Weekly Schedule & Lecture Topic Summaries

RemoteCareEducation: Introduction to International Aid Medicine  

Earn up to 33.5 AMA PRA Category 1 Credits™

Next Course:  Spring CME (Part 1)

March 11-17, 2018

Course Outline:

60-minute Lectures:

  1. Cultural Competency
  2. Running A Successful Clinical Deployment
  3. Medico-Legal Aspects of Mission Work
  4. Mobile Clinic Pharmacy & Supplies
  5.  Diarrheal Disease
  6. *Ultrasound Lecture I : Prenatal & Reproductive
  7. *Ultrasound Lecture II: Cardiac, Renal, Hepatobiliary & Other
  8. **Ultrasound practical
  9. Maternal Health & Births in Remote Settings (Lecture & Practical)
  10. Pediatrics I: Neonatal & Infant Health
  11. Pediatrics II: Child & Adolescent Health
  12. Parasites
  13. Surgery in Resource-Limited Settings
  14. Infectious Disease
  15. Envenomation
  16. Respiratory Health
  17. Musculoskeletal Health
  18. Geriatrics & Palliative Care

*30-minute lecture

**90-minute practical session

Day 1 (Sunday March 11): Arrival Day & Orientation

  • 1:00 PM – 6:00 PM: Arrival (Room assignments & facility tour given on arrival)
  • 6:00 – 7:00 PM: Welcome by Dr. Ben La Brot and Floating Doctors New Volunteer Orientation
  • 7:00 – 8:00 PM: Dinner
  • 8:00 – 9:00 PM: “Cultural Competency”

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Day 2 (Monday March 12): LECTURES

Morning:

  • 6:30 – 8:00 AM: Breakfast
  • 8:00 – 9:00 AM: “Running A Successful Clinical Deployment”
  • 9:00 – 9:15 AM: Break
  • 9:15 – 10:15 AM: “Medico-Legal Aspects of Mission Work”
  • 10:15 – 10:30 AM: Break
  • 10:30 –11:30 AM: “Mobile Clinic Pharmacy & Supplies”
  • 11:30 – 11:45 AM: Break
  • 11:45 – 12:45 PM:  “Mission Medicine: Diarrheal Disease”
  • LUNCH: 1:00 – 2:30 PM

Afternoon:

  • 3:00 – 5:00 PM Pre-Deployment Orientation & Training 

DINNER: 5:30 – 7:00 PM

Evening:

  • 7:00 – 7:30 PM: Ultrasound Lecture I : Prenatal & Reproductive
  • 7:30 – 8:00 PM: Ultrasound Lecture II: Cardiac, Renal, Hepatobiliary & Other
  • 8:00 – 9:00 PM: Ultrasound practical

Group Assignments for Clinical Deployments Given During Dinner

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Day 3 (Tuesday March 13): CLINICAL DEPLOYMENT

  • 6:30 – 7:30 AM: Breakfast
  • 8:00 AM: Clinic teams assemble on the dock & load clinic bags into transport boats
  • 8:00 – 9:00 AM: Groups travel by boat to clinic locations
  • 9:00 – 5:30 PM: Conduct mobile clinic; attend patients
  • 5:30 – 6:30 PM Return from Clinic
  • 7:00 – 8:30 PM Dinner

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Day 4 (Wednesday March 14): CLINICAL DEPLOYMENT

  • 6:30 – 7:30 AM: Breakfast
  • 8:00 AM: Clinic teams assemble on the dock & load clinic bags into transport boats
  • 8:00 – 9:00 AM: Groups travel by boat to clinic locations
  • 9:00 – 5:30 PM: Conduct mobile clinic; attend patients
  • 5:30 – 6:30 PM: Return from Clinic
  • 7:00 – 8:30 PM: Dinner

__________________________________________________________________________________

Day 5 (Thursday March 15): LECTURES

Morning:

  • 6:30 – 8:00 AM: Breakfast
  • 8:00 – 10:00 AM: “Maternal Health & Birth” (Lecture & Practical)
  • 10:00 – 10:15 AM Break
  • 10:15 – 11:15 AM “Pediatrics I” 
  • 11:15 – 11:30 AM Break
  • 11:30 –12:30 AM: “Pediatrics II”

LUNCH: 1:00 – 2:00 PM

  • 2:00 – 3:00 PM: “Parasites”

Afternoon:

  • 3:00 – 6:30 PM: Free time

**Optional mangrove tour / jungle walk excursion to Dolphin Bay botanic medicine conservation area managed by Floating Doctors: Boat departs 3:00 PM, returns 6:00 PM

**Optional mangrove boat tour and coral reef snorkeling: Boat departs 3:00 PM, returns 6:00 PM

DINNER: 6:30 – 8:00 PM 

Evening (optional): 

  • 8:00 – 9:00 PM: “Mission Medicine: Geriatrics & Palliative Care”

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Day 6 (Friday March 16): LECTURES

6:30 – 8:00 AM: Breakfast

Morning:

  • 8:00 – 9:00 AM: “Infectious Disease”
  • 9:00 – 9:15 AM: Break
  • 9:15 – 10:15 AM: “Envenomations”
  • 10:15 – 10:30 AM: Break
  • 10:30 –11:30 AM: “Mission Medicine: Respiratory Medicine”
  • 11:30 – 11:45 AM: Break
  • 11:45 – 12:45 PM: “Mission Medicine: Musculoskeletal”

LUNCH: 1:00 – 2:30 PM

Afternoon:

  • ALL AFTERNOON OFF

**Optional beach afternoon & snorkeling at Isla Zapatilla. Depart at 2:00 PM, return at 6:00 PM

DINNER: 6:00 – 7:30 PM

**Participants may also choose to stay in Bocas town on their last night at one of Bocas’ charming hotels and eat dinner in Bocas town at one of Bocas’ many delicious restaurants

Evening (Optional):

  • 7:30 – 8:30 PM:“Surgery in Resource-Limited Settings” 

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Day 7 (Saturday September 16): Departure Day

6:00 – 8:00 AM: Breakfast

*Shuttles to Bocas del Toro airport departing as needed throughout the day

 

 Summary of Lecture Topics

**Note:  This list comprises all lectures from our different courses; please check the list at the top of the page for which lectures are included in the upcoming course.  All of these lectures will be available as online CME modules later in 2016.

Running a Successful Mobile Clinic
Lecturer:  Dr. Benjamin La Brot
A summary of fundamental and specific pre-mission, intra-mission, and post-mission deployment considerations for ensuring successful and safe medical aid work.  This leadership review includes mission due diligence, logistics, team dynamics and clinic organization, important roles, and patient flows in mobile clinic work.  Participants should develop improved mission planning and administration skills and be better prepared for executive-level mission decisions and leadership .

Medico-Legal Aspects of Mission Work
Lecturer:  Dr. Benjamin La Brot
Explore the complex medico-legal considerations surrounding mission work in developing regions.  Learn how to avoid placing you or your team in legal trouble while far from home, how to license and ensure the security of your team, and how to make best-practice decisions in resource limited settings.  Also review the ethical considerations for mission work and handling medical errors.  Participants should develop an appropriate ethical framework to guide their behavior during medical aid work, reduce their liability on missions, ensure better informed consent, and work more smoothly with local services.

Maximizing the Scope of Service in Resource-Limited Settings
Lecturer:  Dr. Benjamin La Brot
Review the fundamental ways that any mission’s scope of service can be improved.  Learn to do more with less:  a critical skill for functioning in resource-limited environments.  Includes planning skills to maximize the impact of medical aid work.   Participants learn to add more value to medical aid deployments in the planning stages and during the mission.

Mobile Clinic Pharmacy & Supplies
Lecturer:  Dr. Benjamin La Brot
Learn how to assemble the most appropriate mobile pharmacy for your mission needs, safely get it all through customs, and use it effectively during your deployment.  Participants learn how to choose the best medications for different setting needs and assemble the most powerful and portable diagnostic tool kit their mission resources allow.   Participants develop skills to increase patient compliance and decrease prescribing errors.

Infectious Disease in Tropical & Resource-Limited Settings
Lecturer:  Dr. George LaBrot
An overview of common infectious disease fundamentals in resource-limited settings and a review of conditions that may be rare in developed nations but commonly encountered in medical aid settings, with an emphasis on clinical diagnoses.  Participants should gain confidence approaching the diagnosis and treatment of a variety of specific infectious disease issues.

Cultural Competency
Lecturer:  Dr. Benjamin La Brot
Review common but often-unexpected cultural issues that arise during consults across wide religious, ethnic, geographic, language, and socio-economic gulfs.   Learn skills to communicate more effectively with patients, utilize translators, and reduce medical error related to miscommunication.  Participants should gain confidence when approaching consults in unfamiliar cultural settings and using cultural competency skills to improve clinical outcomes.

Maternal Health
Lecturer:  Isobel Atkinson
A review of the burden of maternal health issues and common presentations in developing regions, as well as protocols for rapid assessment of maternal health emergencies and the role of pre-natal care in preventive health.  Participants should gain confidence with the assessment and treatment of maternal health conditions, and improve patient outcomes through high-value preventative interventions.

Births in Remote Rural Settings
Lecturer:  Isobel Atkinson
Learn what to do when one of your patients goes into labor, especially in remote settings or otherwise without access to advanced services.  Learn tips to make sensitive pre-natal consults a positive experience for you and your patients and their families.  Review normal progression of labor and common birth emergencies, as well as neonatal care needs and resuscitation.  Participants should gain increased confidence approaching maternal health consults in resource-limited settings, and improve maternal outcomes in medical aid settings.

Pediatrics in Developing Regions I: Neonates and Infants
Lecturer:  Dr. Jordan Amor-Robertson
Review the common medical mission issues that arise early in life, and preventive and acute approaches to diagnoses and treatments.  Also learn how to promote successful breastfeeding and management of breastfeeding issues.  Participants should be more motivated to highlight neonatal and infant health in medical aid due to greater physician appreciation of neonatal and infant health as high-value intervention targets in resource limited settings.  Participants should also develop improved breast-feeding promotion ability both in and out of mission settings.

Pediatrics in Developing Regions II: Children and Adolescents
Lecturer:  Dr. Ben LaBrot
Review of general child and teen health issues in the developing world, and approach to common specific conditions, including problems of growth and development, abuse and mental health, and infectious conditions.  Participants will gain improved confidence in resource-limited pediatric primary care consults, and improve outcomes in medical aid deployments.

Nutrition
Lecturer:  Dr. Jordan Amor-Robertson
Review of the principles of nutrition in health care applications, especially as applied to resource-limited settings and the non-medical management of chronic disease. Includes a review of common malnutritive conditions encountered in mission settings and the barriers to nutrition in developing regions.  Participants gain competence assessing acute and chronic nutritional status in resource-limited populations, recognizing and managing nutritional deficiencies, and utilizing recourse-limited nutritional knowledge to improve patient outcomes.

Neurologic Disorders in the Developing World
Lecturer:  Dr. George La Brot
A summary of neurologic health in mission settings, with an emphasis on tropical & developing world causes of neurologic pathologies and a review of some common mission neurology presentations such as stroke, epilepsy, neurologic pain, infectious neurology conditions, and movement disorders, with an emphasis on management in resource-limited settings.  Participants should gain increased confidence and competence approaching neurologic health issues in tropical and developing settings.

Mental Health in the Developing World
Lecturer:  Dr. Ben La Brot
A summary of mental health in mission settings.   Burdens of mental illness in the developing world are highlighted, as well as common barriers to effective care.  Specific mental health conditions common to mission settings are reviewed, as well as conditions that require different approaches in resource-limited settings.  Participants should gain increased confidence and competence approaching mental health issues in tropical and developing settings.

Genitourinary & Breast
Lecturer:  Dr. Jordan Amor-Robertson
Review of men’s and women’s genitourinary health issues including lithiasis, masses, infections, functional disorders, and special tropical manifestations of genitourinary disease such as quartan malaria, filariasis, and envenomation.   Breast health is included, with an emphasis on primary prevention and diagnosis in remote settings.  Participants should gain confidence and competence recognizing and managing genitourinary and breast health issues in remote or resource-limited settings.

Approach to Fever in the Tropics
Lecturer:  Dr. Ben LaBrot
A summary of strategies for treating fevers in mission deployments utilizing clinical signs (such as skin signs), fever pattern recognition, and a systemic approach to differentiate fevers in resource-limited settings, with an emphasis on tropical presentations.  Includes a review of common acute and chronic, as well as infectious and non-infectious causes of fever.  Algorithms for general and empiric treatment of fevers are included. Participants should gain confidence and competence recognizing and managing febrile presentations in remote or resource-limited settings, as well as in their home country in returning travellers.

Parasites
Dr. George La Brot A comprehensive review of parasitic organisms that prey on vulnerable populations, including protozoa, blood parasites, worms, arthropods, and mammals.   A special emphasis is placed on malaria, and regional knowledge of parasite burdens to improve clinical diagnoses.  Management of parasite in resource-limited settings—especially without access to laboratory diagnosis—are emphasized, as well as primary prevention.   Participants should gain confidence and competence recognizing and managing parasite presentations in remote or resource-limited settings, as well as in their home country in returning travellers.  

Gastroenterology in the Medical Mission Setting
Lecturer:  Dr. George La Brot
A review of gastrointestinal issues in mission settings, ‘from stem to stern.’  Infectious and non-infectious issues are covered, with special emphasis on unique tropical and developing region-specific conditions.  Management in resource-limited settings and empiric treatment strategies are included, as well as symptom-based and clinical exam-based diagnoses. Participants should gain confidence and competence recognizing and managing gastrointestinal presentations in remote or resource-limited settings.

Diarrhea Management
Lecturer:  Dr. Holly Gettings
This ubiquitous medical mission issue receives special attention.  Common causes are reviewed, with an emphasis on pattern recognition and clinical diagnosis, common causes, dehydration, public health and primary prevention.  Management strategies in remote settings are included, as well as regional barriers and strategies for larger scale interventions.  Participants should gain confidence and competence recognizing and managing diarrheal presentations in remote or resource-limited settings.

Respiratory Medicine in the Medical Mission Setting
Lecturer:  Dr. George La Brot
A review of respiratory medicine in mission settings, including infectious and non-infectious conditions.   Tuberculosis and approach to chronic conditions such as asthma receive special attention, as well as tropical conditions such as tropical pulmonary eosinophilia.  Participants should gain confidence and competence recognizing and managing respiratory presentations in remote or resource-limited settings.

Cardiology in the Medical Mission Setting
Lecturer:  Dr. George La Brot
This introduction to medical mission cardiology includes a summary of the specific burdens of cardiology disease in developing regions, and barriers to effective care.  Diagnosis and management of common conditions including tropical cardiology presentations such as Chagas, with an emphasis on diagnosis and management where advanced laboratory and imaging facilities may not be available. Participants should gain confidence and competence recognizing and managing cardiology presentations in remote or resource-limited settings.

Musculoskeletal Issues
Lecturer:  Dr. Holly Gettings
Common musculoskeletal conditions in mission settings are reviewed, including tropical conditions such as mycetoma and polio. Special discussion is made about improved performance on orthopedic specialty missions, as well as non-pharmaceutical approaches to chronic musculoskeletal issues and primary prevention.   Participants should gain confidence and competence managing musculoskeletal issues presentations in remote or resource-limited settings.

Envenomations
Lecturer:  Dr. Benjamin La Brot
A review of different types of venom, modes of envenomation and snake, arthropod, and marine vectors.  Management of acute envenomation and primary prevention are emphasized, as well as the regionality of venomous organisms and diagnoses by clinical signs.   Participants should gain greater diagnostic and management skills to be able to provide better care more rapidly in venomous encounters, and experience reduced exposure risk while travelling in endemic regions.

Allergies in the Medical Mission Setting
Lecturer:  Dr. Holly Gettings
A discussion of fundamentals of allergy treatment and review of common causes of allergic conditions encountered in tropical and remote mission work.  Food, cutaneous, respiratory, and systemic allergies are discussed and effective management in resource-limited settings is emphasized. Including a review of anaphylaxis management.  Participants should gain confidence and competence managing allergy-related issues presenting in remote or developing regions.

Dermatology
Lecturer:  Dr. Benjamin La Brot
A introduction to medical aid dermatology for non-dermatologists.  Included are dermatology packing tips for remote deployments, a review of infectious and non-infectious with an emphasis on tropical presentations such as leishmaniasis or Buruli ulcers, and a review of the regionality of dermatology presentations in developing regions.  Dermatology as a diagnostic tool for systemic disease and a review of clinical diagnostic algorithms and empiric treatments are also discussed.  Participants should gain confidence and competence approaching dermatology issues in resource-limited settings and improve their overall mission performance, utilizing increased dermatology skill to augment the management of non-dermtatologic conditions.

Endocrinology
Lecturer:  Dr. Holly Gettings
The emergent chronic endocrine diseases such as diabetes, and acute endocrine conditions encountered in remote settings are reviewed.   Added risk factors and barriers to effective primary prevention and treatment in marginalized populations are discussed, as well as strategies for overcoming these barriers and the management of endocrine conditions in developing regions.  Cultural context relating to thyroid and other endocrine diseases, as well as primary prevention strategies are included.  Participants should gain increased understanding of the contextual nature of endocrinology in developing regions and more effective management in medical aid settings.

Geriatrics and End-of-Life Care
Lecturer:  Dr. Benjamin La Brot
The burden of geriatric conditions in developing regions is reviewed, and a resource-limited approach to geriatric and end-of-life care is discussed.  Non-pharmaceutical strategies, especially for palliative care, are emphasized.  Handling of patient deaths in different cultural contexts is included.   Participants should gain greater awareness of the scope of approaches to geriatric and end-of-life issues in mission settings.

Ophthalmology & Dental Care In Mission Settings
Lecturer:  Dr. Ben La Brot 
An overview of ophthalmology and dental burden in mission settings, and empiric approaches to these issues in rural primary care.  Ophthalmology and oral health indicators for clinical diagnosis of systemic disease, ocular parasitoses in developing regions, visual assessment algorithms, managing squints, and ophthalmologic exam as a clinical indicator for HIV status are included.  Special dental considerations for developing region aid work are also discussed.  Participants should gain confidence and competence at managing ophthalmologic and oral health issues in unfamiliar, resource-limited settings and improve their effectiveness on mission trips.

Surgical Procedures in Medical Mission Work
Lecturer:  Dr. Benjamin La Brot
An overview of fundamental surgical considerations in medical aid work, with an emphasis on strategies for remote field settings.  Participation in dedicated surgical specialty missions is discussed, as well as surgical procedures in the field, review of anesthesia and sedation techniques in remote settings, developing the most appropriate surgical tool kit for your mission needs, different wound closure strategies, review of common procedure techniques in the field, and the ethical considerations for surgical interventions in mission settings.   Participants should gain increased contextual understanding of the requirements for effective and safe surgical work in medical aid, and increased confidence and competence at planning for surgical mission work and management of specific surgical presentations.