So you want to be a global health doctor.
You went into medicine to help others and now want to give back to less fortunate communities
who don’t have the resources for proper healthcare.
Let’s debunk the public perception myths and give it to you straight.
This is the reality of global health.
Dr. Jubbal, MedSchoolInsiders.com.
Welcome to our next installment of So You Want to Be.
In this series, we breakdown a specific specialty within medicine, in this case, global health,
to help you decide if it’s a good fit for you.
You can find dozens of other specialties on our So You Want To Be playlist.
Make sure you’re subscribed if you want to vote in upcoming polls to help decide what
future specialties we cover.
If you’d like to see what being a global health doctor looks like, check out my second
channel, Kevin Jubbal, M.D., where we’ll cover a day in the life of a global health
physician.
Global health is the field of medicine that helps spread medicine and surgery to developing
countries and underserved populations.
The need for global health is immense.
Just from a surgical standpoint alone the disparities are immense.
Currently, 75% of the world’s surgeries are performed in the wealthiest one-third
of the world, and the poorest one-third make up only 6% of the world’s surgeries.
In addition, there are five billion people in the world who don’t have access to safe
and affordable surgical care.
Global health aims to decrease this health gap of inequality by partnering with local
physicians and advocates to empower those populations.
Through it, the hope is for longer, healthier lives; improved quality of life, better medical
systems across the board, and improved economies.
Global health doctors do much more than provide care for their patients.
These physicians also have administrative roles, reach out to local leaders, physicians,
and other community leaders; and oftentimes are involved in the physical aspect of setting
up care.
A good portion of their time is spent educating others, such as teaching local physicians
techniques and providing medical education to the local population.
However, this learning is not a one way street.
There’s also much to learn from their hosts, such as the techniques that local doctors
have successfully implemented with their limited resources.
The scope of practice for a global health doctor depends on multiple factors, such as
your own expertise, the local infrastructure, and the ability to keep continuity of care
after treatment.
For example, if you’re practicing medicine in a war-torn country, you’re more likely
to deal with trauma.
It may be more difficult to treat patients who need follow-up for years, such as transplant
patients.
Another limiting factor can be the country’s resources, which, unfortunately, means you
might not be able to provide the care that’s “cutting edge” for a patient.
Sometimes, it's a work with what you have situation, which is not what North American-trained
doctors are accustomed to.
This brings us to an important method of differentiating global health practice: seasonal vs. embedded
vs. one-time.
Doctors who practice global health on a seasonal or intermittent basis go to these countries
during regularly scheduled intervals.
Their schedules can vary.
Some may prefer traveling in the summer months, and some may prefer the spring.
They typically travel once a year or once every six months.
The reason they only go once a year is these projects are usually self-funded and these
physicians still have their own practices back home.
The upside of working on a seasonal basis is you get to provide continuous care and
build trust with the local community.
However, the downside is there are long lags between your visits, which can hinder the
progress you make.
Embedded global health doctors are those who decide to move to a different country altogether
and work locally.
They are able to fully integrate into the healthcare system and build more trust with
the local community.
However, embedded doctors are limited by the resources available in the community they
practice in and can’t supplement as easily.
It’s difficult to acquire industrialized technology and medical supplies when you don't
travel back and forth seasonally.
It’s also financially challenging, as you’re working in environments that don’t have
the funds to pay near what you’d expect to earn in the US.
One-time global health doctors usually do a mission for a short period of time, such
as a few weeks, and then return home.
While it may not be as impactful as seasonal or embedded practices, these physicians still
get the opportunity to share their expertise with others and learn from local physicians.
The downside of one-time global health endeavors is there’s no continuity of care, and if
you’re not incredibly careful, you can risk disrupting the local medical system.
Another categorization of global health is surgical vs. medical care, and each has its
pros and cons.
Surgical global health is procedural, and these surgeries are usually instantly life-changing
for patients.
You get to immediately heal patients and solve their problems.
However, surgical care is expensive, and you must consider additional factors, such as
the patient’s baseline health, pre and post op management, the rehabilitation resources,
and the patient’s ability to buy medication after the surgery.
There’s also the risk of postoperative complications, which the patient and local physicians may
not have adequate resources to deal with after you've left.
Medical global health is mostly associated with managing comorbidities through medications
and lifestyle changes.
These problems are much more common than surgical issues, and the interventions are not as invasive.
Counseling patients about certain modifications to their lifestyle can lead to long-lasting
change.
However, this is a much longer process, and the patient’s costs can build over time.
You might be able to provide the patient with medication to last a few months, but who will
pay for these medications on an ongoing basis?
There’s also combined surgical and medical global health, which can provide more services
to patients.
However, this needs much more coordination between different specialties, which can be
complex and difficult to organize.
Let’s clear up some of the misconceptions about global health.
Many may think of global health as a form of colonialism, where doctors believe they’re
the good guys who can fix all of a local population’s problems.
Global health is more nuanced and should never result in a “west is best” attitude.
Both global health doctors and local physicians have their own set of expertise.
For example, a US-trained surgeon may be better at performing certain laparoscopic procedures,
whereas local surgeons may be more skilled in traditional open surgical techniques.
It’s not a unilateral relationship.
Plenty of back-and-forth teaching and collaboration occurs with local teams, which consist of
everyone the local population trusts, including doctors, nurses, religious leaders, politicians,
and more.
Another important misconception is that the care in these countries is substandard.
While their limited resources may affect how patients are diagnosed or which treatments
they receive, the level of care the local doctors and nurses provide is still exceptional.
To become a global health doctor, you must first complete four years of medical school
followed by three to seven years of residency, depending on your chosen specialty.
Surgeons typically complete five years of general surgery training, and however many
years of a surgical subspecialty you’re passionate about.
If you want to be a medical global health doctor, you will need to complete three years
of internal medicine or another primary care specialty, followed by a few years of fellowship
training in the field of your choice.
You can become a global health doctor in any field you choose, and you can choose to go
into global health at any time.
There are always opportunities to enter the field at every level of training.
When pursuing global health, there are a few priorities to keep in mind.
The first is to be as well-trained as possible.
Just like back home, people are still entrusting you with their lives, except now you may not
have all the tools you’re used to.
People trust your knowledge, skill, and intentions- the more expert you are, the better.
You also need to build problem solving skills that can help you adapt to any situation.
You may not have the equipment you’re used to working with, and this will require outside-the-box
thinking.
Learning how to network is also very important.
As a global health doctor, you’ll be building relationships with professionals in various
fields, such as local physicians, politicians, manufacturers, and more.
Building a large network is essential to making your visit impactful.
You have to consider long term health outcomes, local health infrastructures and how to build
it rather than discredit it, and ways to empower all parties involved.
There’s a lot to love about global health.
To start, it’s a very fulfilling and rewarding career.
You get to meet patients from less-fortunate backgrounds and use your training to give
back.
You often get to give these patients a new lease on life.
Usually, their diseases are disabling, and you’ll be able to help them to go back to
a life in which they can work and live without pain—something they could not afford to
do on their own.
Typically, you get to work in an environment without as much bureaucracy or paperwork,
which means you can spend more time practicing pure medicine.
In some situations, you’ll also help build the local infrastructure and medical capabilities
from the ground up.
Working in global health will help you become a better doctor overall.
As a global health doctor, you’re forced to provide the same exceptional care with
fewer resources.
You learn to think on your feet and pick up new skills that will make you more adaptable,
no matter where your career takes you.
You also get to travel and learn about different cultures, countries, and their medical systems.
Through these experiences, you’ll learn what you’re truly capable of, enabling you
to grow both as a physician and a person.
Lastly, you get to meet incredibly diverse people inside and outside of medicine.
You can build strong, long-lasting relationships with people from all over the world.
While global health is an exciting specialty, it’s not for everyone.
To start, it’s an expensive career upfront.
You’ll either be contributing a considerable amount yourself toward seasonal missions,
or you’ll be giving up your potential to earn a US doctor's salary.
While money isn’t everything, cost is an important factor to consider for your future
career, especially if you’re graduating with considerable student loan debt.
It can also be scary to leave your comfort zone.
You’ll have to adapt to new situations you aren’t comfortable with across all aspects
of your work and personal life, including cultural differences, language barriers, and
unfamiliar food, just to name a few.
In countries that lack adequate resources, the living arrangements might not be as comfortable
as you’re used to.
You may also have to tolerate traditions or politics you don’t agree with but must respect
as a visitor.
Professionally, it can be intimidating to practice medicine with equipment you’re
not used to.
You’ll need to rely on your clinical skills due to the country’s restrictions on tests
and imaging modalities.
These are all factors to consider when it comes to diagnosing patients and trying to
determine the best way to follow up with them over time.
Lastly, if you’re not incredibly careful, there’s potential to do more harm than good.
Providing medical care in another country is a delicate balance.
For example, if you don’t follow up with patients, you lose the continuity of care
and can disrupt the healthcare system.
While this is more of a historical issue, these problems can persist without adequate
planning.
When you plan a medical mission, you need to consider the sustainability of your impact
after you leave or until you come back.
Is becoming a global health doctor right for you?
If you’re a born idealist and firmly believe in the importance and value of altruism and
giving back, then global health may be for you.
You must enjoy practicing medicine or surgery in its purest form and be comfortable problem
solving and adapting, as you won’t have all of the resources and tools you’re accustomed
to.
If you love collaborating with different teams and different specialties, there’s a lot
to love about global health.
You’ll work with many different people and serve various different communities, all of
which have something to teach you in return.
You’ll be able to practice a specialty you love while learning about different cultures
and healthcare systems.
If you're passionate about traveling or have always wanted to immerse yourself in other
parts of the world, global health may be the ideal path for you, whether seasonal, embedded,
or a once-in-a-lifetime experience.
Huge shout out to Dr. Kevin Climaco, Army general surgeon, for helping with the creation
of this video.
Check out a day in his epic life on the Kevin Jubbal, M.D.
channel - link in the description.
Are you hoping to become a global health doctor?
To get into medical school and match into the residency of your choice, you’ll need
to crush your class tests and standardized exams.
As you look at resources and companies to work with, seek out those who are actual M.D.
physicians, not Ph.D. or other types of doctors who didn't go to medical school.
Look for those who have achieved stellar results themselves, a track record of success with
positive ratings from customers, and a systematic approach, so you know you'll always receive
high-quality service.
If you decide on Med School Insiders, we'd love to be a part of your journey to becoming
a future physician.
Visit us at MedSchoolInsiders.com.
Thank you all so much for watching!
If you enjoyed this video, check out our So You Want to Be an Internist video or another
specialty in our So You Want to Be playlist.
Much love and I’ll see you all there.