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Advisers urge students to avoid performing procedures abroad

By Ariana Assaf, Daily Staff Reporter
Published November 19, 2012

Pre-health students seeking to impress medical schools by performing elaborate procedures abroad might want to think twice before putting their foreign experiences on their applications.

In recent years, University academic counselors and medical school application offices have noticed a significant rise in students who claim to have performed procedures they are not properly trained for. According to counselors, some pre-health students struggling to find shadow opportunities in the United States have started working with disreputable organizations located primarily in Central America, taking advantage of the lack of supervision and looser medical protocols.

Mariella Mecozzi, the senior assistant director of pre-professional services at the University’s Career Center, said the pre-health students she primarily advises often want to boast about their procedural experience in applications.

She noted that medical and dental schools don’t prioritize these qualifications, and engaging in foreign procedures “reflects poorly on the applicant’s judgement.”

According to Mecozzi, while certain medical volunteer groups were more prone to encouraging students to make unethical decisions in exchange for experience, many have “gotten their act together.” She noted that increased attention has been paid to the problem, and said it seems to be improving under more severe supervision.

“We were absolutely aware of an issue, but compared to where we were three or four years ago, there is definitely a greater level of awareness,” Mecozzi said.

The University of Michigan Pre-health Advisors Forum released a list of recommendations last year, in response to an increase in student desire for hands-on medical experience, particularly abroad. The guidelines point out that “without adequate training, licensure, and/or attention to appropriate legal parameters, these ‘hands on’ clinical experiences can pose a variety of risks,” including endangering a patient and sabotaging the chances of being accepted into one’s medical school of choice.

The American Association of Dental Schools, the American Association of Medical Colleges and other colleges also developed similar recommendations in 2011. The AAMC acknowledged that health code regulations in other countries are often less strict than in the United States, creating a disconnect for students studying abroad.

David Brawn, an adviser in the Newnan LSA Academic Advising Center, said while it is under advising regulations not to publicly share the experiences of other students, counselors seek to ensure that students are aware of sources for concern as they seek experiences abroad.

MEDLIFE, an organization working to provide health care and education to developing areas in Peru, Panama and Ecuador, allows students to take vitals and observe licensed doctors. The program’s CEO, Nick Ellis, said the group was created to provide better health care than other medical mission models that allow students to perform procedures they aren’t qualified to conduct.

“In this new model, students participate to learn about poverty, how to combat the root causes of disease and partner with individuals in poor communities to increase their access to (medicine, education and development),” Ellis said.

LSA junior Melanie Askari went on a mobile brigade with MEDLIFE, and said she is unaware of anyone who violated medical ethics codes while abroad with the program. Program protocol dictates that patients must provide consent for students to sit in on appointments and appointments only.

The University’s chapter of ATRAVES US Inc., an international nonprofit focused on providing health care aid to underprivileged areas, has continued to work to advance access to health care in countries like Nicaragua. In 2007, the organization helped build a primary school and clinic in Managua., the country’s capital.

Brady Dunklee, the executive director of ATRAVES US Inc., agreed that students working abroad can find themselves treating a patient without proper training, but added that such an incident would vary by country and organization. Dunklee said his program has never been involved in a case of an unlicensed student treating a patient.

He noted that, in the clinic, undergraduate volunteers, “are strictly limited to helping with logistics and administration.”

Though students are occasionally interested in participating in advanced procedures, program staff and volunteers are on-site to enforce limitations, Dunklee added.

LSA sophomore Hayley Martin, the vice president of public health for the University’s Honduras Health Brigade, also described how volunteer students served mainly as shadows to licensed doctors while participating in the program.

“They don’t just drop us off and leave us to set up shop. We are accompanied by at least eight staff members everywhere we go,” Martin said.

Students are responsible for establishing a triage system to record the weight, temperature and blood pressure of new patients, as well as to make a list of these patients’ symptoms. According to Martin, those that assist dentists are only permitted to handle the dentist’s tools and to observe, and to occasionally provide fluoride treatment.

LSA sophomore Adam Eickmeyer, fellow member of the Honduras Health Brigade, said the most important policy to remember is that if it’s not something a student should be doing in the U.S., they shouldn’t be participating in it while abroad.

“Just because the patients don’t have the same access to quality health care doesn’t mean we can exploit them,” Eickmeyer said.


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