Linda Kamuzangaza and Tafadzwa Chipfuva, physicians from Zimbabwe, made the most of their first-ever trip to the United States and the CU Anschutz Medical Campus.
Through a new program launched by the School of Medicine’s (SOM) Department of Medicine, they observed in clinics and went on rounds at the University of Colorado Hospital (UCH) and Denver Health, sat in on academic lectures and even squeezed in trips to Coors Field and Red Rocks.
“We have the same medical knowledge, but our practice might not be the same because we don’t have the resources you have here,” Kamuzangaza said. The MMeds (equivalent of medical residents) discovered that not everything they saw during two weeks in Colorado – including the computerized patient records system that allows physicians to see real-time, centralized data on each patient – is possible to perform in Zimbabwe. “We’re in a resource-limited place,” Kamuzangaza said. “Some of things we’ve seen here we won’t be able to do back home.”
‘We’d like to come back’
Both of the MMeds are interested in pursuing a specialization in endocrinology, and during their visit they worked closely with endocrinologists from CU (see list at end of story). Overall, Kamuzangaza said, “we learned a lot coming here, and we’d like to come back.”
The feeling is mutual among the CU Anschutz residents and faculty who recently went on hospital rounds and visited clinics in Harare, capital city of the East African country. The Department of Medicine has enjoyed longstanding ties to the University of Zimbabwe College of Health Sciences (UZCHS), and this new program – the Colorado-Zimbabwe International Exchange (CoZIE) – further strengthens the collaboration.
CoZIE launched its first exchange during the past academic year, sending five faculty members and three internal medicine residents from CU Anschutz, while receiving one faculty member and two residents from Zimbabwe. The pool of potential CoZIE participants for this academic year already exceeds the number of available slots, and a Department of Medicine team is evaluating applications.
Thomas Campbell, MD, a CU professor specializing in infectious diseases, has been traveling to Zimbabwe for almost 20 years. He views CoZIE as an important step toward even more robust exchanges of healthcare information between the institutions.
“It’s great to see others getting involved and enthusiastic about it,” he said. “Zimbabwean trainees are getting help with not just HIV treatment, but medical treatments on a much broader scale. Also, it’s gratifying to see that my colleagues in Zimbabwe, who have become friends over the years, are able to continue their education programs, and better their education, with our help.”
CU faculty and residents get exposed to a different spectrum of disease and different presentations of diseases in Zimbabwe, and they see how physicians cope in a resource-limited environment, Campbell said. “In doing that, we think they will become better doctors themselves. It’s a win-win for both institutions.”
In Harare, the CU Anschutz contingent lives in an apartment that’s within walking distance of the university-affiliated hospital, where they go on daily rounds, attend academic lectures, visit specialty clinics and teach. Part of the goal is to encourage physicians-in-training in Zimbabwe to become future faculty, thereby increasing the education capacity at the country’s major medical school.
The program is funded by the Department of Medicine in the CU School of Medicine, where Department Chair David A. Schwartz, MD, is a strong supporter. “He thought it was important to support what’s going on in Zimbabwe and give his faculty and trainees this kind of opportunity,” said Suzanne Brandenburg, MD, Professor of Medicine and Vice Chair for Education.
Suzanne Brandenburg, MD, Professor of Medicine and Vice Chair for Education, Department of Medicine, has traveled to Zimbabwe for about six years, working on Campbell’s grant-funded program to improve healthcare education. Brandenburg teaches a curriculum which was developed to enable UZCHS residents to become effective educators, integrate scientific methods into clinical practice and develop leadership skills.
“It’s very meaningful and very energizing to see how talented the faculty and trainees are in Zimbabwe,” Brandenburg said. “They are some of the hardest-working people you’ll meet anywhere, but they’re challenged by political and economic instability on top of everything else in their resource-poor healthcare system. They don’t have the resources to order all the tests, etc. that we have, so they have to be better at clinical reasoning and physical exams – and those are skills all physicians need.”
It will take some time to measure how much the Zimbabwe medical school faculty has expanded during the Department of Medicine effort. “Anecdotally, I think we’ve inspired some trainees to stay on as faculty, but it will be a while before we can measure statistically significant outcomes,” Brandenburg said.
Mariah Hoffman, MD, chief medical resident at UCH, has spent over a year in the East African nation of Malawi doing research and working in a hospital setting, but her April trip to Zimbabwe allowed her to experience direct patient care, a new and entirely different experience.
“I’ve always been interested in global health,” said Hoffman, who was joined on the trip by another chief medical resident, Aaron Strobel, MD. “It was very eye-opening. I was able to really think about treatment options and diagnosis in a setting where I don’t have the resources I normally use. We saw firsthand the shortages in pharmaceuticals, basic medical supplies, personnel and infrastructure. Things that seem routinely common here in the U.S. – such as a cardiac cath lab – don’t exist there at all.”
Hoffman noted that while the epidemic of AIDS and HIV has begun to change in Zimbabwe due to more widespread availability of antiretroviral therapy (ART), infectious disease remains a major problem. The Zimbabwe physicians said their country is increasingly seeing cases of non-communicable diseases such as diabetes and hypertension.
Hoffman is grateful for the opportunity to explore global healthcare issues in a hands-on way that can’t be replicated in the United States. “Our residency program and Internal Medicine Department is greatly improved by having global health and international opportunities,” she said. “We go there to teach, but also to learn how they work under limitations. We go there to see the diseases we don’t see here.”
Overall, Hoffman said, “we took away more than we gave, which I think is a really important part of this exchange. You do learning and teaching on both sides, and that’s pretty invaluable in my opinion.”
The CU endocrinology faculty, fellows and staff who welcomed the Zimbabwean CoZIE scholars into our clinics, rounds and daily lives during their visit included: Dan Bessesen, Mike McDermott, Cecilia Low Wang, Janice Kerr, Marc Cornier, Maggie Wierman, Micol Rothman, Jenny Morrison, Nikita Pozdeyev, Sarah Mayson, Katja Kiseljak-Vassiliades, Matt Wahl, Michele Glodowski, Ken Tompkins, Bridget Everhart and Kim Vigliotta.