There is great diversity in systems for healthcare delivery globally due to differences in disease prevalence, resource availability and approaches to medical education. It is therefore important that today's medicine faculty and trainees, who will become the medical academics and medial policy advocates of tomorrow, have experiences that expose them to diverse models of academic medical practice. Colorado-Zimbabwe International Exchange (CoZIE) was launched in 2015 as a bilateral exchange program between the Department of Medicine in the University of Colorado School of Medicine (DOM UCSOM) and the Department of Internal Medicine in the University of Zimbabwe College of Health Sciences (UZCHS). CoZIE is based on the long history of strong and productive collaborations in education and research between faculty at UZCHS and UCSOM and is designed to provide diverse experiences in internal medicine practice for faculty and postgraduate trainees, and to introduce post-graduate trainees at both institutions to modern methods of clinical teaching and clinical research.
DOM/UCSOM faculty spend 2 weeks at UZCHS as a Visiting Professor and during that time participate in bedside clinical teaching, didactic teaching, and career mentorship of UZCHS trainees. UZCHS faculty are invited to the CU Anschutz campus as DOM Visiting Professors to give DOM grand rounds, morning report, plan collaborations, and teach residents, fellows and faculty. Postgraduate trainees are expected to develop their own individualized training plan, with the oversight of their mentors, to fit their personal career goals. UZCHS MMeds spend two to three consecutive weeks at CU Anschutz where they observe patient care at UCH or other SOM-affiliated hospitals and participate in teaching of medical students.
DOM/UCSOM Internal Medicine and Medicine-Pediatrics residents can rotate through UZCHS for a one-month elective which is fully funded. Residents spend four consecutive weeks at UZCHS during which time they participate in direct patient care at the Parirenyatwa Hospital, bedside teaching of students, outpatient continuity clinics, and clinical research. Interns and residents will work on inpatient teams with UZCHS faculty, residents, and medical students. This clinical rotation is designed to provide meaningful exposure to healthcare provision in resource-poor and diverse academic settings and to model modern methods of clinical teaching.
The focal point for CoZIE activities is the Parirenyatwa Hospital, the major teaching hospital of UZCHS, located on the UZCHS campus adjacent to the medical school. This rotation provides UCSOM visitors with global health experience in a large hospital in an academic setting in southern Africa. There are opportunities to learn about the diagnosis and care of diseases that are uncommon in the United States including tuberculosis, malaria, rheumatic heart disease and Kaposi’ sarcoma, to see uncommon presentations of common diseases such as diabetes and hypertension, and to experience academic medical practice in resource-constrained setting. Moreover, there are opportunities to mentor and teach Zimbabwean students and young doctors. CoZIE participants interact with variety of learners on the hospital wards including medical students (third-years through final years), house officers (interns) and MMeds (residents) and registrars (post-residents). Teaching/educational opportunities include Post-take (post-call) Rounds and bedside teaching on ward rounds. There are also weekly specialty clinics and lectures/conferences most days including Progress in Medicine talks, Endocrine Clinic, Endoscopy Lab, Neurology Clinic, Skin Clinic, Cardiology Clinic, Kaposi Sarcoma Clinic and Opportunistic Infections Clinic.
“Patient care with limited resources was impressive as it required a completely different approach to medicine than what I am accustomed to in the United States.”
“We have much to learn from each other given our unique circumstances though we share a commitment to education, scholarship and clinical care.”
“I was reminded of how much can be accomplished in a setting with scarce resources based on the skills and acumen of the physicians.”
“I was impressed by the clinical skills of the residents and doctors who were working with limited resources. Their clinical knowledge was very extensive and they were very thorough and confident in their physical exam skills.”
“I was forced to take a different perspective in approaching diagnoses and treatments due to the limitations that I saw. It forced me to think deeper about my patients with less information.”
“I was exposed to many fascinating patient cases that presented as advanced pathology. Many HIV-related illness, congenital cardiac conditions and how other chronic diseases including hypertension and diabetes affect populations across the globe. I learned an immense amount about triage and prioritization of care and management of patients from house-staff and faculty.”
“Even in a relatively resource-limited setting, the quality of care that can be rendered is quite robust for many conditions. This is a testament to the diligence of the clinical staff and trainees.”
“I really gained a renewed enthusiasm for bedside teaching…I think renewed emphasis on this aspect of medicine would be helpful in the United States.”
“I was really impressed by the quality of bedside teaching by the faculty and MMeds at Parirenyatwa Hospital. The medical team at UZCHS does not have an over-reliance on costly diagnostics, and I believe has excellent physical exam diagnostic skills.”
“The experience reintroduced me to the importance of physical exam, the diagnostic approach to problems in the setting of limited resources, and the ability of medical teams to accomplish so much in this setting.”
Applications for CoZIE are solicited annually at each institution and are reviewed by the Selection Committee which will include faculty from both institutions. Please contact Suzanne Brandenburg (firstname.lastname@example.org) or Tom Campbell (email@example.com) for more information.