Since 1989, Moi and AMPATH'S Consortium of universities have
enjoyed a powerful, growing bilateral academic medical exchange
program. IU School of Medicine/Riley Children's Hospital
began hosting pediatric registrars from Moi University in a formal
exchange program in 2007 and has hosted twenty young clinicians to
date. After completing one's medical school training,
internship, and often several years of general medical practice,
one may pursue this master's level or "registrar " training in a
given subspecialty, such as pediatrics.
The bilateral exchange between Moi and
the Consortium institutions allows Kenyan students and registrars
to experience a different clinical environment with some resources
and technology that are not available in Kenya, as well as
collaborate with North American medical students, residents, and
staff, many of which visit Moi University. In turn, North
American learners also visit Eldoret and benefit from the medical
education system at Moi University/Moi Teaching & Referral
Hospital. The ongoing partnerships between these schools
makes this reciprocal exchange possible and mark one of the
highlights of trainees' medical education in both
Drs. Justus Simba, Felicitas Okwako, and Evans Ronoh are current
third year paediatric registrars, who pursued rotations at Riley
Children's Hospital in Indianapolis, between August and December
2013. During a recent debriefing session with the
newly-returned registrars, we asked them about their experiences in
Tell us about your pediatric experience at
Okwako: I had a very good experience in IU/Riley for
four months during which I did specialized pediatric rotations. The
experience was awesome and enlightening. It gave me an opportunity
to learn and interact with specialist pediatric attending and learn
a lot from them.
Ronoh: My arrival in Indy was one great experience in
my life. It was my first time in the US and the experience at Riley
was phenomenal. I got integrated into the system immediately (when)
I got there and life started moving really fast.... It was tough
getting used to the American accent initially…but soon later things
started looking up and I became comfortable with the
Simba: I had a fruitful experience in the US where I
was able to appreciate many conditions we read of. It
provided also an opportunity to see all the management options
being attempted in various conditions.
What were the highlights of your rotation experience
(both medical & social)?
O: Interacting with the IU residents over the Thanksgiving
holiday was my best social encounter. I enjoyed the turkey, mashed
potatoes and pumpkin pie.
R:I enjoyed the level of technology at Riley. In cardiology
I was able to go to the interventional lab, otherwise known as the
cath lab, where I was able to see textbook knowledge in practice
S:The high moments for me (were) when an attending would say
"where Justus comes from…" this made me feel part of the
team. Going to Chicago, thanks to the Mathews, made me
appreciate how a big city can be and why some buildings are called
What were the greatest challenges of your
R: It was difficult waking up so early in the morning to get
to work at 7 unlike the norm in Kenya where work begins at 9.
Initially communication was a problem considering that the American
accent is different. It was also challenging meeting new
people every two weeks some of whom had a lot of difficulties
understanding our mission at Riley.
Which were your favorite rotations?
O: My best rotation was NICU in Methodist hospital and
Hemo-Onc in Riley. The rest of the rotations were good and
R: My favorite rotations were the PICU, GI and
Oncology. the people I met in these services both the attending and
the students were very good to me.
S: I had a great opportunity in 7/8 rotations and thus
I just highlight some not because the rest were unfavourable.
Cardiology, Neonatology and Pulmonology were my favourite for
various reasons. The outpatient clinic in cardiology provided a
real learning opportunity as I would clerk patients and present to
attending with my plan and then we go on to see the patient.
This is similar to NICU where there was also great learning
opportunity including teaching sessions. I am inclined Pulmonology
which I did my elective to make up my mind on my future
sub-specialization and the Doctors there were great.
Did you have one most influential/inspiring
O: I was inspired by the commitment of Prof James
Lemons to improving newborn care in Eldoret and Kenya as a whole.
It made my interest in neonatology stronger.
R: Yes I did. I found one Dr. Gupta of GI service very
caring and concerned about my wellbeing while in his service. The
others were Dr. Howbson of PICU who showed much concern and
interest in where I was coming from and helped me through the
rotation; he was always patient with me. I also can't forget to
mention Dr. Joyce Hubbard one motherly figure. She was a source of
encouragement to me while I went through
S: I will just single out one Consultant, but honestly
each rotation has some one I could truly say they were good. Dr.
Joyce Hubbard is a great teacher she was truly patient in
explaining even complex things in cardiac
What were the greatest differences between IU/Riley
O: The IU/Riley residency program differs from the
Moi/MTRH program in terms of doing research projects but both are
based on learning by clinical apprenticeship. The American
food is different from Kenyan food and had difficulty coping with
cheese containing foods.
R: The technological deference was big. IU is
able to carry out advanced investigations and many times faster
than how we do it in Kenya. I also noticed great sense of
commitment to patient care both from the staff and the
S: While in MTRH we see patients and try to figure out
what they have, the inpatient teams in Riley had prior knowledge of
what the patient was having and thus try to fit in the patient
there. On the other hand, 'attendings' spent a lot of time
explaining to patients and their parents their conditions. I
found this very good, it made them part of the decisions.
This is one of the things I desire to keep doing, always tell the
patient and their parent/guardian what my thoughts are, as it
How will this experience impact your future as a
R: My attitude and commitment to patient care will
never be the same also my relationship with my patients will be
Is the exchange program between Moi & N. American
schools in pediatrics a valuable program to continue?
O: This program should go on because it give us a
opportunity to experience advance pediatric management that we only
read about in books like transplant, ECMO and many others. I
hope in future, fellowship programs can be established through this
relationship and utilizing IU faculty to train missing specialties
like endocrinologist, gastroenterologist to boost pediatric care in
Eldoret and Kenya. Thank you.
R: It is very valuable because it exposes the Kenyan
students to different environment with different medical conditions
and different ways of doing things different from how we do it in
Kenya and it should continue and all post graduate students should
get this experience.
S: The exchange program is a worthwhile venture. In my
opinion, it should continue as it will enrich the training of
future paediatricians in Kenya as it has done to us. I
acknowledge all those who have made this possible.
Top photo: Dr. Evans Ronoh with one
of his Riley teams; Bottom photo: Drs. Jordan Huskins, Justus
Simba, Meghan McHenry, Felicitas Makokha, Avika Dixit, and Evans
Ronoh reunite in Eldoret.