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February 21, 2019

Finding Global Health through Clinical Medicine

By Nomazwe Ncube

After looking down at my watch which showed four minutes past the hour, I hurriedly scampered through the streets of Georgetown towards the Berkley Center. My final clinic patient, whom I had just left, had arrived late and presented an issue which required more than the standard 20 minutes allotted per appointment. I had patiently listened to her concerns, conducted a physical, and presented an assessment and plan to the attending physician. As soon as the appointment ended, I excused myself and stuffed my white coat and stethoscope into my backpack, which I later shoved under my chair, the last available seat in a room filled with students waiting to hear a Conversations in Global Health lecture. As I settled myself, I heard our speaker introduced: Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the U.S. National Institutes of Health. As my heart rate relaxed, I wondered, “How in the world do I get from here to there?”

Many medical students are interested in the field of global health. The 2018 Association of American Medical Colleges Medical School Graduation Questionnaire found that 25.9 percent of medical graduates participated in global health experiences. A number of medical schools have rolled out initiatives to upscale education and elective opportunities in global health for students, many of which are student-run. Georgetown's Global Health Initiative (GHI) serves as one such example. As a university-wide platform, GHI encourages interdisciplinary engagement, allowing for student participation from all schools, including the medical campus.

Still, the road to engagement in global health from medical school is not clearly defined. In his talk, Dr. Fauci explained how he found himself working in global health through a series of opportunities after medical school. He said, “I was not completely clear in what I wanted to do… a lot of what happens to you involves things that are completely out of your control. You just have to be alert and make use of the circumstances you are put into.” He went on to explain how the spur of the AIDS epidemic initiated his work in global health. While the path to other specialties in medicine is usually clear cut from medical school through fellowship, the same is not quite true in global health. Opportunities exist, but Dr. Fauci made it clear that there are elements of chance and creativity underlying this vocation.

Despite the challenges, Dr. Fauci explains that being a clinician and treating people sick with the diseases he studies through his work in public health has allowed him a unique view point. “You have a different perspective,” he said. While I sat in the crowd of students hearing this, I thought back to my patient who I had just left and how meeting with people like her would one day inform my work advocating for people who are ill around the world. “You’re in medical school,” he continued, “You’re going to be a physician, and you want to go into global health; you’re going to have a lot of opportunities to do that and do it from the standpoint of a physician.”

Nomazwe Ncube (M’20) is a third-year medical student and student fellow with the Global Health Initiative.