So here I find myself in a new city, a new country as a ~newly~ minted doctor (though still in my "posgrado"). My past experiences in global health have largely been related to a research project, whether it was tracking down influenza patterns in the Peruvian Amazon or collecting a variety of soil samples or attempting to find not-sketchy medicinal plant users/vendors/experts (again, in the Peruvian Amazon). My first ever experience in global health was literally making cotton balls in a Centro de Salud in college. So finally here I am, in a position to provide some actual medical care except I'm in a large city at Hospital Vozandes, a private hospital, working with local family medicine residents, attendings, and specialists. There's no obvious need for me. In fact, this residency has one of the best reputations in the country. While my personal idea of how I fit into global health is not quite this, I find myself in an interesting position to see how our Ecuadorian family medicine colleagues train and work. Ecuador has been fighting for family medicine physicians to have recognition beyond a "medico general". The residents and faculty at Hospital Vozandes seem especially invested in this. One wonderful example of this was witnessing a POC ultrasound workshop where multiple family doctors came to get hands on practice with OB ultrasounds.
Other than discovering our common fight for recognition of the value of family medicine, I've experienced the typical gringa things: getting lost in the hospital, getting lost walking back to my hostel, trying to figure out transportation and failing, misunderstanding local phrases, and I'm sure about a million other things I haven't even realized yet. Thankfully the majority of the those I've worked with are gracious hosts to the poor, fumbling gringa. We shall see what the rest of the rotation brings as I rotate with the resident-run medicine team, the ED, a handful of willing specialists, and the family medicine clinic.
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