Internal Medicine Residency Program
Overview
The Internal Medicine Residency program in Laos began in 2002 and has graduated 23 internists to date. There are currently 18 IM residents in training who come from all over the country, with 6 new interns added each year. Some will return to provincial or military hospitals to teach and care for patients after residency. Others will remain in Vientiane to mentor and educate the next generation of residents and medical students. Still others will have opportunities to pursue fellowship training.
Educational Activities and Resources
- Regular lectures given by Health Frontiers volunteer physicians, Lao teachers, visiting physicians or the Chief Residents
- Grand Rounds given by Thai sub-specialists and foreign visitors
- Case Conferences where residents present patients for discussion
- Weekly Radiology Conference to review films with an expert Lao radiologist
- Subspecialty conferences organized by the Lao IM Board and postgraduate staff
- Monthly Journal Club
- English instruction to improve conversation skills and comprehension and increase access to medical information.
- Microbiology and parasitology laboratory training in collaboration with Mahosot Hospital laboratories
- Computers, Internet access and IM resident library
Donated Resources
- Up-to-Date has made their materials available through several donated subscriptions for the past 3 years
- Access to educational videos on surgical procedures, including endoscopy and colonoscopy, courtesy of Videosurgery www.videosurgery.com
Dr. Steve Stoltz, volunteer from UC Fresno,
teaches IM residents and medical
students on rounds.
Clinical Activities
IM residents do month-long rotations in 3 teaching hospitals in Vientiane and at the University Hospital in Khon Kaen, Thailand. They provide care to patients on General Medicine wards, in the ICU, and on the Pulmology Cardiology, Infectious Disease and other subspecialty services. They teach and supervise junior residents and students.
Common medical problems in Laos include cirrhosis, hepatocellular carcinoma, GI bleeding, HIV and AIDS, TB, severe lupus, renal failure, cardiovascular disease, stroke, diabetes, tropical infections, sepsis, thyroid disease, pancytopenia, biliary obstruction, nephrotic syndrome, hepatitis and alcoholism. Every day Lao residents manage complex patients, often with limited resources for diagnosis and treatment.
Visiting Volunteers and Collaboration
Dr. Rosemary Quirk, former Internal Medicine
Residency Coordinator, with IM residents.
Visiting physicians who donate their time and expertise are critical to the success of the IM residency. Every year involvement increases. The University of Khon Kaen in Thailand is a tertiary care center which sends sub-specialists to Vientiane to give monthly Grand Rounds in Vientiane, teach at the bedside and assist Lao doctors with curriculum and staff development. Previous visitors from America, New Zealand and Canada helped organize an Emergency Medicine Workshop, taught a formal CPR course to IM residents, have given many lectures and rounded daily with ward teams.
IM Coordinator Cindy Chu
shown with IM residents
Graduates
As of 2007, the Internal Medicine Residency program has graduated 23 Lao internists. These doctors continue to work tirelessly to improve health care in their country. Many graduates have stayed in Vientiane and are taking on the responsibility of rounding daily on resident teams, providing excellent patient care and teaching for residents and medical students, both at the bedside and with lectures. Some have returned to their home province, where they are faced with the challenges of providing care to patients of all ages in their provincial hospitals with much more limited resources than they had even in Vientiane.
Few trained subspecialists currently exist in Laos, but from the pool of residency graduates some have had the opportunity to pursue fellowship training. One 2005 graduate has completed a two-year Neurology fellowship in Malaysia and has returned to be the first trained neurologist in Laos. He is now working in Vientiane and teaching Lao residents. In the summer of 2007, one graduate began fellowship training in Gastroenterology at Khon Kaen University, and a second graduate has started a fellowship in Endocrinology. Through a unique collaboration with KKU, these fellows will complete part of their training in Thailand but then continue clinical work and academic projects in Laos during their training, thereby contributing to resident and faculty education as well as patient care, and ensuring that their training is tailored to meet the needs of the Lao population.