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I’ve only worked for 2 days, so this may be premature, but here are my very early observations: (1) Even in Ministry of Health hospitals, many of the medical officers are ex-pats, including Cubans, Burmese (!), and South Asians. It seems many Jamaican doctors emigrate to the US whenever the chance presents itself. Additionally, I am told the cost of medical education in Jamaica is quite high, further causing shortages in health providers. (2) I am surprised by how few “tropical” diseases there are here. For the most part, what I’ve encountered is not unlike what I see in the US: lots of viral URIs, AGEs, constipation, asthma, etc. (3) For good or for bad, practicing in Port Antonio or Annotto Bay is not too unlike practicing in low-income areas in the US. Here, limitations revolve around immediate access to diagnostics; in the US, limitations to treatment can be just as severe based on insurance status or ability to pay. (4) A nice change of pace from other parts of the world: Because of national health coverage, patients can actually get diagnostics and treatments, though they may have to travel 2+ hours to Kingston to do so… it’s uplifting to see after working in areas where even if a diagnostic test or treatment is available, unless payment is offered up front, the patient cannot access these. (5) It’s wonderful to have Dr. Ramos’, the pediatrician for the region, experience. He is practical and has a good sense of local epidemiology. So far, this is already proving to be a great experience. Will have more to report as time goes on.

Today I was in Annatto Bay. After being in Port Maria where we see tons of kids and are busy all day Annatto bay is a nice change of pace. There are 2 pediatrics trained folks consulting and a whole team of pediatric focused medical officers. I wasn’t very busy but I learned a lot from rounds and from a presentation one of the interns gave about pediatric UTI. We got to discuss the standard of care for UTI here as far as imaging is concerned and I got to hear how it differs from the US and what kind of studies that have been done to inform the recommendations. I feel like I help the least here because there are so many other amazing people seeing the kids, but I’m sooo glad we come here for my education. I got to run some cases that I saw in clinic yesterday by the pediatricians and learned a lot about hospital care. They were saying they have never had to put a child with asthma on continuos or bipap or anything like that in the 8 yrs since of the peds has been working there. And the kids get better. If I had come here but not had these interactions then I would not be up to speed on the local standards so I’m grateful to have the Annatto Bay experience. I went to the Emergency area after ward rounds and saw a few really good cases. I have seen clinic patients a lone with “attending backup” at home for many months now. But this experience really helps build my confidence when no one is there to just “run things by”. I have been here long enough to have some patients come back and have been pleased by the results I have seen. I’m also getting better at seeing patients faster. I’m still in awe at just how specialized it is to be a pediatrician and how valuable our knowledge base is even among very experienced practitioners. I had a really sick kid in A and E today that myself and 2 other doctors helped stabilize. I felt really good about our efforts. I was nervous but once I calmed down I realized that I know stuff lol and we worked together. There was an ER trained doc there for support and she thought we did great and just added a few recommendations. I’m also really having fun at work. The docs and nurses are just as awesome as they are back home and its been easy to joke and have fun despite working hard. Thats like the icing on the cake.