(Left to right) Sarah Mandigo, MD, Jonathan Teubl, MD, Marta Hantke, MD, and Lisa Gilbert, MD
International Family Medicine Fellowship benefits patients across the globe
Jonathan Teubl, MD, began his year of post-residency training in Morgantown, W.Va., completing an eight-week course in Public Health and Tropical Medicine.
He then spent a week in Wichita, before heading to Minneola, Kan. — population 745 — seeing patients with everything from minor infections to broken bones to an acute heart attack.
Come January, he'll be in the scrublands of Saharan Africa, dealing with dysentery and dehydration in children, malaria, labor complications and more.
His unlikely itinerary is part of the Via Christi International Family Medicine Fellowship (IFMF), a program designed to prepare physicians to effectively serve the world's poorest and most underserved people.
As a program fellow, Teubl will gain experience during his seven months of training stateside in areas U.S. family medicine residencies typically don't provide: tropical medicine, primary surgery, orthopedics, anesthesia and dentistry, to name a few. He and three other fellows will spend the other five months serving at Galmi Hospital in Niger, one of the program's four partnering mission hospitals.
"I'll get the opportunity to develop skills in areas that typically would be referred on to specialists," says Teubl, whose depth and breadth of experience in developing nations ultimately will afford him a greater confidence and competence to practice in underserved areas worldwide.
Thirteen physicians have completed the IFMF program started in 2008 in response to Via Christi family medicine residents who saw a need for specialized training for doctors intending to serve overseas on a long-term basis. This year's fellows include Sarah Mandigo, MD, who will be heading to Niger in January along with Teubl, and Lisa Gilbert, MD, and Marta Hantke, MD, who are there now.
Initially funded entirely through contributions to the Via Christi Foundation, for more than a year a large portion of the program's cost has been paid for by "locum tenens" agreements with more than a half dozen rural Kansas hospitals. Under this arrangement, fellows spend approximately 20 percent of their Wichita rotation providing physician coverage at rural hospitals. The reimbursement paid for their services goes to offset program costs, including the modest stipend fellows receive.
"So many critical access hospitals have difficulty finding adequate physician coverage to meet the needs of their communities," says Todd Stephens, MD, who serves as an associate director for Via Christi Family Medicine Residency Program, as well as director of the IFMF program. "Our fellows are helping meet that need." In August, Teubl provided weekend coverage at the Minneola District Hospital, a rural critical access hospital, where two full-time physicians provide the bulk of the health care to the 2,200 Clark County residents living in and around Minneola.
Located 2½ hours west of Wichita on K-54, Minneola is typical of rural Kansas: a tiny town nestled in a landscape of wheat fields punctuated by a single grain elevator and a water tower. One in four residents is over 65, a statistic backed by the number of seniors Teubl saw during his weekend rotation.
He and the other fellows will have an entirely different experience in Niger, where the average life expectancy is just 53 and, according to UNICEF, one in seven children dies by age 5.
There, they'll treat critically ill children with the limited resources and technology at Galmi Hospital, where seven physicians can expect to see 200 to 500 patients a day.
Before her departure, Mandigo is trying to prepare herself for what to expect. "I realize that I may have two or three children dying each day that we have been unable to save with the resources that we have. Ultimately we are placing those children in God's hands."
But as Gilbert says, every effort makes a difference even when you can't save a life. "Most people understand that we don't have to be God, but we do have to respect people and love them."
For Teubl, faith fills in when resources run short. "I think there is a false sense of security that if we were here in the states, we could control everything, which is really not quite true. And there is another false sense that in Niger we can't control anything. And really, we trust God for both."
About the Via Christi International Family Medicine Fellowship The Via Christi International Family Medicine Fellowship is a 1-year post-residency training program designed to prepare and equip family physicians to go where others won't, to care for those without, and to give so much more...