybe a social group decision bigger than the family. That’s a very different way of looking at things. The residents learn to appreciate that, learn from it and respect it.”
Dr. Suttor encourages residents to travel without any preconceived ideas about what it will be like, to go into the experience with an attitude that they are going to do whatever they can to help.
“When people come back from an international rotation, they have their minds opened and they look for opportunities to serve, to make a difference, that they might not have seen before. They have a new lens to see things through.”
Bringing Valuable Experience Back Home
Residents who serve during an international rotation touch the lives of hundreds of people around the world. But the skills and knowledge the residents bring back to our region potentially benefit thousands more over the years.
“A proportion of our residents end up staying in our community and serving our patients – I’m one of those people,” Dr. Jennings said. “I had no connection to South Bend. I came here for the residency program and I did not think I would stay here.”
“The international rotation is an important opportunity that helps us to attract the best of the best from around the country to come here.”
Kristine “Tina” Jennings, MD Memorial Family Medicine Residency Program Director.
Some of the countries where resident physicians from the Memorial Family Medicine Residency program have served abroad include:
- Dominican Republic
- El Salvador
- Papua New Guinea
- South Africa