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AAP National Conference: Going overseas? Get some advice on how to prepare :

October 23, 2016

To say many physicians and trainees who embark on global health experiences are unprepared is an understatement, said Sabrina Butteris, M.D., FAAP, a member of the AAP Section on International Child Health.

“It’s a huge problem,” she said.

A few years ago, Dr. Butteris and her colleagues collected data on global health educational opportunities offered at U.S. pediatric residency programs. They found that two-thirds of the programs offered pre-travel preparation for global health rotations. That meant one-third were not preparing residents for their experiences abroad.

There are no data on preparation for faculty members, but Dr. Butteris said she suspects the numbers are even lower.

“Preparation is probably the most important burning issue for global health at the moment,” she said.

To help both novice and seasoned travelers, Dr. Butteris will co-present an Interactive Group Forum titled “Global Health: Challenges of Working in Resource-Limited Settings (I2173)” from 4-5:30 p.m. Sunday in Room 122 of Moscone North. Joining her will be Michael Pitt, M.D., FAAP, a member of the Section on International Child Health and assistant professor of pediatrics, University of Minnesota.

During the session, Drs. Butteris and Pitt will focus on culture and culture shock and preparing people for the emotional challenges they will experience.

“All of us will have culture shock whether we believe it or not,” Dr. Butteris said.

Those participating in global health experiences also face what Dr. Butteris calls “medical culture shock” that comes from being in an unfamiliar hospital or clinic with extremely limited resources. “They’re going to see more deaths and much sicker patients than they’ve ever seen before.”

Both Dr. Butteris and Dr. Pitt have a wealth of global health experience. Dr. Butteris started traveling abroad as an undergraduate student. She spent time in Costa Rica and Cuba as a medical student and in Tanzania as a resident and chief resident.

She now directs global health education in the Department of Pediatrics at the University of Wisconsin School of Medicine and Public Health and coordinated a partnership with Addis Ababa University in Ethiopia.

“Much of the motivation to teach people about global health and prepare them for global health stemmed from that period of time where I was a trainee and coordinating a partnership with another institution and seeing the difficulties that residents have in those experiences,” Dr. Butteris said.

She and Dr. Pitt developed an online educational module and a curriculum that uses cases to help people begin to understand what it might feel like to practice in another setting and “try to process before they are thousands of miles away from home and away from their normal support structure,” Dr. Butteris said.

Those attending the session will be presented with a case that involves the culture piece and working in a resource-limited setting. They will have a chance to reflect individually on their own culture, work in small groups and debrief with the larger group.

The goal, Dr. Butteris said, is for people not only to learn themselves but also to walk out with tangible, fun activities they can use to teach others to be more insightful and thoughtful about how they engage in global health experiences.

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