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United Kingdom Ireland Netherlands Poland France Germany Bulgaria Spain Italy Turkey Japan Lebanon Syria Israel Jordan West Bank Canary Islands Nepal Pakistan Egypt Saudi Arabia India South Korea Thailand Ghana Vietnam Nigeria South Africa Global Reach enriching educational opportunities medicine. "I made a promise to myself at the time to go into medicine and go back and try to help address the disparities I encountered there," Styczynski says. She currently is interning at George Washington University Hospital in Washington, D.C., in internal medicine and plans to work on health policy for an organization such as the Centers for Disease Control or the World Health Organization. At McCord Hospital, where she estimates 80 percent to 90 percent of the patients were HIV positive and many were dying, she participated on rounds. She also took part in a Harvard Medical School research project evaluating HIV therapies. Similarly, Styczynski added that more than once, she found herself transporting patients in respiratory distress to a hospital floor that had a defibrillator. Afshar had a similar experience during her rotations at foreign hospitals, where medical students function more like interns. In Colombia, for example, she served as the primary assisting physician on Caesarean sections. At the same time they're being extended clinically, students in international rotations also often grapple with the limited patient care resources available to them. "The American medical education system is very technologically oriented. When [our students] go abroad, they learn how you have to think differently when you don't have the resources or the technology," Tekian observes. "It forced me to be a thoughtful practitioner and ask, 'Why am I doing this? Could this be done a little more efficiently?'" Styczynski says. Such constraints also hone students' examination skills, notes Saul J. Weiner, MD, vice provost of planning and programs, and former senior associate dean for educational affairs. During his fourth-year at Dartmouth Medical School, Weiner received a fellowship to train in Schweitzer Hospital in Gabon, in West Africa, where he became accustomed to palpating enlarged spleens in patients with malaria. While Weiner acknowledges that physicians in the U.S. rarely will encounter conditions common in Africa, he says that rarity makes international medical education even more valuable. "The whole point of going to the doctor is that the doctor is supposed to catch things that are uncommon," he observes. Furthermore, training in another country helps prepare students to be culturally sensitive while providing care in diverse communities. "It makes you more confident as a student and as a physician to be able to work with people when you're uncomfortable in your setting," Afshar says. "You're able to assimilate quickly and to adapt to a new environment and excel where you don't know the nuances." Styczynski feels that those kinds of lessons made her South African rotation the most important part of her preparation to be a doctor. "The skills and confidence I realized from being in that situation were essential to me flourishing as an MD and taking ownership of my patients and the responsibility I have for them," she says. "Having the flexibility to choose international electives is really an asset of the COM curriculum. Being able to encounter a health care system in other countries is a critical component to medical education and should be offered to every student." illinois medicine | 17