What use is a medical student elective in a country like Palestine?

Problem

Planning my medical elective, like many students, I weighed possible benefits to vocational decision-making, and widening medical experience against worries that working in family practice in Palestine might be “health service tourism” and not helpful to those I visited, while personally dangerous.This Poster aims to describe the first elective in Family Practice linked to An Najah National University (ANNU) in Nablus and to reflect on its impact on the ground and on my career intentions at finals, in order to help other students in their elective decisions.

Approach

I was fortunate to connect with the Foundation for International Development of Family Medicine in Palestine (FIDFMP) http://fidfmp.org. Before travelling, we considered safety and devised a doable project. We devised an interview guide to to help in an evaluation of monthly on-line tutorials, developed by FIDFMP to support the Family Medicine residents’ training programme. The tutorials link residents with teachers in UK and beyond in case-based teaching and learning that encompasses consulting skills, clinical knowledge and empathic attitudes. The interviews explored residents attitudes and opinions on the tutorials.On the ground, I spent time with the residents on their university day-release, completed group and individual interviews with residents and faculty, and accompanied residents in their daily clinical practice.

Findings

The interviews demonstrated residents valuing of the “Family Medicine way of thinking” and clinical aptitude that could be concealed by conducting tutorials only in written English. My reflections and recommendations are helping guide tutorial development including Arabic discussions. I was able to see and experience the difference that specialised Family Medicine training is already making. Thus in one clinic the doctor turned to me, after asking the patient for their ideas, and said ‘I would never have known to do that before the tutorials’. Communication skills are not part of the mainstream medical curriculum in Palestine, and the residents were finding their use in clinical practice transformative.

Consequences

I experienced the profound challenges faced by primary care in a country with a complex socio-political context; the importance of, and difference that specialised “generalist” training can make.My project made a difference; to the tutorials and to me- my experience has inspired me to go into academic primary care in the future.This was the first such elective that AnNajah/FIDFMP or MAP have run in Family practice and I hope that future students will follow in my footsteps, both in using their electives and in further involvement with the Foundation.