Osteopathic Medicine and Global Health
Posted by chads on February 16, 2008
I was asked the following questions by a student recently:
1. Is there a limitation to what I can do in international medicine with an Osteopathic degree? That depends on what you want to do. If you are interested in clinical medicine, then there may be a problem in some countries. If I remember correctly, for example, in England, osteopaths do not have the same practice scope as they do in the United States. It seems to me that most developing countries don’t have a specific policy regarding osteopathic practitioners, and it would depend more on the organization that you are working with than anything else. If you are interested in public health, on the other hand, there shouldn’t be a problem. Having said all of that, my own personal bias is that there is not much of a role for clinicians volunteering or working short-term in developing countries, and that they can usually do much more good in other capacities (public health, advocacy, public awareness, health systems development, etc.).
2. In your experience, is it realistic for me to plan to spend most of my time abroad (outside of the US) practicing medicine? Again, it depends what you want to do. It probably isn’t realistic if you have a family or live a typical American life style. 1-2 years might be more realistic.
3. What would you recommend as the best route to getting involved with quality organizations abroad (residency selection, specialty choice, etc.)? It seems to me that the best way to answer all of these questions is to try to imagine where you picture yourself in 5 years? 10 years? 30 years? Do you want to become proficient at practicing medicine in developing countries? Do you want to help people who need a doctor? Do you want to see different cultures and exotic places? Do you want to make an impact on the global health situation? Different answers to these questions will, in my opinion, likely take you down VERY different paths. (Realistically, I realize that most have motives that are a combination of these!) In any case, if you are interested in a long-term academic career tropical medicine, I’d recommend a fellowship in infectious diseases. On the other hand, if you’re interested in fulfilling a personal need or desire to help people, I’d follow your heart (or your Spiritual or moral compass).
Finally, if you are interested in making a significant dent in the global health situation, I’m not sure I can help you much, but I’ll try. I would recommend a long-term, consistent, evidence-based approach (along with following your Spiritual or moral compass!) I would also specialize in something OUTSIDE of clinical medicine (epidemiology? community advocacy and change? health systems? journalism? economics? anthropology? behavior change?). Then I’d recommend meeting and collaborating with people in that same field that have much more experience than you. I think you’ll find that much (even most!) of the effective work you’ll do will be INSIDE the United States through communication, research, evaluation, awareness campaigns, fund raising, teaching/mentoring, etc. I am also convinced that the third path (making a significant dent in the global health situation) would be the most challenging (and worthwhile), and the one I definitely recommend…
4. Have you had any experience of repaying med school loans through serving in underserved/rural areas? I don’t have any personal experience, but I know that there are programs out there. Maybe someone else can chime in?