Every year, the UNC School of Medicine’s Office of International Activities (OIA), along with the Institute for Global Health and Infectious Diseases (IGHID) fund and send first year UNC Medical Students and Resident Physicians to participate in UNC Project Malawi, a HIV/STD research, care and capacity building project in Lilongwe, Malawi. This June, OIA Program Manager, Shay Slifko, was able to make her first journey to the popular elective site and got a first-hand look at what these global health electives entail.

As Program Manager of the Office of International Activities, Slifko’s role involves organizing and preparing quality global health learning opportunities for UNC Medical Students and Residents throughout their programs. Since 2009 the OIA has partnered with IGHID to fund and send students to Malawi through an approved course (MEDI 527), through which rising second year medical students are integrated into an ongoing research project for 8 weeks over the summer. On occasion, students may have the opportunity to do some observing in Kamuzu Central Hospital with faculty, but the main focus of the elective is research.

“I think above everything,” Slifko said, “this was kind of a learning exhibition for the OIA- for me to better understand the context of how complex the UNC Project Malawi is on-site and what we can do to better prepare our learners, both students and residents, to function well.”

During her time on-site, Slifko was able to meet with and shadow two of the three UNC Medical Students currently working on research projects through the elective. The first of these was Eric Cui, a first year medical student who is working closely with UNC’s Elizabeth Fitzgerald, MD., Emily Ciccone, MD., and Alyssa Tilley MD., to organize a digital database for the Pediatrics team. MS1 Allie Bukowski is assisting with breast cancer report analysis alongside Tamiwe Tomoka, MBBS, the first female pathologist in Malawi; and the final student, Lisa Wanda, is working on a study at Bwaila District Hospital, outside of the UNC Project Malawi’s main campus.

Beyond observing the UNC students and residents on site, Slifko was able to immerse herself in the daily activities of Kamuzu Central Hospital by observing rounds and morning conferences in Pediatrics, witnessing the use of the new radiology technology drawing UNC radiology resident physicians to the site, and touring the general campus grounds and labs with the Country Director, Innocent Mofolo.

“I was really impressed with the entire UNC Project,” said Slifko. “They’re also currently constructing a pretty substantial research oncology center that’s being constructed right now and it’s going to be pretty impressive, so that blew me away. I was just so impressed when the County Director introduced me to all the various research initiatives and projects that are being developed by Malawi faculty and researchers, alongside the visiting undergraduates from UNC, visiting graduate students from UNC School of Public Health, and our own medical students- so there’s a LOT underway at any given time.”

Not only will this experience help in advising students and residents for their own Malawi experiences, but Slifko plans to use feedback she received on her trip to improve resident experiences both on-site and back at UNC. After meeting with Cecilia Kanayama, MD, an internal medicine physician and infectious disease researcher with UNC Project-Malawi, the OIA has invited Kanayama and her team to record an online lecture for the Foundations in Global Health course to allow UNC students access to her knowledge from anywhere in the world. Slifko is also using feedback from Kanayama and her team to advocate longer stays for visiting resident physicians, who at this time are only in Malawi for two-week periods.

“I think the faculty see the absolute value in their education and in their teaching when they (UNC resident physicians) are there, but would love to have them stay a little longer,” Slifko said of the idea. “It can only benefit them and the team, and the patients while they’re there.”

Aside from this slight change in program, Slifko maintains that the key purpose of this voyage was to better work alongside what faculty and staff at UNC Project Malawi have already built, rather than try to deliver a laundry list of changes or advice.

“I think an important piece in global health is just being present and showing up and taking interest,” Slifko says. “So, I was interested to learn with the administrators, the faculty, the researchers and staff are doing, their everyday work. I know that hosting students for a short term can often times be considered to be burdensome, so I want to make sure that we’re preparing students to hit the ground running and be integrated into a team where they can work alongside and learn from the Malawi team members.”