Taking a year off to volunteer abroad?

Pre-Med & Medical School Pre-Med Topics
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<p>I'm about 1.5-2 years ahead of my age group. I graduated early and I have about 27 semester hours of credit. I'm currently an EMT-B and enrolled in an EMT-I program with my university. I'm really considering taking a year off to volunteer in a third-world nation. Not for medical school admissions, but because I sincerely want to...and I think I need this right now to help me grow into a better person.</p>

<p>Would this be completely and utterly wrong? I don't care if it looks good to medical schools, as long as it doesn't look bad.</p>

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<p>Both my Ds did medical service abroad in Africa. One was an EMT-I and worked in South Africa as an ER EMT, surgical tech and did whatever else was needed at the hospital; the other didn’t have significant medical training but worked doing hospice care and HIV education in Kenya. </p>

<p>Both found it a life changing experience.</p>

<p>D1 (now a med student) wants to go back to Africa and do more service there. </p>

<p>If you want to go, go! But be sure to do due diligence as to the legitimacy of the organization you volunteer with. Some are much better organized than others. Some are complete shams who do little to actually find a placement for you once you arrive there and only want to extract as much money as they can from you.</p>

<p>D1 said she thought her service was viewed positively by the med school interviewers she talked with.</p>

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<p>Definitely nothing wrong with doing that. If you really want to do it, and for the right reasons (which it sounds like you do), then go for it. It definitely won’t be a bad thing for med school admissions.</p>

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<p>Thanks! :)</p>

<p>WOW, would you mind telling me which service your daughters worked with? It is really hard to find any online.</p>

<p>Thanks again!</p>

5

<p>D1 went South Africa with Child Family Health International and was quite pleased with her placement and the support she received from the organization. A friend of D2’s went with same organization and did a quarter program with them thru her college (UC-Davis) in Oaxaca and was quite pleased. She has since returned to Oaxaca several times. I recommended the program to D of the lady across the street (a long time neighbor and friend).The D went to South Africa this past spring with CFHI and, again, was quite pleased with the program.</p>

<p>D2 used International Volunteer HQ–which is an umbrella group which matches volunteers with placements, but does not actually supervise or monitor the charities it places volunteers with. D2 received two or three different placements thru IVHQ over the course of 8 weeks–and none of them were really satisfactory for a bunch of reasons. Mostly the charities were ill funded, poorly organized, and had no clue how to utilize their volunteers. D2 said she thought it was more a function of the particular country since she met other IVHQ volunteers who had a very successful & positive placements in other countries. If you use IVHQ, caveat emptor–check out the charity they place you with BEFORE accepting the placement.</p>

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<p>just to make the opinion more resounding, if you genuinely want to give your time to those in need it would certainly not be frowned upon (probably would look good to be honest) by ANY medical school.</p>

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<p>Hey, I definitely don’t think it could be seen in a bad light; getting more experience, doing something selfless and broadening your perspective of other cultures. Just make sure you make the most of the placement; really get involved with the work and with local life. This program might be worth checking out [Vacation</a> in Malawi - Malawi Medical Volunteers](<a href=“http://www.realgap.com/Malawi-Medical-Volunteers]Vacation”>Travelling in Thailand | Real Gap Experience), a good way of getting experience and a trusted and recognised organisation. Good luck!</p>

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<p>Why not here? American people need help too. You will be very young, 18, correct? I feel that you yourself will need to be very closely supervised being that young.</p>

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<p>One reason to volunteer abroad is that overseas a student may have greater latitude in the kinds of medical procedures he/she can perform/assist or observe. In the US, hospitals and clinics have some pretty severe limits on the kinds of things even an volunteer EMT is allowed to do. In other countries, these limits don’t necessarily exist or are significantly different. D1 was allowed to attend daily rounds with the med students. That wouldn’t happen here in the US.</p>

<p>(OTOH, one needs to be careful not to overstep one’s scope of practice and behave unethically. D1 was offered the chance to do procedures–like spinal taps and some surgical procedures–which were waaayyyy outside her training. She declined to attempt them, but not everyone in her program did.)</p>

<p>Also third world medicine can be an eye opening experience. One gets to see people in desperate need and one can practice medicine often under the most basic and primitive conditions. Consider that one of D2’s jobs was to stand next to outdoor operating theater and catch any trash that would blow into the ‘sterile’ surgical field.</p>

<p>In Africa at D1’s hospital there is ONE 10-year old CAT scan machine for the entire public hospital system which treats over 4 MILLION people. Doctors used to have fist fights over which patients were going to get sent for a CAT. MRIs were unheard of. But D1 saw some of the best diagnostic work she could ever hope to see. There were doctors who diagnose conditions that in the US would require a week in the hospital and multiple tests/xrays with a simple physical examination.</p>

<p>There is also the opportunity to live in a completely different culture with different attitudes towards medicine, health, social and gender equity and a whole host of other things.</p>

10

<p>I agree with WOW. What could I possibly do here? There is already so much being done. We have a welfare system here that is something unheard of in many third world nations. Not only that, but how could I possibly medically volunteer? The most I could do is file papers in a hospital (believe me, I’ve called). And sorry, if I put in my precious time and effort for an EMT-I certification, I am NOT filing papers. Especially not for a year. </p>

<p>I could work as an ER Tech, but that wouldn’t be volunteering–it’d be a paid job. I could volunteer with an ambulance service, but none of these things will help me grow. The snobby elderly patients sure wouldn’t help. In reality, there’s just nothing I can do here.</p>

<p>My fathers best friend is an American doctor that has a practice in Nigeria. I’m thinking of possibly doing a four week program with one of the organizations above, and then spending the rest of the year volunteering with my fathers friend.</p>

11

<p>First off, let me mention that I think WOWMom’s explanation of global service is spot-on (having worked in clinic settings in Central America for a few weeks, I agree with many of her observations). And BaylorMed, I think it’s great that you want to do service and have the opportunity to do so with your father’s friend. That’s one I would certainly jump on if I had the chance.</p>

<p>Miami says “Why not here?” and the response was “What could I possibly do here?,” and I’d like to address this. </p>

<p>I think the first thing you need to realize is that there’s a lot more to volunteering than “just” providing a service to the individuals you’re working with. Using WOWMom’s D as an example, the value of her service work had to have been beyond that of performing the LPs and surgical procedures–after all, she got something out of it despite refusing to do those procedures (which for the record I think was the correct and ethical decision to make). </p>

<p>So if it’s not about providing a tangible service (LPs, minor procedures, etc) to individuals in need, what is this all about? I think at the level of a premed, what it’s all about is discovering something about you and something about what makes you tick and something about why you want to go into medicine. A great way to do those things is to get involved by volunteering in a medical setting. </p>

<p>But what on earth is “in a medical setting”? What counts? Who knows. I doubt there’s a list. As far as I can tell, if you can use an experience to prove to someone else that you genuinely care about the well-being of another person, it counts. Newsflash, you don’t have to volunteer in a hospital. It’s just the easiest and most generic thing your advisors can tell you to do–one size fits all. I’ve never volunteered in a hospital. I have no clue what it would take to become an EMT. The handful of times I was in a nursing home it was to visit relatives. I had no idea undergrads could be phlebotomists (or even what a phlebotomist was, for that matter) until I was already a med student. I couldn’t tell you what floor the peds wing, where many premeds volunteer playing with patients and families, is on. The only reason I know where the ER is located is because I pass it on the way to the vending machine. The point is, it’s not about assisting with procedures or learning how to tie surgical knots or holding sterile drapes or whatever. (At least, not at the level of a premed.)</p>

<p>So what did I do? I found a group of people I care deeply about–happens to be pregnant teens, teen parents, and their children–and begun getting to know them. I found a few things they needed–help navigating the health care system in my community, and some information about their health during pregnancy–and worked with others at this agency to meet those needs. The programs I developed ended up morphing into a nonprofit (which has somehow gained attention at national and state levels) I am oh so proud to direct. The relationships I’ve formed with the women and families I work with, as well as with the professionals in my community I’ve met as a result of this work, have changed my life and have probably influenced my career in ways I cannot yet fully understand.</p>

<p>I hope you don’t interpret this as me bragging about my service work. I’m absolutely not trying to do that. Rather, I’m trying to give you a glimpse into how meaningful service at a local level can be if you’re willing to put forth the effort to make it into an incredible experience. Traveling halfway around the world is a fabulous opportunity, and if you have a strong enough drive and passion to serve others that you’d move across the globe to do so, I can’t help but think the people in your own backyard are seriously missing out on someone who could really champion them.</p>

<p>See what you can find in your college town or your hometown. I think you’ll be pleasantly surprised to find there are quite a few more people out there than the ones who use the hospital. My recommendation is to start with a group of people you know very little about but are eager to learn more about. They’re out there–go find them!</p>

<p>Good luck!</p>

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<p>Holding a baby for few hours, the one who was abandoned in a hospital by her mother right after birth, the one who did not have a chance to be held since everybody is so busy at the hospital could have made a big difference in this human being life. Yes, one could be more useful in Africa, but this precious American human being needed love at the moment when only volunteer could provide it. There were many others that were simply changed diapers again when all nurses were busy, they were bought to where they needed to be because only volunteer had time to do it. Volunteer who offered help at American hospital, who were not available in Africa because of that.</p>

13

<p>I understand both of your points, but they aren’t really reasonable–at least where I live. The hospitals I’ve contacted would give me little if any patient contact. I’d mainly be doing the dirty work for the hospital that no one else wants to do. I wouldn’t enjoy it at all. I’d never get the opportunity to hold a baby. I’d be lucky if I got to see one. </p>

<p>Many hospitals have extremely rigid structures. Many hospitals don’t want to give volunteers patient contact opportunities due to liability if something went wrong (like if somehow I dropped the baby). I wouldn’t mind filing papers, organizing shelves, and changing linen for a little, but I surely couldn’t survive a year; I wouldn’t in a million years trade a year of college for that.</p>

<p>Now Kristen, working with a teen group or a homeless shelter might be a good idea, but I think that would be more of a side job. There aren’t events going on 8 hours a day/5-6 days a week. So if there isn’t, how could I possibly devote a year to something like that. I want something full-time.</p>

<p>To me a third-world country seems like the best option. I know my training is nothing compared to that of a physician, but I still want to use my skills for a cause. Anyone can hold a baby or talk to teen girls, but not everyone can save a life. I’d feel like I was limiting myself by doing any of that–even if it was a possibility. </p>

<p>The only way I can further prove if medicine is right for me is by practicing my skills. I could never tell an adcom that I discovered my passion for medicine by filing papers in the back of a hospital. I just feel like practicing in a third-world nation will accomplish more than one goal for me.</p>

14

<p>I really don’t know what you’re expecting to do overseas. A lumbar puncture? A minor surgery? Anything you do overseas that you can’t do here won’t impress anyone. It’s irresponsible and there’s a reason why you can’t perform those procedures on US patients. Doing it overseas where the laws are more lax reeks of exploitation. One of the most important attributes in medicine is the ability to say “I don’t know” and to realize your own limitations. I would not accept any prospective med student who can’t determine what’s safe and what’s not.</p>

<p>When I hear premeds whining about how they can never do anything in a hospital in the US, I think “lack of imagination and lack of initiative.” You aren’t going to impress anyone by doing a procedure, which is what most premeds think of. It’s about understanding the US health system. Citing your work in Africa as one of your primary motivators is naive because you aren’t going to be practicing in Africa. You will be practicing in the US and you need to display insight into the US system. </p>

<p>For example, studies have shown that when patients have follow up appointments made for them upon discharge from the hospital, rather than being trusted to do so themselves, compliance increases 30%. But, this isn’t standard of care at most hospitals. If you can organize a program where you and a group of hospital volunteers make follow up appointments for patients on discharge (and all you need is the patient’s name and DOB and no medical knowledge is necessary), you’ve done something that has been proven to be helpful and to reduce rehospitalizations and poor health outcomes. That, my friend, is a lot more impressive than going to Africa for 4 weeks. </p>

<p>And this is not to diss anyone who did volunteer work in Africa. If you have a solid resume of clinical experience in the US, then you can certainly supplement it with overseas work. But, frankly, it has become cliche to see premeds spend $2000 to go abroad for a month simply because they can’t think of anything better to do.</p>

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<p>Baylor-- I don’t what you’re expecting to do overseas, but “saving a life” certainly won’t be on the schedule. Volunteer work isn’t that glamorous or exciting.</p>

<p>Even with your EMT training, you will be doing mostly grunt work: patient intake paperwork, monitoring IVs, patient transport, patient education, cleaning, changing dressings…You will not be treating patients-- not even out in the bush.</p>

<p>(D1 is older than you and most of the doctors assumed she was a med student on rotation from Australia or the Eastern Europe–which is why some the offers to do procedures were made to her. She wasn’t there for just a month–she stayed for 4 months and worked at the same location the entire time.)</p>

<p>Part of being a medical volunteer includes knowing your limitations (scope of practice) and having the ethical wherewithal to observe them. </p>

<p>There are opportunities to volunteer in the US. They’re harder to find and may require you to go outside of your comfort zone. Think homeless shelters, long term nursing care facilities or group homes for the disabled. Not all medicine happens inside antiseptic hospital corridors.</p>

<p>BTW, if you live in a rural area, consider volunteering your EMT training with your local volunteer fire dept or a search & rescue organization. They are usually happy to accept all the EMT volunteers they can get.</p>

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<p>HIV education and other education-type stuff is probably the most useful thing a premed can do oversees and will impact far more lives than a medical procedure. However, the same argument can be made that there are plenty of communities in need of HIV education here as well. I think overseas volunteering is an interesting experience but you really have to examine your motivations for going abroad. There are plenty of opportunities to help here in the US.</p>

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<p>I’m not expecting to practice out of my scope. I understand there are limitations and I would never violate them. </p>

<p>Practically what I’m saying is, if you had a nurse who wanted to volunteer, you would put her nursing skills to work. If you had a construction worker who wanted to volunteer, you would put his construction skills to work. I’ve invested 1.5 years (by this summer) in my Advanced EMT training so that I could use my skills (in emergency medicine) to help other people. I want to do something where I could put my skills to work (even if it’s just a little). </p>

<p>What distinguishes me from the average premed is that I’ve done EMT training and most have no medical background. What a waste of all the time and money I put into EMT training if I stayed here to do non-medical related projects. I don’t think going to a hospital and changing their policy would work because: </p>

<p>a) Is a side project. It’s not a 40-hour/week–1 year assignment that I’m looking for.</p>

<p>b) I probably couldn’t get very far. I don’t think I will be liked much for walking into a hospital and asking to change their policies. </p>

<p>I’m not planning to go to Africa to get the opportunity to perform neurosurgery. I want to use my skills attained from EMT training in Africa for the following reasons:</p>

<p>a) I’d be acknowledged and respected. As a current EMT-B and an EMT-I student, I’m still being pushed out of the way by nurses to do something as simple as taking a blood pressure. I’ve always hated hospital rotations because all I ever do is watch. EMS is highly disrespected. The amount of times I’ve heard “he’s just an ambulance driver” at the hospital is astounding. In third-world nations, they’ll take all the help they can get and I feel like my service will actually be appreciated. </p>

<p>b) To me, although all the above recommendations are great, I truly wouldn’t enjoy doing any of them. Also, I don’t know if I would be necessarily good at any of them. I don’t see myself adequately convincing teens to use protection during sex. In high school those speeches never worked for my peers, and I don’t think my speeches could be any better than those of the speakers from high school. </p>

<p>Talking to pregnant teens also wouldn’t be a good option for me, because I’m a guy and I have never been through it, so I don’t feel like I’d be in the right position to lecture them.</p>

<p>The EMS systems in my area have tons of volunteers. There are usually no less than 3 EMT’s on the truck. </p>

<p>I’d never volunteer at a hospital. If I had to volunteer at a nursing home I’d die. I can only listen to grandpa’s war stories for so long. So don’t try that one. There is really nothing for me to do here (that’s interesting/unique, requires full time commitment, and would take about a year). </p>

<p>c) Again, this isn’t a game on which choice will get me more points with medical schools. I’m doing this for me. I just don’t see myself changing for the better in the same environment I’ve grew up in for the past 17 years of my life. I also think it’s quite selfish of me to only think of my nation (which quite frankly is doing pretty decently).</p>

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<p>Baylor–Your EMT training will not necessarily distinguish you from the “average premed.” I would estimate about 1/3 of D1’s fellow MS1 have some sort of EMT/advanced first aid training. (And not because it will give them a leg up at application time, but because they’re interested in medicine in the first place.)</p>

<p>a) acknowledgement—this is more a function of your age (and perhaps your immaturity) than your training. EMS are not disrespected at most hospitals because they are a vital part of the trauma/first response team. D1 was a practicing [volunteer] EMT and has friends who are career EMTs/paramedics and EMT instructors (some have been EMTs for decades), NONE of them ever mention being disrespected by physicians. </p>

<p>If you do go to Africa, you may garner some respect, but this will not necessarily be because your training. To be blunt, it will be because of your skin color. The most uncomfortable part of both my D’s experiences in Africa was being hailed as “Teacher,” “Doctor” and other honorific titles because they were white–and not because they had actually done anything.</p>

<p>In third world countries often the greatest need is not for personnel but for supplies, equipment and medicines. Often there are plenty of people who are capable of delivering medical services–but there aren’t enough medical supplies, medical facilities or medications to go around. (See my comment about the dearth of CT machines.) It’s not a matter of needing extra hands; it’s a matter of needing the supplies and equipment in the first place.</p>

<p>b) if you can’t deal with pregnant teens or the elderly–whatever are going to do when faced with real patients? You don’t get to choose who you treat. And you need to be able to communicate effectively and empathetically with whoever crosses the threshold into your care. And communication often involves a skill called listening…</p>

<p>c) You sound bound and determined to get the hell out of Dodge (wherever Dodge is…) and have seized upon this idea as a justification to do so. If that’s your reason for heading off overseas, so be it. But don’t delude yourself that you’re going to be the noble hero who will be saving the lives of grateful natives.</p>

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<p>To this day, I still have no idea why people rush to become EMT’s. It has very very little overlap with being a physician (except an ED physician). And it certainly doesn’t impress med school adcoms.</p>

20

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<p>I think it could be if you made it, but in my experience you’re right–it was a side job (something I did for a year and a half as an undergrad). </p>

<p>But could you make it full time? Sure. And actually, one of my classmates did. He took a year off (after having been accepted) and worked at a homeless shelter–actually, he both lives there and works there. He loves it!</p>

<p>

I think it would be very worthwhile for you to have a solid understanding of what you’ll be doing with any organization you choose to go with (or at least, talk to your father’s buddy about what you’ll be doing there). Is it realistic to believe you’ll be saving lives in Africa?</p>

<p>Sounds like you have considerably more experience with service work than I do, as you’d be limiting yourself by doing anything other than directly saving lives. </p>

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<p>If this were a true assessment of the only way to prove if medicine is the right path, don’t you think sharpening such skills would be required for admission? I think, if anything, developing these practical clinical skills before you’re “ready” (and by “ready” I mean at least a medical student) could be slightly detrimental, and might even be construed as exploiting the individuals you’re working with (both doctors and patients). Just my opinion though.</p>