Moi Registrars in Indianapolis

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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 continents. 

            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 Indianapolis:

 

Tell us about your pediatric experience at IU/Riley.

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 patients.



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 real-time.



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 skyscrapers.

 

What were the greatest challenges of your rotation?

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 educative too.



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 staff/attending?  Why?

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 electrophysiology.



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 electrophysiology.

 

What were the greatest differences between IU/Riley & MTRH?

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 students.



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 concerns them.

 

How will this experience impact your future as a pediatrician?

R:  My attitude and commitment to patient care will never be the same also my relationship with my patients will be much better.

 

Is the exchange program between Moi & N. American schools in pediatrics a valuable program to continue?  Why/Why not?

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.



Riley Moi Residents

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.

Posted by Jordan Huskins at 05:04

Transitions

June and July mark a time of transition for the AMPATH Consortium and IU House.  Many individuals are moving on to pursue further education or other career opportunities.  We recently remarked that we have had a "send-off" party or two every weekend for the past month.  This is indeed a difficult time of parting with friends but also exciting as we send them off into new adventures and opportunities.

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One profound loss for the AMPATH community is the transition of the Stone family to Boston as Geren pursues the position of Global Health Residency Director at Mass General Hospital.  Jessica Gardner, Abi Huskins, and several other individuals helped plan a special "send-off" party for the Stones, complete with meat kabobs, Boston-themed cupcakes and an "Ice Cream Parlor", as well as an audience response "Stone Family Trivia Game", prepared by Sonak and the Stones' friends.  We wish the Stones all the best as they transition to Boston.  We will miss you all sorely in our community!

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As we part with several colleagues, we also welcome new partners into Eldoret.  There are many new faces on the ground that will be pursuing research, programmatic, clinical, and educational activities.  We are excited to get to know these new individuals.  Karibuni Kenya!  

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Posted at 02:51

Merit Awards Ceremony

On May 27, Moi University College of Health Sciences reinstituted the student Merit Awards Ceremony after a brief hiatus.  Historically, the Merit Awards represented an opportunity for Moi University's School of Medicine to honor its top students in each class and specialty on the basis of distinguished academic performance.  This year, Principal Fabian Esamai of Moi's College of Health Sciences led not only the reinitiation of this special ceremony but also extended the program to include dental, nursing, and public health schools. 

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The lively ceremony began with special music by a Seventh Day Adventist Church choir in Eldoret and two numbers by a medical student leader and "Master of Ceremonies" for the evening, inspiring medical school Dean Paul Ayuo and Prin. Esamai, (as well as the whole head table, including Geren) to "wave their hands in the air" to the music.

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The program continued with speeches by each department and presentation of awards to "top" students in each discipline, as well as overall "best" student.  Assistant Dean of Students and head of this year's Merit Awards Committee, Dean Amayamu, made a significant mark on the evening by presenting a first-time award to a student who had modeled exemplary service to the school and her peers. 

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The Merit Awards was successful overall and was especially powerful as Moi University's leadership honored its own learners in this exceptional way.  Prin. Esamai announced his intent to make this ceremony an annual event.  We continue to savor our time teaching Moi learners and appreciate the opportunity to reinforce the partnership between North American Consortium schools and Moi University through educational involvement in both institutions.

 

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Posted by Jordan Huskins at 05:11

Building Kenya's foundation for tomorrow (Part 2)

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Nearly 2 months removed from my last post, much has changed here in Kenya. National elections took place on Monday March 4 and by all respects were peaceful and organized. The day was characterized by millions of Kenyans waiting often in long queues for hours to cast their ballots and to help determine Kenya's future. My personal favorite images were some of the images of women waiting in queues with babies on their backs.

Following the Election Day, we were closely following the news as ballots were counted and preliminary results started to appear. The process hit some snags along the way as some of the technology failed to capture, calculate, and transmit results as had been hoped. With an initial goal of reporting a preliminary winner within 1-2 days, the process slowly moved forward over the course of the week.

In the end, Uhuru Kenyatta, the son of Kenya's 1st president Jomo Kenyatta, was declared the outright winner of the election with just enough votes to escape a runoff election. Opposition leaders claimed the election process had been flawed and took their claims to the Kenyan Supreme Court. The Supreme Court heard all sides of the case and deliberated.  On March 30, the justices ruled that the elections had been free and fair. Thereby, they upheld the election of Uhuru Kenyatta as Kenya's 4th president. Opposition leaders respected the decision and called for peace throughout the country. Days later, on April 9, 2013, Kenyatta was inaugurated and took office while opposition leaders vowed 'to continue struggle peacefully'  for the benefit of all Kenyans.

Through it all, Kenyans have much to be proud. The foundations were solidified for a democracy where the voice of the people can be heard and respected. Moreover, these foundations were set over the bedrock of the rule of law where all heard and respected the ruling of the Supreme Court.

As we continue to watch AMPATH's new Chronic Diseases Building quickly take shape and imagine all the patients that will benefit from these building blocks, we celebrate the future of Kenya on these foundations of democracy and the rule of law. Pongezi Kenya.

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Posted by Geren Stone at 15:34

Connections and Reunions

In January and February of 2009, I visited the IU-Kenya Partnership as a fourth year medical student.  After my two-month elective, I hoped to return to Eldoret to continue participating in the program in some capacity.  I was therefore thrilled to have the opportunity to return as Pediatric Team Liaison for the program this past July 2012.  

 

Remaining connected to the IU-Kenya Partnership after initial participation is hardly unique to me.  Many visiting medical students return as residents and residents as fellows and staff.  Drs. Marisa Holubar and Laura Ruhl, both who were rotating as residents in Eldoret during the period I was visiting as a student in 2009, returned to become Pediatric Team Liaisons for the program in subsequent years.  Many other physicians, nurses, pharmacists, researchers, teachers, engineers, agriculturalists, and other professionals return to Eldoret for follow-up or even regular visits to Eldoret after initial contact with the program.  It is safe to say that Eldoret and the AMPATH community mark people for a lifetime and often foster long-term relationships.

 

One of the best parts of my position is getting to meet a myriad of different people as they visit the IU-Kenya Partnership throughout the year, witnessing that natural connection that is made when individuals interact with the program.  Most of my time is spent with medical students and residents who visit Eldoret on global health electives.  Though I have only been in Eldoret for eight months, we have hosted twelve students and fifteen residents thus far this academic year.  It is a pleasure to get to interface with these individuals not only when they are in Eldoret but also afterward as they begin their careers.  In March, during a visit back to the States, I had the opportunity to connect with nine of the pediatric and combined medicine-pediatric residents who have rotated at Moi University this year.  My wife, Abi, and I enjoyed reminiscing, sharing stories, and getting updated on each of their lives over coffee.  Below is a photo from our time together with some of these residents in Indianapolis.

 

It is our hope that (like many before them) some of these residents will remain involved in global health and even return to the IU-Kenya Partnership as faculty, continuing the relationship with the program that started as a result of their international elective in Eldoret. 

 

Residents Reunion

Posted by Jordan Huskins at 08:55

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