Exchange program brings Ugandan and Chinese med students to Yale

Adam Sang, a fifth-year medical student, placed empty water bottles and soda cans in the shape of a diamond on a picnic table. “These are the bases, and you have to run here—home,” said Sang, who was about to begin his fourth year at Yale, as he explained baseball to Sam Kizito, a visiting medical student from Uganda. Kizito was shocked at how little time the players spend running.

“It’s a sport with a lot of sitting around,” said Sang.

Sitting around is not something Kizito had done in the previous few weeks. On a Tuesday evening in July, he and other foreign exchange students gathered with current Yale medical students and faculty at Lighthouse Point Park in New Haven to picnic and catch up after an Independence Day trip to Washington, D.C. Though the exchange includes a full four-week clinical rotation, the students’ free time is heavily occupied by a shadow rotation in American culture. The trip to the nation’s capital, a weekend blitz through New York City, and nights out in New Haven ensured that the foreign students feel welcomed by and immersed in the United States.

“When students come here and feel welcomed, they then act as cultural interpreters for our students who travel abroad to their institutions,” said Robert Rohrbaugh, M.D., professor of psychiatry and director of the office of international medical student education at the School of Medicine.

In 2011, about 30 percent of Yale medical students traveled abroad for clinical electives in Uganda, China, Indonesia, Thailand, South Africa, and Latin America. About 80 international students come to Yale for clinical electives each year, and most pay tuition. However the medical school provides funding for students who come from sites that accept Yale students, such as Makarere University in Uganda and Xiangya University in China’s Hunan Province.

This summer, eight students selected by their home institutions (four each from Makerere and Xiangya) came to New Haven to experience medicine in the United States—and overseas travel—for the first time. They were the third group of students to take part in the exchange, a program Rohrbaugh calls an “eye-opening experience” for all parties involved. “Foreign students provide cultural interpretation for our students who travel to their countries. And at Yale they learn about medicine in America, which often means more empathy and less paternalistic models of care.”

Michael Ma, a fifth-year medical student, learned the day of the picnic that he’d be going to Uganda for a rotation early next year (2012). Harriet Nabukwasi, a fourth-year medical student at Makerere, gave him packing and travel advice; and she asked him in turn about the dearth of grocery stores near Harkness Dormitory, where Nabukwasi is staying while she completes her internal medicine rotation.

Nabukwasi said she was enjoying her experience, which has made her think about the different roles of doctors in Ugandan and American societies. “Here the patients are very informed, much more so than in Uganda,” said Nabukwasi. “But they don’t look up to the doctor. They’re not afraid to say, ‘I don’t want this,’ or ‘I won’t take that drug.’ ”

Hui Li, a fifth-year medical student from Xiangya Univeristy, was at Yale for an orthopaedic surgery rotation. He’s been impressed by how much more time doctors in America spend with their patients.

“At a clinic in China, each patient gets maybe five minutes,” said Li. He and Nabukwasi both said the principles of medicine are the same at Yale as in their home institutions, but the culture of the clinic is radically different. The use of computers and smartphones by physicians while a case is presented would be uncommon in Uganda or China.

Majid Sadigh, M.D., formerly an associate professor of medicine who is still involved in the program, said that bringing Ugandan students to New Haven is an outgrowth of a broader exchange program that started in 2006 with Yale residents going to Kampala. Sadigh travels to Kampala several times a year and has been instrumental in establishing the Yale-Makerere connection. Though he supports the exchange, he’s also aware of the program’s risks. “We don’t want to create a brain-drain situation,” said Sadigh. “But students [who come to Yale] do end up being instruments of change at their home hospitals.”