Going “Glocal” in Yuma Arizona: How to Introduce Global Health Into Family Medicine Curriculum

By Natalia V. Galarza, MD and Kristina Diaz, MD

Global health has been identified as an increasing field of interest in medicine. As Koplan et al, mention, it can be thought as a notion, depending on current events. A definition for global health has never really been reached by consensus, and so it seems that global health can be adapted to the necessities of the location and time.

Many definitions touch on the fact that global health should improve health and achieve equity for all people and protect against global threats that disregard national borders.(1,2) It has deep connections with public health, blurring the boundaries between public health and global health. Within these connections, we have “border health” as a unique part of public health, with many characteristics being shared with the broader “global health.” For family medicine residency programs that are geographically located near the United States-Mexico border, the teaching of border health is embedded seamlessly in the medical resident education, so much that we tend to diminish its importance and gravitate toward other subjects of public and global health. It is easy to overlook the unique populations that we have in our own communities and focus on those that are more conventional and shared with other residency program or educational goals.

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Breastfeeding Behind a Bookshelf

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Laura Bujold, DO, MEd

The office is about to open when my office manager—I’ll call her Sally—walks up to me and says, “Did you see the pumping space I made for you?”

“No,” I respond. Sally and I walk in the door to an office that holds two nurse triage personnel. There is a rod with a shower curtain hanging that exposes a 3 x 21/2-foot area at best. One of the “walls” is the bookshelf and the other two walls are the corner of the office. The fourth “wall” is the shower curtain. Sally says she bought the supplies herself, smiles, and then leaves.

I run to grab my pump and pumping bag while panic consumes my confusion. There is no room for my pump. Even in a true office space, I could barely manage enough room for the pump, tubing, flanges, bottles, paper towels, water, and nursing bra, let alone the cooler for the milk.

I move quickly—my first patient will be here soon. I search the office for a small table and I find one in the bathroom; I put it immediately outside the homemade cubicle. I put my pump on the table. The electrical cord to my breast pump doesn’t reach any of the outlets. My heart skips a beat. My patient will be here any minute. I move the table toward the closest outlet. With the breast pump’s electrical cord completely extended and the tubing stretched, my pump is plugged in but it is sitting about 1 foot outside of the cubicle.

In order to breastfeed and meet patient access demands, I am dividing my lunchtime throughout the office day to pump. However, this dedicated pumping time frequently gets booked with patients. When I ask for the patients booked in my pumping times to be rescheduled, I am told “Oh, you can’t see them?” or “Are you sure?” or “But there isn’t another time available in your schedule.”

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Mi Gente

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Edgar Figueroa, MD, MPH

I work as a solo-practice student health director at a target school (a medical school that lacks a department of family medicine). I’m located in a major metropolis and work at a very large academic/research medical center. Admittedly it feels a bit odd, then, to be invited to write a post on The Path We Took to leadership within academic family medicine, but STFM serves as my academic home, and being a part of this great organization has allowed me to find my people.

I won’t lie—I have a pretty good job providing direct care to a special patient population while managing to maintain work-life balance. There are drawbacks—my scope of practice has narrowed and I probably have forgotten a lot more than I realize; I’m not part of a department of family medicine and miss the rich exchanges that come from curbsiding a colleague or sitting in a faculty meeting; I don’t have residents on site to educate and learn from and medical school accreditation rules prohibit me from participating in the education of medical students at my institution. Lastly, the job can get pretty lonely. STFM has been invaluable in filling in the gaps.

I was a member of STFM as a resident but never attended an Annual Spring Conference until the first year of my faculty development fellowship. At that meeting, I led one of my first academic presentations, but more importantly got to connect with the most black and Latinx physicians I’ve ever encountered anywhere outside of a National Hispanic Medical Association or Student National Medical Association meeting.

And these were all family medicine educators—mi gente (my people)! I was hooked and have attended every STFM Annual Spring Conference ever since 2004.

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