Sherlyn Kirui, a fifth-year medical student at Moi University in Eldoret, Kenya, recently finished a six-week clinical and educational rotation at Kaiser Permanente Bernard J. Tyson School of Medicine (KPSOM). She closed out her stay with a presentation on how working with advanced U.S. medical technology, preventive care models, and a collaborative culture of patient care at KPSOM and Kaiser Permanente medical centers had shaped her training.
Kirui gave her presentation on September 23 to faculty, staff, and KPSOM students. She walked the audience through her clinical rotations, compared the Kenyan and U.S. health systems, and shared what each one can learn from the other. Her time at KPSOM was part of the school's Global Health program, which collaborates with the AMPATH consortium to send KPSOM students on rotations abroad and bring medical students from partner institutions to Los Angeles.
"When we come to this program, it's not a matter of what the exchange students can only take from [KPSOM], but what we learn from each other," Kirui told the audience. "My major goal was to soak as much as possible in, and to just learn from this other different clinical setting and to interact with students to [understand] how medical school is here."
Before she arrived, Kirui said, "My expectations of the U.S. health system were majorly shaped by watching U.S. medical shows and hearing stories from other students who came here before us." She said she "expected to learn in a technologically advanced setting to see patients have access to very advanced diagnostic and therapeutic procedures and a very subspecialized and specialized healthcare system."
This summer marked the third year that KPSOM has hosted students from Moi University School of Medicine, said Jeffrey Brettler, MD, Faculty Director of Global Health. KPSOM does this rotation differently from many other host institutions, which usually keep a visiting student on one service for all six weeks, said Brettler.
"Our philosophical approach has been to do more of a portfolio of programs within Kaiser Permanente, so they get exposure to inpatient, outpatient, highly specialized tertiary care referral programs with a lot of emphasis on technology and cost, all the way to primary care, where they can learn about Kaiser Permanente's health system and our approach to population management," he said. "They may only rotate through a particular service for a day or two, but they come away with a much broader understanding of how care delivery is established here."
Much of Kirui's time was spent in cardiology. There she got hands-on practice with point-of-care ultrasound, which she said is not readily available in Kenya, and watched cardiac catheterizations. She noted that Moi Teaching and Referral Hospital, where she trains, opened its own cardiac catheterization laboratory only a year ago. "And seeing that patients can be able to access this type of procedure for life-saving interventions is really good," she said.
In neonatology, she saw a baby born at 22 weeks being cared for. "And in Kenya we say that 26 weeks or 28 weeks is the age of viability," she said. "And seeing a 22-week-old preemie being supported was a game changer."
She also rotated through anesthesia and surgery, where robotic surgery was a highlight, and through interventional radiology, which she has not yet studied at home. "I got to see diagnostic biopsies being done, minimally invasive procedures that are lifesaving, like angiograms," she said.
