Supporting Medical Education in Haiti

Berkowitz FDB 2012-2 (2)
Dr. Aaron Berkowitz joins Haitian physicians on rounds to assess a patient at Saint Boniface Hospital.

On Jan. 13, 2010, just one day after a devastating earthquake struck the island nation of Haiti, a group of BWH physicians huddled in the Department of Medicine’s Eppinger Conference Room to ask: What can we do to help?

One of them, Michelle Morse, MD, MPH, went to Haiti during her residency in Global Health Equity at BWH. After the earthquake, she met Zadok Sacks, MD, a resident at BWH and Boston Children’s Hospital.

“There was just an incredible energy among people here about doing something and making a contribution together,” said Sacks, who now runs the young adult consult service at Children’s.

Together, Sacks and Morse founded an organization called Physicians for Haiti, which supports the work being done around medical education in Haiti.

“Haiti is full of amazing health care professionals, and they deliver care without access to any of the resources that we have here-the network of colleagues, technology and equipment,” Sacks said.

Physicians for Haiti connects health professionals in Haiti with professional development opportunities, resources and information to enhance the care they are providing, as well as the necessary training to become medical educators.

Michelle leading interactive small group
Dr. Michelle Morse leads an interactive educational session for Haitian clinicians.

Reactions in Haiti to the organization’s work have been overwhelmingly positive. “Medical students especially are interested in working with us because they want to learn innovative approaches to medicine,” said Morse, who now serves as the Partners In Health deputy medical director for Haiti. “There is a lot of energy around ‘building back better’ after the earthquake, and we hope our work can get that spark going to create a movement supporting medical education.”

Although Morse and Sacks run the group in their spare time as a volunteer effort, they’ve accomplished quite a bit to date. The visiting professor program has been particularly successful in partnering experts from the U.S. with Haitian colleagues around particular topics they are interested in. So far, 35 visiting professors have gone through the program, and 500 clinicians in Haiti have participated in the related classes.

Aaron Berkowitz, MD, PhD, a chief Neurology resident at BWH, just returned from his second trip to Haiti as a visiting professor. “There is just one practicing neurologist in Haiti for a population of 10 million people,” he said. “This means that most medical students, residents and physicians have never interacted with a neurologist during their training. Yet the burden of neurological disease is enormous.”

The gap in access to a neurologist puts neurology experts and information in high demand for the visiting professor program. As a visiting professor, Berkowitz holds conferences on core neurology topics for physicians and residents in two hospitals and conducts bedside teaching about patients with neurological issues. “Even more important than the lectures is seeing patients together with my Haitian colleagues, as so much of neurologic diagnosis and treatment comes from examining the patient and interpreting the examination,” he said.

Because technology and other resources are limited in these settings, Berkowitz finds himself learning from the way his Haitian colleagues practice. “Haitian physicians have extraordinary bedside clinical skills because they routinely have to make very difficult decisions with much less lab or radiology data (not to mention treatment options) than we would have here,” he said. “In the U.S., we can order all of these tests for our patients, but in Haiti, physicians have to figure out how to do the best for patients with the limited diagnostic and treatment resources available. It’s very humbling and very educational.”

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Dr. Zadok Sacks, right, with participants in Physicians for Health’s Teach the Teacher program.

In addition to the visiting professor program, Physicians for Haiti also holds several conferences for physicians and nurses in Haiti throughout the year and a social medicine course each summer for Haitian and foreign medical students.

In addition, their newest program, called “Teach the Teacher,” is being piloted at Mirebalais University Hospital. It consists of interactive training sessions that focus on skills integral to being an excellent educator.

“Haiti is now prioritizing the expansion of medical training programs to close the gap of needed health care professionals, but there is a shortage of medical educators who have experience running these types of programs” said Sacks. “There’s a lot of desire among our Haitian colleagues for training programs that can help clinician-educators become better teachers, and this new program is working to address that need.”

Physicians for Haiti, a nonprofit organization that depends on donations to fund its work, hopes to one day establish a medical education fellowship. “We have this dream where the fellow would receive training and intensive education on being an educator and come to BWH for part of it to learn from our own medical educators,” Morse said.

Sacks and Morse are extremely grateful for the encouragement of their colleagues and mentors at BWH, who have supported them in establishing the organization and ensuring its success to date.

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Read a Boston Globe article from Jan. 12, 2014 that highlights Physicians for Haiti.