CFHI Accra July 2019

I am a second-year medical student and I went to Accra, Ghana through the CFHI program.

I rotated in the ER department and was able to round with the fifth-year medical students from Accra College of Medicine and Family Health Medical School. On my first day I rounded with the fifth-year medical students and I was terrified and intimidated. The way they presented, answered the doctor’s questions and interrogations on details about their cases, and dissected their differentials was astounding. With only one year of medical school under my belt, I felt useless and unknowledgeable compared to them. However, I tried to stay as engaged as I could, listening to patients’ hearts and lungs, interpreting x-rays and EKGs, and perfecting the craft of the history and physical exam. This coming year we’ll learn more about chronic illnesses and management, so I’ll be able to deepen my clinical knowledge and skills.

I was happy that I was able to recognize a lot of drug names since Pharm is one of my favorite classes and could ask questions about treatment plans and care management. Most of the pediatric cases were acute tonsillitis, acute otitis media, bronchopneumonia, bronchiolitis, and complications of sickle cell disease (SCD). I was able to see an infant that was diagnosed with Trisomy 21 aka Down syndrome and had a heart murmur. I was also able to see a patient that had a palpable thrill and murmur. I sat in on my first Morbidity and Mortality (M&M) meeting and learned a lot about that part of medical care. I also participated in various lectures on proper handwashing skills, stages and treatment of malnutrition, how to properly clean the umbilical cord postpartum, triaging, and common respiratory/cardiovascular diseases in children.

One of the most memorable days was when I clerked with one of the fifth-year medical students. His partner wasn’t coming till the afternoon, so I was there to make sure he asked all of the right questions. We exchanged mnemonics on the history of present illness (we learned OLDCARTS and he learned SOCRATES) and social history. I quickly jotted down all the aspects of the history that should be asked and felt grateful that my school had forced us to create our own SOAP note from scratch countless times. He was grateful that I was able to ensure he asked all of the necessary questions. Our main differential was Vaso-occlusive crisis as a complication of SCD. Our other differentials were osteomyelitis and cellulitis. Both doctors ended up supporting our top differential and it felt good to be able to come up with the correct diagnosis. The child also had otitis media but we weren’t sure if it was secondary to the SCD since they are more prone to infections, or independent of the SCD.

All in all I learned a lot this week, more than I ever thought I would and I’m so excited to rotate in other parts of the hospital. This experience is strengthening my desire to go into Family Medicine even more apparent and necessary.