Med School Myth: Practicing Abroad


Palmer Montalbano

“You are not useful until you have been trained,” states an article in the International Urogynecology Journal, which discusses urogynecology medical volunteerism by doctors. Even fully licensed doctors trained in the United States can do harm when conducting procedures in other countries. Different health problems exist in foreign countries that are difficult to resolve, especially without the extensive and modern United States equipment. Untrained medical students are even more unprepared to conduct procedures in foreign environments.

Every year there are an estimated 10 million volunteers that travel abroad, spending four billion dollars combined to do so. On the surface, a large force of volunteers appears beneficial. But all too often, volunteering is detrimental to the societies and people they aim to help.

Catie, a Vanderbilt junior, travelled abroad to a rural western town of Ecuador with the goal of developing a reproductive health curriculum and distributing other health-related information.

During her trip, Catie interacted with a group of physician-assistant students from the Northeast who were told no clinical work would be done at this site. Catie said that the students, however, wanted to “perform actual medical tasks on people with no way to communicate with [the patients] in a clinical setting.”

“We ended up having to do two separate health fairs,” she recalled. The volunteer students did not know Spanish and could not communicate with the community members, so the students took blood pressure and pricked fingers without explanation to the patient. The results of the tests were then translated to the patient, but without proper medical professionals and pharmaceuticals, local Ecuadorians had no method to reduce high blood pressure or fix blood-sugar levels.

“[The health fairs] were not necessarily the most productive use of our time” says Catie, who wasted multiple days giving these students a clinical experience.

Volunteers abroad are delivering babies, dressing wounds, participating in surgeries, and even conducting amputations. Although the goal is to help others, many volunteers incorrectly provide episiotomies (cutting skin to create room for a baby’s head during delivery) or pull breeching babies, potentially causing the child to suffocate. Even simple medical tasks, such as taking blood pressure, should be left to professionals. Mistakenly reading blood pressure can result in unnecessary surgeries or a misdiagnosis.

Although Catie’s experience was a lot less dangerous than others, she says “it was a little bit frustrating . . . when [the students] came in it felt like they were just trying to do things to benefit themselves. Why are you working for non-profits then?”

This falsely “helpful” volunteerism is not rare. Health professionals in common medical tourist destinations, such as Tanzania, do not discourage volunteerism because of the monetary benefit it provides. The risk of detrimental service is sacrificed for the funding provided by rich volunteers.

In some countries, the critics of foreign aid express concern that non-governmental organizations (NGOs) offer the government an excuse to not invest in their country’s healthcare system, preventing the ability for the nation to sustain its own health without aid. If NGOs continually provide untrained volunteers while states make no effort to improve healthcare, the cycle of malpractice is destined to continue.

“We like to think there are not doctors or intelligent medical professionals in developing countries who know more than we do, but there absolutely are and they are absolutely a better asset to the communities than we would be” Catie says.

A driving factor of volunteerism is resumé-building for medical school students and high school students looking to enhance their acceptance chances.

According to the Association of American Medical Colleges (AAMC), 73% of medical schools either recommend or require applicants to have had a form of experience in practice in which they observe and learn. Over 80% state that not having this experience is detrimental to an application; however, clinical and physician shadowing fulfills this requirement. Half of the schools surveyed by AAMC place no value on international procedure experience or have a negative view of invasive procedures conducted abroad. It is far better, and safer, to engage in a shadowing program within the United States than to risk the health of others on a resumé-builder that may be detrimental to an applicant anyway.