Tour of Student Field Placements- I

Some of my best times in Uganda have been with medical students during their rural field placements. They spend about 6 weeks in remote health centers following a short orientation. Over the years the program has grown and improved. Recently field supervisors drawn from the health centers were recruited and attended a week-long leadership training workshop. I attended for one day and found the facilitators excellent and the group energetic. Although as busy managers and clinicians in rural centers they have little time to spend with the students, they were interested and committed. Involving them as field preceptors seems a great way to strengthen the service in rural centers.

For the past several years, the university has made the field placements multidisciplinary so the medical students have been joined by laboratory science, nursing and most recently pharmacy students.

I started staying for days and even weeks at a time with students at one of the sites where the health workers for our project are also trained as there is accommodation for trainers. When we were doing interactive training in Child Health, we would include the students in some of the sessions. Three of the Level IV health centers used as field sites for students had groups of the community health workers I help to train attached, so I was able to spend some time at each of the three sites. It helped that our child health project had an interest in developing a way for students to learn about and to appreciate the work of community health workers. Some of us also felt that involvement with the student teaching at the health center was a way to improve the quality of service provided in rural health centers.

The Dean, Associate Dean and the Head of Community Medical Education have been actively involved in and committed to improving the field experience and using as a way to influence future practitioners, coming up with the idea of involving field preceptors, providing leadership training and revising the curriculum.

It isn’t always possible to combine my visits to Uganda at the same time as the field placements but when it has proved possible, it is always a highlight. Over the years I have been pulling together a number of interactive training sessions related to community health in Uganda that can be delivered on site. Topics include specific areas students request such as Community Entry as well as topics the Coordinators ask for such as Community Participation and even issues I feel need more of a community and preventive approach such as Motor Vehicle Accidents.

The response from the students has been very positive. One group said they all wanted to do community medicine after the week. I had to assure them that that wasn’t my intent and I would be happy if in whatever field they chose, they took a more preventive and community approach. Some of the success of these interactive sessions is likely due to the contrast it provides to their past exposure to rote learning and to the isolation they often feel in the field. Even a modicum of the mild amalgam of challenge and direction that is provided by participatory training seems to combine to light nascent flames of interest and excitement. But whatever the reason for their enthusiasm, it is a delight to work with them.

To be continued in the next blog.

Photos: the line up at the Rubanda water pump; student groups at Rubanda work on action steps of development; participation ladder with Bukindi students; Muko group in front of the new building.