Throughout medical school, I have held my grandfather, a government physician in India, as a major role model. Thus, having the opportunity to travel to Aurangabad, India, for my last medical school rotation not only meant a lot to me, but also excited me because I had the chance to learn from and practice with physicians within a different health care system with limited resources.

By following the doctors at my hospital site, I was able to experience all aspects of the Indian health system from privately owned inpatient ICUs and outpatient clinics to publicly funded government hospitals. Patients with better socioeconomic standings would often decide to go to their local private hospital for care, where care was fast-tracked and beds were more expensive. In this setting, I saw the continuity of care from the ward to the outpatient clinic and had an opportunity to see how physicians abroad dealt with health disparities and engaged patients to take an active role in their care, especially because all tests and medicine were out-of-pocket expenses. One of my attendings held free COPD and asthma educational sessions and used skits, demonstrations and visuals to teach patients about these conditions and the importance of their medications. Additionally, I was exposed to a new set of stigmas and ideas that surround the culture of medicine. Patients and physicians handled issues such as death, mental health, gender issues and the role of alternative medicine differently from what I had seen on my clinical rotations back home. Understandably some of these discussions were different due to cultural and societal norms, however being a part of these conversations, it helped me learn more ways to address these difficult patient topics.

On the other hand, within the public hospitals, there was a constant influx of patients and limited resources. Doctors had to rely on their history-taking and physical exam skills in order to triage patients and establish a working diagnosis. Working with my supervising doctors in the casualty section of the hospital, I had an opportunity to get involved and help out as much as I can. Initially, I was overwhelmed with the volume and acuity of the patients as well as the efficiency of the doctors. On my first day, I remember there being two cases of strokes, two heart attack patients, one snake bite and one pesticide poisoning case all within one hour. Initially, I had chosen to observe, but the physicians encouraged me to get involved with procedures such as placing IVs and NG tubes as well as showing me interesting physical exam findings. By my third day, I was getting more comfortable in interacting with patients who came from very different backgrounds, occupations and religions, and felt a part of the team.

Overall, I am extremely grateful and thankful for having had this experience and hope to engage in another global health initiative or rotation in the future.

 
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