Guest blogger Cameron Nicholson-Gardner shares immersive clinical experience in South Africa

Ohio University offers many global opportunities for students, including medical students, who would like to earn credit while also learning more about the world. Cameron Nicholson-Gardner, a second-year student on the Dublin campus who serves as Vice President of the Student National Medical Association, is participating in the South Africa program, which provides students with an immersive, hands-on experience in clinical and hospital settings. In this blog post, he gives us a closer look at his first week in South Africa.

The first week of practicing medicine in Cape Town, South Africa has already broadened my understanding of cultural competency. During my first week of three here, I observed and worked with medical students from the UK and Germany under the residence of chief surgeons in the Cardiothoracic Ward at Groote Schuur Hospital. The difference that I first noticed in this ward, is that most of the patients deal with chronic conditions caused by health disparities that limit their access to preventative medicine. Not having the proper health resources sooner rather than later impacts their morbidity, which often can lead to higher mortality rates. However, the doctors and residents do not let these conditions determine how they treat their patients, and they work to provide patients with proper treatment.

This week I watched the chief surgeons and residents on grand rounds in the Intensive Care Unit and worked with the UK and Germany residents during rounds in the Cardiothoracic Ward. During my rounds with the residents, they were empathetic and listened to their patient's concerns. They are great teachers who've allowed me to practice my medical clinical techniques on the patient, such as heart and lung sounds and pulse pressures. They even let me order chest X-rays for patients using their medical system. I appreciated how open they were with teaching by doing and not just remaining lectured-based. I learn best by observation and kinetics, so their teaching style was beneficial in combining my pre-clinical knowledge with hands-on practice with patients.

Another highlight this week was the opportunity to observe my first surgery. The surgery involved a coronary artery bypass graft and heart valve replacement. It was amazing to see how the chief surgeon, residents, scrub nurses and the anesthesiology team work together in the "Theatre," called the Operating Room at Groote Schuur Hospital. Everyone had a role and no part felt out of place. It was amazing to see true collaboration and cooperation between physicians who all had the common goal of having a successful surgery for this patient. It showed what a health care team is.

A bonus part of this week was having the opportunity to hang out in the Anesthesia and Perioperative Services Department. I never had that much interest in anesthesia before, but it plays a more significant role than I imagined. It is more technical than maintaining the patient's health while they are under operation. They genuinely care for the patient during and after surgery, which many do not consider. They were true craftsmen in their approach to not harming the patients. Overall, my experience in South Africa doing medicine has been great. I've been so receptive to all the cultural and medical knowledge this place offers and look forward to what it brings!

August 1, 2024

During my last two weeks in Cape Town, I worked at St. Joseph Intermediate Paediatric Care Center and Maitland Community Health Clinic. Both locations are equally my favorite places to learn and grow as a medical student. They pushed me to grow in my procedural skills as a clinician, as I helped assist with procedures during patient visits. The locations also made me think more humanistically as I cared for sick patients who ranged in age from infants to the elderly. These well-rounded experiences made me work on my cultural competency skills and allowed me to understand and respect the cultural practices and beliefs of my patients, which is crucial in providing effective health care. This prepared me to advocate for future patients of different cultures, religions or identities. 

St. Joseph Intermediate Paediatric Care provides solace for children with chronic illnesses and diseases. I worked with the nurses in the Daisy Ward at St. Joseph, who treat infants aged six months to 2 years. The children there are provided with treatment and medication for their conditions until they are well enough to return to their families. While caring for the children, the facility provides a respite for their caregivers or family members. Despite their challenges, the children I worked with exuded energy and curiosity for the world around them. Seeing young patients being so optimistic about life despite their difficulties was admirable.

While working in the Daisy Ward, I assisted the nurses with feeding, changing and washing the infants. This made me connect with them personally, hopefully making their day more enjoyable. Because I want to pursue pediatrics, I felt right at home practicing my bedside manners and ensuring I gave them all my undivided care and attention. I also sat in on case discussions involving the ward's children.

Seeing the interpersonal health care disciplinary team that included dieticians, social workers, occupational therapists, pediatricians and nurses was striking as each person was dedicated to each child's betterment. Those meetings emulated the classic saying, "It takes a village to raise a child," proving that there are people who have the empathy and compassion to care for sick children.

In the last week, I had the opportunity to work at Maitland Community Health Clinic in Cape Town. The clinic sees many acute and chronic patients who cannot afford to go to public hospitals. At Maitland Clinic, I had a lot of firsts, from performing diagnostic tests such as X-rays and blood tests to doing procedures like wound dressings and suturing and handling paperwork.  This facility is run mainly by professional nurses, with physicians visiting to help and assist patients.

This place pushed me out of my comfort zone and forced me to continue believing in my capability as a student doctor. Much of my teaching came from guided practice, which favored my learning style. Learning all these techniques, I was able to be more helpful and felt more valuable to them than just observing. Being forced to learn helped break some of the doubt and worry I've had in myself. It showed me that I can handle patients and correctly provide them with treatment.

These last two weeks have been a profound learning experience, emphasizing what global medicine can provide for a medical student; and how much it can broaden one's knowledge of cultural competency and health care. The time I spent at St. Joseph Intermediate Paediatric Care Center and Maitland Community Health Clinic has not only honed my skills but also influenced my career path.

The compassion and dedication I witnessed in the health care disciplinary team, the resilience of the young patients and the importance of cultural competency in health care have all left a lasting impression on me.

I appreciate this experience and will use it to sharpen my skills as I continue my journey in medicine. OU-HCOM provides a great opportunity, and I genuinely encourage all medical students to look into these global health summer programs, as they will be life-changing events!