In Panama Exchange, Medical Students Learn Through a Global Health Lens

Jessica Simon and Jacqueline Mosher met during their first year at Tufts University School of Medicine, but they developed a strong bond through shared experiences as roommates and providers in Panama City, Panama this spring during the Tufts Fourth-Year Global Health Elective in Panama.

The elective was created to provide an exchange for six students from the School of Medicine and six students from the Universidad de Panamá Facultad de Medicina (UP). It places students at hospitals affiliated with the respective universities in Boston and Panama City, where students engage in four-week rotations in a variety of specialties. Tufts students travel to Panama City in the spring, and Panamanian students travel to Boston in the fall each year.

Simon, who chose an internal medicine rotation at the Irma De Lourdes Hospital in Panama City, said experiences there forced her to think more critically about what doctors in nations like the United States really need to effectively and safely treat patients.

“In the U.S., we use and waste a lot of things,” reflected Simon, who matched into a psychiatry residency at Harbor-UCLA Medical Center in Torrance, California. “The one thing that really stuck with me was the resourcefulness of the medical team within the hospital in Panama.” 

Simon noted that gloves, for instance, weren’t worn for every procedure, and in most cases, blood was drawn with a syringe and later injected into a tube, rather than a vacutainer, which allows for automatic collection of a blood sample.  

Mosher was placed into a rotation in obstetrics and gynecology at the same hospital. There, she spent most of her time in labor and delivery or operating rooms for cesarean sections and learned to adapt to new standard treatment protocols. 

“One thing I found really surprising was how labor is managed,” said Mosher, a current obstetrics and gynecology resident at Mountain Area Health Education Center in Asheville, North Carolina. “There is essentially a laboring room that has about 12 beds in it for all of the patients who are in labor but not ready to give birth, and there’s an expulsion room that patients will go to when it’s time to actually deliver.”

Another major difference Mosher observed was the absence of pain management options for Panamanian patients in the public hospital setting. She learned that resources for pain management and patient-centered care are more abundant in private hospitals. 

This awareness forced Mosher to reflect on the ways that health inequities manifest in different countries, and on the similarities and differences that exist between the Panamanian and U.S. healthcare systems.