Physician Residency

AHD trains Ecuadorian physicians at its two hospitals to be tomorrow’s rural health care leaders.  Residents are recruited from the Catholic University of Ecuador and learn best medical and administrative practices, specific to the rural context.

Hesburgh Hospital houses the training of a second residency program, one for Ecuador’s Ministry of Health doctors who do not yet have postgraduate (residency) training but are working at public hospitals.  Through this training program, AHD is raising the standards for medical education and services delivery in the country.

Residents learn best practices using 21st century technology in Hesburgh Hospital’s medical simulation lab, which was designed in partnership with Northwestern University.

Physicians working in the public sector are generally hired straight from medical school with little or no hands-on training.  It is AHD’s vision to transform this system of medical training.

Family Medicine Residency Overview

I. Selection criteria

  1. Graduated medical school
  2. Supplementary courses
  3. Research activity
  4. Written Exam (medical knowledge)
  5. Written English exam
  6. Practical exam
  7. Interview

II. Curriculum

Overview:

The mission of the program is to develop healthcare professionals to be leaders in the future of healthcare throughout rural Ecuador.  Rurality is important because most training programs exist in urban centers with a focus on urban populations and their corresponding culture.  Rural populations are distinct economically, anthropologically, politically, and socially.  Approximately half the Ecuadorian population lives in rural areas.

Bringing modern medical services to rural populations requires a focus generally not covered in traditional medical training programs.  The ability to understand a patient within his or her own context increases the likelihood that medical services will be more effective.  If we are willing to believe that effective medical services improve quality of life, we have made progress for these rural populations.

Each Monday the group meets in Quito at the PUCE (Catholic University) to discuss topics mentioned below.  During the third year, residents are required to complete a graduate thesis on a topic germane to Family Medicine.

The three year program consists of alternating 2 month rotations in PVM and Quito.

Rotations:

First Year (12 months)

  • Internal Medicine (4 )
  • Emergency Medicine (2 )
  • Pediatrics (2 )
  • Obstetrics (2)
  • Surgery (2)
  • Family Medicine (1)

Second Year

  • Emergency Medicine (2)
  • Internal Medicine (3)
  • Obstetrics (1)
  • Gynecology (1)
  • Pediatrics (1)
  • Neonatology (1)
  • HIV & TB: (1)
  • Family Medicine (2)
  • ENT, Dermatology, Orthopedics, Ophthalmology during Family Medicine rotation

Third Year

  • Internal Medicine (3)
  • Emergency Medicine (2)
  • Obstetrics/Gynecology (1)
  • Neonatology (1)
  • Family Medicine (3)
  • Electives (2)

 

III. Family Medicine Study Plan

Each Monday residents meet at Catholic Univ. in Quito to learn principles of Family Medicine.

1st Semester: Introduction to Family Medicine

  • Framing the patient, problem hierarchy, problem resolution, rational medicine use
  • Doctor-Patient-Family relationship, communication, non-verbal language, empathy
  • Laboratory and imaging interpretation
  • ACLS, NALS, ALSO
  • Trauma evaluation & treatment
  • Family Life cycle, Ecuador “Family”
  • Family Crisis: recognition and management

2nd Semester: Family in Formation

  • Marriage, contraception, STDs, anticipatory guidance
  • Prenatal Control
  • Families with children less than 1 year
  • Families with children less 1-6 years
  • Pelvic Pain in women
  • Children with worrisome yet benign problems
  • Children with common health problems
  • Children with chronic illness

3rd Semester: Families with Adolescents

  • Culture, ideology and adolescence
  • Adolescent Depression
  • Preventive Health , Women >36 years
  • Preventive Health, Men > 40 years
  • Hypertension/Headache
  • Psychosomatic Patient
  • Peptic Acid Disease
  • The Problem Adolescent

4th Semester: Family and aging and retirement

  • Health issues in Adults > 45, 55, 60, 65, 70, 75, 80, 85 years

5th and 6th Semesters:

  • Family Therapy
  • Sexuality
  • Community work
  • Research Fundamentals for senior thesis (defended prior to graduation)

IV. After graduation…

As AHD finances a significant part of the residency, residents are required to “pay back” one year of work at a healthcare facility determined by AHD/Saludesa.

A “Fellowship” (not in the academic sense) of graduates will be developed in which they will participate in continuing medical education and share experiences in the workplace.  The national social security system of Ecuador is requesting the training of Family Physicians to be the human resource behind a national model placing the Family Physician at the center.

These AHD Fellows receive support from AHD as they work in rural areas where healthcare issues arise requiring research and investigation.

Below are a few of our many residents at Hospital Pedro Vicente Maldonado.  They are all Ecuadorian and have a focused curriculum specific to the Rural Hospital Model.  This is one of the best programs in the country for medical training.  In fact, it’s the only one of its kind!

Dr. Amanda Tene Rueda

“My name is Amanda Elizabeth Tene Rueda. I am 26 years old. I was born in Quito, but my family is originally from Loja. I studied in Universidad Central del Ecuador. I was interested in family medicine when I was working as a rural physician in San Gabriel.  I liked my first rotation in Hospital PVM.  It was very hard and I learned very much about rational medicine, even though I never had enough time to study!!

I think family medicine is very important in order to improve the health conditions in my country, especially in rural areas. Fortunately, I can dedicate more time to my career because I don’t have children or any other huge responsibility. I am single, my family is big — 8 members, I am the second, but I am the only physician.

Mi nombre es Amanda Elizabeth Tene Rueda.  Tengo 26 años.  Naci en Quito, pero mi familia es de  Loja.  Estudié en La Universidad Central del Ecuador. Hice el año de medicatura rural en San Gabriel provincia del Carchi.  Ahí me nació la el interés por la medicina familiar. Me interesó mucho desde el principio la idea de hacer un postgrado en hospital rural. La primera rotación ha cumplido con las espectativas, aunque siempre hace falta mas tiempo para estudiar. Estoy contenta de haber escogido la carrera.

Pienso que la medicina familiar será un pilar importante para el mejoramiento de la salud sobre todo en las comunidades rurales.  Afortunadamente, puedo entregar mucho más tiempo al postgrado porque no tengo hijos, ni otra responsabilidad mayor. Mi familia es un poco grande somos 8 personas, soy la segunda, la única médico de la familia.

Dr. Juan Carlos Perez

“My name is Juan Carlos and I am 30 years old. I was born and have always lived in Quito, Ecuador. I studied in a well-known school, Colegio Media.  I have very fond memories of living in Quito. I graduated from medical school at the Central University of Ecuador and then applied to the Andean Health and Development post-graduate family medicine residency program. I am interested in the different ways of approaching medicine. I like to view medicine in both a biological and a psycho-social light.

Andean Health  & Development has been a great experience! I always hoped to be part of an institution that really has a primary objective: to provide care to the neediest communities and in places where they really need health services.

I am growing every day with this program. I am learning medicine while reaching more needy people in a rural part of my country.

I’m single, I’m the third of four siblings, my parents and my family are very close and have always supported me.  I thank Andean Health for this opportunity to further my career while serving those in need.”

Dr. Mónica Judith Reimundo Carrera

“My name is Mónica Judith Reimundo Carrera, and I was born in the city of Sangolquí, Ecuador, south of the capital city, Quito.  I studied in the Central University of Ecuador in Quito.  With Andean Health & Development, I have learned to live in the community [of Pedro Vicente Maldonado] while strengthening the relationships with my colleagues and the patients in the area. AHD offers quality medical attention to people in an area that is very distant from the city. We take each patient’s physical and mental situation into account.

I was LITERALLY born to work in my field. (I deliver babies!) As a physician, my purpose is to work with patients to prevent disease, cure ailments, and assist in their rehabilitation in order to maintain their good physical and mental health.

To me, medicine is a career that unites everything: strength, honesty, perseverance, and personal and professional growth.

In my family, I am the second of five. We all live with our mother, including my husband, Oswaldo.  We don’t have children yet but we would like to once I finish the Residency Program with Andean Health & Development.”


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Andean Health & Development
UW Department of Family Medicine
1100 Delaplaine Ct.
Madison, WI 53715
Email: info@andeanhealth.org  Phone: (619) 788-6833