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Course Number: FMME 404

Course Title: Global Health in Family Medicine- Shoulder to Shoulder, Honduras. Community Health

Who can Participate?: 4th year medical students

Requirements: Completion of application phase. By Permission Only. Permission for enrollment must be obtained from Lisa Keiber, Director of 4th Year Programming, UNC SOM Asheville. Email: or 828-255-5856.

Course Director: Benjamin Gilmer. Contact Lisa Keiber/ / 828-255-5856

Course Credit: 6 credit hours

Time of Year & duration: Late July or early August

Course description:

Learning Objectives: Within the context of a third world country, students will be to: 1. Delve more deeply into the basic science of clinical problems than what was encountered in the third year clerkships. 2. Re-emphasize basic science from preclinical years. 3. Provide a foundation for evidence-based practice of clinical medicine. 4. Present an oral presentation according to course guidelines. During the first two weeks of the rotation, students will travel to rural Honduras to work in clinics and on community health projects and attends seminars with Shoulder to Shoulder staff. Upon return students will complete their personal project and present to supervising faculty. Grading will be H/HP/P/F. Possible Learning Issues 1. Epidemiology: Practical statistics in public health, disease surveillance, measuring health status, DALYS, morbidity and mortality 2. The World Health Organization, the World Bank and NGOs: What do they do? What don’t they do? What kind of information can one obtain from these organizations? 3. Communicable Diseases and the Burden of Disease in Developing Countries: What is the impact of the major communicable diseases in the world? How is it different in poor versus rich countries? What interventions have been shown to reduce the burden of disease? 4. The Growing Burden of Chronic Disease: Most countries in transition are facing the challenge of continuing to fight communicable diseases but they must also confront the emerging aging population with chronic diseases such as diabetes, heart disease and cancer. (The so called “double burden of disease”) What is the extent of the problem and how will it be addressed? 5. War, Poverty and Displaced Populations: There are millions of internally and externally displaced people in the world who bear a disproportionate burden of disease. What are the problems and potential solutions? 6. Health Care Systems: How do countries deliver health care services and which systems get the most for what they spend? 7. Mental Health: What is the burden of disease of mental health disorders and what are the essential components needed for improving delivery of mental health services? 8. Essentials of Clinical Care in the Tropics: Case based approach to common clinical conditions such as malaria, intestinal parasites, respiratory diseases, etc. Includes an introduction of available clinical resources in tropical medicine. 9. Disorders of nutrition: Introduction to the clinical and public health problems associated with calorie malnutrition and deficiency of specific vitamins and nutrients. 10. Cross-cultural medicine: Working in different cultures requires a unique set of skills such as language acquisition, using translators, understanding of traditional beliefs and remedies and developing cultural humility. 11. Women and children’s issues: Women of childbearing age and children are at the greatest risk for poverty and increased disability and premature mortality. These risks and evidence based effective interventions at the individual and community level will be discussed.

Learning Activities: History/Patient Interview,Physical exam,Literature review,Interpretation of lab results,Observe procedures,Perform procedures with supervision,Research

Evaluation: Interview patients/Take history,Physical exam,Observed administering procedures,Develop differential diagnosis,Develop treatment plan,Presentation/Patient presentation,Patient write-ups,Interpretation of labs/test results