International Rotation

 

An exciting opportunity afforded the residents at the Alpert Medical School of Brown University Department of Surgery is a chance to travel to Kenya for an ACGME / ABS approved elective rotation. 

The Brown University Program in Surgery has a longstanding educational relationship with the Tenwek Mission Hospital.  Russell E. White, MD, a 1995 graduate of the Brown program, and Kirby I. Bland, MD, former Chairman, Department of Surgery 1993–1999, instituted this relationship.  In 1998, the Department of Surgery sponsored the first Brown PGY 3 resident to travel to Bomet, Kenya as an international resident volunteer at Tenwek Hospital.  

The Brown University Program in General Surgery offers a four week elective rotation to two residents per academic year at the PGY 3 or PGY 4 level.  These elective rotations will take place during the months of February/March and May/June.  The entirety of the elective occurs at the Tenwek Hospital located in Bomet, Kenya.  Residents interested in participating in this elective must submit their request to the Program Director.  A generous endowments from the J. Murray Beardsly and Drs. Stanley Simon and Martin Felder provides for the resident’s salary, travel, and housing expenses. 

Russell E. White, MD is the supervising physician of our residents during the elective and will be responsible for evaluation of the resident's performance at the end of the four week rotation.  Dr. White has also recently been joined by two additional Brown graduates, Robert Parker, MD and Andrea Parker, MD.  Drs. Robert and Andrea Parker who are Clinical Instructors in Surgery at Brown University. Dr. White graduated from the Brown University General Surgery Training program in 1995, and completed a Thoracic Surgery Fellowship in Bristol, England.  Dr. White holds an Academic appointment as an Associate Clinical Professor of Surgery at Alpert Medical School, Brown University.  He has been Board Certified in General Surgery by the American Board of Medical Specialties since 1996.  Dr. White was named Chief of Surgery and Endoscopy at Tenwek Hospital in 1998 and has been the Hospital’s Medical Superintendent since 2008.  He is the current Program Director for the Tenwek Hospital General Surgical Residency Program affiliated with the College of Surgeons of East, Central, and Southern Africa/Pan-African Academy of Christian Surgeons. This program has a total of 19 trainees: 9 interns and 10 residents.  

As one of the largest mission hospitals in Africa, Tenwek provides health care to the surrounding Kipsigis, Maasai, and Kisi communities, and serves as a referral center for hospitals and clinics in neighboring towns and villages. Tenwek provides for all areas of inpatient and outpatient medical and surgical care.  Medical work at Tenwek began in 1935 when World Gospel Mission missionaries arrived in the area.  The first full time doctor was an American missionary doctor who arrived in 1959.  Since then, Tenwek has grown from a 35 bed cottage hospital to a 300 bed major referral center.  Tenwek Hospital provides primary health care for 600,000 people in the local area and serves as a referral hospital for most of Western Kenya.  Tenwek is administered as a subsidiary of Africa Gospel Church in cooperation with World Gospel Mission. Between 100,000 and 140,000 patients are seen in the outpatient area per year, and on average there are 140,000 patients admitted to the hospital yearly.  Approximately 2,500 major operations and nearly 3,000 minor operations are performed each year.  In addition, nearly 1,000 endoscopic procedures are performed annually at Tenwek. There are five major and four minor operating rooms, an intensive care unit, neonatal nursery, as well as internal medicine, pediatric, orthopedic, obstetric, ophthalmologic, surgical wards divided into male and female sections, and a wound and burn unit.  X-ray, ultrasound, CT scanner, physiotherapy, basic laboratory, and blood banking services are available.  There are three full-time ABS Board Certified General Surgeons, one pediatric surgeon, one pediatrician, two family physicians, one obstetrician, and three general practitioners on full-time staff.  However, the faculty staff is supplemented with 30 – 40 visiting physicians and 10 – 20 resident physicians on average per year.  

The breadth and volume of cases and opportunity to learn about third-world disease is endless. The first resident to rotate to Tenwek Hospital in 1997 completed nearly 80 cases and 50 endoscopic procedures ranging from esophagogastrectomies and thyroidectomies to bowel obstructions, appendectomies and hysterectomies. Orthopaedic, neurosurgical, pediatric, and trauma cases including burns are also plentiful. Similar experiences have been the case with successive residents chosen for this rotation.  The opportunity for growth in mind, body, and spirit are limited only by the resident’s stamina and fortitude.