Rodolfo is a Center for Global Health Scholar Award in Medicine recipient. What does this mean? All CGH in Medicine scholars are 4th year medical students conducting clinical rotations at UVa sites, and Rodolfo chose to conduct his clinical rotation in Guatemala. Read about his experience below.
I write this at 27,000 feet of altitude and contentment—returning from a wonderful rotation in Quetzaltenango, Guatemala. Last night I packed my duffle bag with all I had brought—aspirations, expectations, and medical knowledge grown from education in a U.S. medical school—now accompanied by all I acquired, and grown, in the previous two months. Eight months ago, when deciding how approach the fruit of opportunity that is the fourth year of medical school which allows you to schedule your own electives, I knew I wished to squeeze from it the most it held of its juices of learning and potential experiences. The Guatemala Service, Language, and Culture elective stood out to me immediately. Before arriving I already knew I would be able to experience Guatemala in a way that would be unique from most of my classmates. Spanish is my mother tongue, having been born in Mexico and raised in a household of Mexican culture and Spanish only. Already during my clerkship year at UVa I relished the opportunity to be involved in the care of Spanish-speaking patients. Coming to Guatemala for me represented a continuation of that service, and a way in which to polish the edges of my medical Spanish, as well as to continue to grow within medicine.
Upon arrival, immediately I felt as if I were returning home to Mexico—a mentality that while comfortable, I had anticipated and knew I had to guard against. To navigate through Guatemala as if I were in Mexico would have been to void this country of its uniqueness and to only seek the familiar instead of pursuing the novel this Central American republic holds. The first week I fulfilled the obligatory minimum of one week of Spanish classes. While they did not advance my general Spanish as I
am already fluent, I took the opportunity to learn of the differences between Mexican and Guatemalan Spanish and learn more of the organization and state of the Guatemalan health care system. The healthcare system I would be entering for the remaining weeks. Totonicapán National Hospital is located forty minutes from Quetzaltenango, where I resided with a host family. The entirety of my time there I split rotating between general Internal Medicine and the Emergency Department (ED). I will never forget my first day rounding on the Internal Medicine floor. The attending greeted me kindly as I joined the group at the bedside. “So, you’re Rodolfo, the Mexican student at UVa?” he asked warmly. “Excellent, welcome to Toto. We have here a diabetic patient presenting with a neurogenic bladder. Why don’t you tell us what you know about diabetes and its neurological effects?” And with that, I was incorporated into the team. I appreciated how the Socratic method was applied equally to me as it was to the other students, maximizing my learning experience and opportunities to teach the other students. It became clear within the first week that UVa had prepared me well and I could function at the knowledge level of the interns in the hospital. Learning the logistics took a bit longer, but with the help of my Guatemalan medical student colleagues, by the second week I was presenting patients, ordering labs, and writing the progress notes. The ED was equally exciting, as I saw
patients on my own or in tandem with the other students, weighed in on differentials, and was taught how to maximize the physical exam and limited lab tests available to best serve patients. In addition, I participated in point-of-care ultrasound workshops led by UVa ED physician Dr. Moak that accompanied by a donation of a handheld ultrasound for use in the Totonicapán ED. Currently I am finding myself in the process of submitting a needs assessment survey I wrote to help guide the building of an ultrasound training curriculum I will be working on exclusively in a four week elective in October.
I return from Quetzaltenango with my bags stuffed with memories and learning. Contentedness also fills my luggage, at the thought that I was able to contribute to patient care and student learning. And I also have a sense of looking forward, excited for the continuation of the ultrasound project and to stay in touch with the friends I made in Guatemala.