During my time abroad, I along with a cohort of other medical students, participated in a clinical outreach project under the supervision of several physicians from the Michigan State University College of Osteopathic Medicine (MSUCOM). Our group traveled to the Dominican Republic to provide healthcare for underserved populations working in the sugarcane industry and living in bateyes. MSUCOM worked in collaboration with faculty members and medical students from the Universidad Central Del Este (UCE) both to deliver these outreach services for patients and to provide medical students with culturally enriching clinical experiences.

Prior to traveling to the bateyes, MSUCOM students completed a series of didactic sessions where we learned about the culture of the Dominican Republic, its healthcare system, and the country’s complex historical relationship with Haiti. We learned how many Haitian people immigrated to the Dominican Republic in the past to work in the sugarcane fields and how their descendants continue to bolster this critical facet of the Dominican economy, while living in extreme poverty and receiving little to no medical attention.

Following these didactic sessions, we traveled to the bateyes to see patients. Over the course of three days, we provided care for nearly 400 individuals. We worked in sweltering temperatures within schoolhouses and community centers that were nothing like the medical facilities we were used to in the United States. I got to independently work through all aspects of a patient encounter including medical triage, taking a patient history, conducting a physical examination, establishing a differential diagnosis, ordering and completing laboratory tests, creating a treatment plan, and conducting patient education. I gained exposure to a variety of pathologies including hypertension, diabetes, urinary tract infections, gastroesophageal reflux disease, stroke, valvular heart disease, bacterial and parasitic infections, and visual deficits. I also had the chance to work with medical interpreters for the first time as the patients we saw spoke mainly Spanish and French Creole. The care and attention to detail these interpreters took in helping MSUCOM faculty and medical student bridge the language barrier to our patients was incredibly inspiring.

Coming into this study abroad opportunity I was extremely apprehensive as I had little experience working directly with patients as a student physician. However, the mentorship and support I received from MSUCOM faculty empowered me to push beyond my comfort zone and participate fully in this program. Following each appointment, the look of pure relief and gratitude on the face of every patient I saw was unforgettable. We couldn’t resolve every issue we faced, but the fact that we were there and that we cared meant the world to them. This program was an experience that I will truly cherish for the rest of my life. It has single handedly altered the trajectory of my future career plans while also allowing me to form lasting relationships with faculty and peers. Words cannot express how grateful I am to have had the opportunity to participate in this study abroad program at Michigan State University.  

Name: Bruin Armwald
Status: Medical Student
Major: Osteopathic Medicine
Hometown: Madison, Wisconsin
Program: Global Health: Dominican Republic - Clinical Immersion