Better Late than Never: the January 2016 Rotation for UTMB Physician Assistant Students

IT’S ALREADY TWO MONTHS since the end of the last Physicians Assistant Student Rotation in Guatemala that CCD facilitated in January.  But now, as the next clinical rotation comes ever nearer, I can no longer with clear conscience prioritize my paying day job, ongoing home remodeling chores, other writing projects, or a host of other tasks and obligations, not to mention leisurely Sunday afternoons fulfilling self-indulgent plans to laze about.   So … I will forget for a moment that I’m still not able to get this blog to function the way I want it to, and will ignore what I feel to be technical inadequacies and take a few minutes to provide a very rough outline sketch of the last rotation.

The group, including the UTMB PA students, along with myself, Dr. Patricia Crane, and almost all of the Guatemalan support staff in Chichicastenango, at a farewell party the last night of our stay in the pueblo, January 19, 2016

And what happened was this: three University of Texas Medical Branch PA students came to Guatemala to study and work with us on what amounted to a pilot project run.  To explain, my associates and I have facilitated many medical missions and working tour group activities of various sorts.  But this was the first time we had taking on the task of providing professional mentoring for practitioners, and in a couple of important ways it was more difficult than our previous mission experiences.

It was, for example, the first time we’ve handled a group of students working for course credit, which necessitated the continuous presence of faculty preceptors to advise and approve the diagnostic and treatment protocols for all members of the group.   Probably more important, however, at least in terms of logistics, the complexity was due to the duration of the rotation.  Most medical missions, to explain, are four or five days long.  But this one ran to three and one-half weeks, meaning arrangements for lodging, food, and travel were more extensive.  The complexity of arrangements was made more complex by the fact that clinics were staged in four locations in different communities, requiring pre-arrangements and ongoing coordination with four different teams of local providers, administrators, and support staff.

And finally, the difficulty of coordination was aggravated on this occasion (as it will be in the next rotation) by the remarkable fact that the Guatemalan government is in even deeper disarray and absurdly poor than it usually has been over the last 26 years that I’ve been working there.  The disarray and poverty no doubt has negative impact on all medical missions in indirect ways.  But because we at CCD believe it is very important to work hand-in-glove with the Guatemalan Ministry of Health, it clearly affects us more – particularly in terms of making it more imperative than ever that we purchase the medicines our own practitioners prescribe.

The bottom line, in any event, is that on the downside, arrangements and coordination of the rotation were a greater chore than usual.  But on the upside – and this is a biggie – the charitable aspects of the mission were more critical and in many ways more rewarding than ever.