Reflections from a Visiting Hospital PVM Resident

I found the elective in PVM a fantastic cultural and educational experience.  From the moment I arrived in PVM, I felt welcomed by the community and the hospital and right at ease in the working and living arrangements.  The faculty, residents and staff were all warm and inviting; everyone was helpful and with answering my many questions.  The patients were friendly and easy going and the medical cases were varied and intellectually challenging.

Initially, it is always disorienting to be in a new environment and unfamiliar medical system, but the small hospital, helpful staff and open atmosphere made it easy to adapt.  Educationally, it was a good contrast to what I normally see in the US.  The pathology was often more acute and severe, but the cases tended to be less complicated with polypharmacy and multiple medical comorbidities. It was a different sort of challenge than I am used to, and it taught me to think through the cases differently.

Instead of relying on a battery of easily accessible tests and an entire pharmacy of different medications, we were forced to think carefully through what we needed, what we actually had and how we could make do to best serve the patient.  It was in many ways a more refined and intellectual approach to medicine in that the cases required critical thinking and decision making instead of following a cookbook algorithm approach to medicine.  I came back feeling more confident with my own ability to work in new environments and approach problems from different angles.

Living with the Ecuadorian residents was probably the highlight of my trip. It was an excellent way to make fast friends and learn the inner workings of the Ecuadorian medical education system.  The residents were wonderfully kind people and included me in everything.  We had a great time making meals together, staying up late to study over cups of coffee, sharing gossip and venting about the usual frustrations of work and life.  It was hard to part ways when my time came to leave but we still keep in touch by email.

-Rienera Sivesind

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Andean Health & Development
UW Department of Family Medicine
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Madison, WI 53715
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