“With limited resources and large hearts, the physicians in Riobamba treated their patients like family. They reminded me of the importance of the art of medicine and the patient-doctor relationship as an integral part in treating a patient.”

Borneo: Health for People and the Planet
Along the Western coast of Borneo lies Sukadana, a rural village neighboring the largest and most diverse orangutan park in the world. Poor health and poverty in the region push villagers into illegal logging and rainforest destruction to pay for basic needs.

Each year, a select number of residents spend six weeks working at the Alam Sehat Lestari Clinic in Sukadana, which was founded by a former trainee of Barry.

Throughout the academic year, many Department of Medicine residents and faculty spend time working overseas or hosting international collaborators on campus. Facilitated by the Center for Innovation in Global Health (CIGH) under the direction of Michele Barry, MD, global health programs in the department aim to equip the next generation of physicians with clinical skills, cultural sensitivity and contextual perspective to improve the health of underserved communities worldwide.

More than 60 trainees and faculty traveled to sites in 13 countries during the 2016 academic year. They extended Stanford’s global impact and fostered new and old collaborations with partner institutions around the world. The following stories illustrate how each site is unique, with a range of clinical and cultural experiences:

Ecuador: Cultural Immersion through Medicine
Baldeep Singh, MD, clinical professor of medicine, traveled to Riobamba, Ecuador, in 2015 to explore training opportunities for residents at local hospitals and clinics, and a way for Stanford to bring needed clinical knowledge to the region. There, in the Andean highlands, he worked with local physicians to construct a six-week rotation in which residents split their time between providing inpatient care at local hospitals and visiting the Cacha community clinics, which serve a vast area of indigenous groups. Residents also take medical Spanish classes and live with local host families.

“Participating in the CIGH Ecuador rotation was one of my most fulfilling experiences in residency,” said gastroenterology fellow Aarti Rao, MD. “With limited resources and large hearts, the physicians in Riobamba treated their patients like family. They reminded me of the importance of the art of medicine and the patient-doctor relationship as an integral part in treating a patient.”

Borneo: Health for People and the Planet
Along the Western coast of Borneo lies Sukadana, a rural village neighboring the largest and most diverse orangutan park in the world. Poor health and poverty in the region push villagers into illegal logging and rainforest destruction to pay for basic needs.

Each year, a select number of residents spend six weeks working at the Alam Sehat Lestari Clinic in Sukadana, which was founded by a former trainee of Barry. The clinic provides health care to local residents in exchange for their commitment to conservation. Jessie Kittle, MD, clinical instructor of medicine, visited the clinic as a resident in March 2016.

At first, Kittle felt uncomfortable being without her usual tools and interventions, fearful that her “digital-doctoring skills” had replaced her human ones. As the days passed, she gained confidence.

“I felt deep satisfaction in facing a patient, both of us barefoot, using hands, eyes and ears to peel through layers of medical and human knowledge to craft a diagnosis and treatment plan that worked for the patient,” said Kittle. “This was health care not just of people but of the earth, and has provided me with endless inspiration for working toward a better planet as a physician.”

Zimbabwe: Deep Rooted and Ever Growing
Collaborations between Stanford and the University of Zimbabwe College of Health Sciences date back more than two decades. More recently, the NIH Medical Education Program Initiative aimed to strengthen medical capacity at Zimbabwe. That initiative has given Stanford residents the opportunity to spend clinical rotations at Zimbabwe helping fill gaps in the medical curriculum.

“Our partnerships in Zimbabwe draw on Stanford’s interdisciplinary strengths and resources. We’re not just approaching medical education from a clinical perspective, but tackling the interrelated challenges of providing internet access, libraries and e-learning resources. Real impact does not happen overnight, but is made possible through long-standing relationships and bilateral collaboration,” said Barry.

The clinic provides health care to local residents in exchange for their commitment to conservation. Jessie Kittle, MD, clinical instructor of medicine, visited the clinic as a resident in March 2016.

At first, Kittle felt uncomfortable being without her usual tools and interventions, fearful that her “digital-doctoring skills” had replaced her human ones. As the days passed, she gained confidence.

“I felt deep satisfaction in facing a patient, both of us barefoot, using hands, eyes and ears to peel through layers of medical and human knowledge to craft a diagnosis and treatment plan that worked for the patient,” said Kittle. “This was health care not just of people but of the earth, and has provided me with endless inspiration for working toward a better planet as a physician.”

Zimbabwe: Deep Rooted and Ever Growing
Collaborations between Stanford and the University of Zimbabwe College of Health Sciences date back more than two decades. More recently, the NIH Medical Education Program Initiative aimed to strengthen medical capacity at Zimbabwe. That initiative has given Stanford residents the opportunity to spend clinical rotations at Zimbabwe helping fill gaps in the medical curriculum.

“Our partnerships in Zimbabwe draw on Stanford’s interdisciplinary strengths and resources. We’re not just approaching medical education from a clinical perspective, but tackling the interrelated challenges of providing internet access, libraries and e-learning resources. Real impact does not happen overnight, but is made possible through long-standing relationships and bilateral collaboration,” said Barry.

Last summer, Akatsu took a sabbatical to develop curricula for a new medical school in Japan — the country’s first in roughly 35 years. “We submitted an innovative curriculum to the Ministry of Education.”

The new medical school, International University of Health and Welfare, aims to be a hub for Asian medical students and will train attendees to serve the global community, Akatsu said. “When the government allowed a new medical school to be established, the condition was that this new medical school will be ‘very different’ from any existing medical schools in Japan. This school will invite students from other Asian countries — like Vietnam or Mongolia — and classes will be taught mostly in English, which is unheard of in Japan.”

In August, Akatsu once again traveled the 5,000 miles across the Pacific Ocean to accept a new role as dean for medical education at International University of Health and Welfare School of Medicine.

During her medical school days at Brown University and residency at Stanford, Haruko Akatsu, MD, who was born, raised and educated in Japan, got to thinking about the differences between medical education in the two countries. “I was surprised to encounter so many different ways of educating the next generation,” Akatsu, a clinical associate professor of endocrinology, gerontology and metabolism, recalled thinking. “That was eye-opening for me.” 

She began to share and record her experiences in a Japanese medical journal and was soon approached by a publisher. Her collection of essays, entitled Medical Education in the United States: A Medical Student Journal, was released in 1995. To Akatsu’s surprise, the book was well received. Invitations, and another book deal, soon followed: “I started to be invited to so many different grand rounds and conferences in Japan to give talks. I think people were interested in knowing more about medical education in the United States, which was not very well known to the Japanese medical community at that time.”

Akatsu noted that while typical Japanese medical school curricula were more textbook- and lecture-based, American schools offered more opportunity for system-based and clinical application. She explained: “Generally, education in Japan is more dogmatic, and information is passed top-down from teachers to students. But in America, we encourage different viewpoints and opinions, and we encourage discussion. I think it’s great to see how we can learn from both of these perspectives.”

Though she trained and worked in the United States for the past 25 years, Akatsu’s strong ties to Japan are evident and have shaped the trajectory of her career. She’s sat on committees, organized education exchanges, and hosted training and faculty development workshops, including a Stanford faculty development workshop at Hiroshima University, where, she explained, “I would bring three colleagues from Stanford out to Japan to share their knowledge.”

Last summer, Akatsu took a sabbatical to develop curricula for a new medical school in Japan — the country’s first in roughly 35 years. “We submitted an innovative curriculum to the Ministry of Education.”

The new medical school, International University of Health and Welfare, aims to be a hub for Asian medical students and will train attendees to serve the global community, Akatsu said. “When the government allowed a new medical school to be established, the condition was that this new medical school will be ‘very different’ from any existing medical schools in Japan. This school will invite students from other Asian countries — like Vietnam or Mongolia — and classes will be taught mostly in English, which is unheard of in Japan.”

In August, Akatsu once again traveled the 5,000 miles across the Pacific Ocean to accept a new role as dean for medical education at International University of Health and Welfare School of Medicine. It’s a natural fit for her, and she will oversee all aspects of education — from curriculum, to teaching, to student affairs. “There’s so much to learn,” she said of the opportunity. “It’s like a start-up in my mind; very exciting, but very challenging.”

Though she’s leaving the Stanford campus, Akatsu says she would like to bring the university’s innovative spirit along with her. “I’m truly grateful for the time I’ve had here. I’ll be bringing along the Stanford attitude and spirit, including entrepreneurship and innovation. That forward-thinking spirit — where you’re not afraid of failure and look for lessons in challenges — that’s what I will miss, and what I’ll carry with me.”

It’s a natural fit for her, and she will oversee all aspects of education — from curriculum, to teaching, to student affairs. “There’s so much to learn,” she said of the opportunity. “It’s like a start-up in my mind; very exciting, but very challenging.”

Though she’s leaving the Stanford campus, Akatsu says she would like to bring the university’s innovative spirit along with her. “I’m truly grateful for the time I’ve had here. I’ll be bringing along the Stanford attitude and spirit, including entrepreneurship and innovation. That forward-thinking spirit — where you’re not afraid of failure and look for lessons in challenges — that’s what I will miss, and what I’ll carry with me.”