Botswana Application Information and Rotation FAQs 

Applicants should send materials and direct questions to the appropriate Department:

For Medicine:
Dr. Jonathan Crocker
Dr. Tomer Barak

For Obstetrics:
Dr. Rebecca Luckett

For Anesthesia:
Dr. Edward Clune

The Department of Medicine offers a year-long clinical fellowship for ABIM eligible/certified internal medicine candidates. Learn more about the fellowship and the application process. 

The Botswana Global Health Program is a collaboration between the Botswana Harvard AIDS Institute Partnership (BHP); Beth Israel Deaconess Medical Center (BIDMC), Boston; and Oregon Health & Science University (OHSU), Portland. The initiative was created to support healthcare capacity building through clinical stewardship, medical education, and quality improvement and research. Read more about the program’s history.

Botswana’s public healthcare system is relatively well-resourced compared to those of other sub-Saharan countries, but in a setting burdened by a high prevalence of HIV, TB and non-communicable diseases, some critical gaps remain. We support initiatives to improve medical training; systems efficiency; quality and safety; and resource utilization. The program is supported and run by three full-time onsite Harvard Faculty from the BIDMC Departments of Internal Medicine; Obstetrics & Gynecology; and Anesthesia, Critical Care and Pain Medicine.

In collaboration with local partners from the Botswana Harvard AIDS Institute Partnership (BHP), the University of Botswana Faculty of Medicine (UBFOM) and the Kweneng East District Health Management Team (DHMT), the program provides clinical stewardship and medical training for medical students, interns and residents from the University of Botswana, as well as district medical officers, nurses and other healthcare staff. The program also helps lead systems improvement and research initiatives with the goal of improving healthcare quality and safety.

The rotation provides an opportunity for residents and fellows to work in a resource-limited setting, hone their clinician-educator skills, and provide medical care to a population challenged by ongoing HIV and TB epidemics as well as a rising burden of non-communicable diseases. The elective’s goals are:

Dr. Tomer Barak is the Botswana Global Health Program Country Director and the on-site Internal Medicine Program Director supervising internal medicine resident electives and global health fellowship rotations. Global Health Fellows from the BIDMC Department of Medicine’s Global Health Fellowship Program provide additional attending-level clinical oversight.

Dr. Rebecca Luckett is the on-site Obstetrics and Gynecology Program Director supervising OBGYN resident rotations.

Dr. Ed Clune is the on-site Anesthesia and Critical Care Program Director and provides supervision for anesthesia resident and critical care fellow electives.

Dr. Jonathan Crocker directs the Boston-based BIDMC Department of Medicine’s Global Health Program and Global Health Fellowship.

Dr. Rebecca Zash is Assistant Director for the BIDMC Department of Medicine’s Global Health Program. She is also a BHP affiliated researcher and oversees resident and fellow quality improvement and research projects.

Drs. Roger Shapiro and Shahin Lockman are Boston-based BHP affiliated researches who help oversee program research and quality improvement projects.

The entire Botswana Global Health Program team works closely with local partners and BHP leadership on all programmatic training, clinical care and safety & quality initiatives.

Prior to arriving in Botswana, participants are provided with detailed orientation materials and expectations for elective. Trainees work closely with BIDMC faculty, and are integrated into the daily routine of the hospital depending on their specialty, serving as clinician-educators in the operating room or on the adult inpatient, critical care and obstetrics wards. Participants will work alongside hospital medical officers, nurses, and medical residents, interns and students from the University of Botswana Faculty of Medicine.

Elective participants may also pursue ambulatory activities in the post-discharge and specialist consultation clinics as well as in outreach activities at other district healthcare facilities. Commonly encountered conditions include chronic medical diseases such as heart failure, hypertension, renal failure, infectious diseases (including TB, complications of HIV infection) and a broad range of obstetric, gynecologic and critical care conditions. The onsite BIDMC-affiliated attending physicians (in Medicine, OB and Anesthesia) and/or the attending-level global health clinical fellows supervise all clinical activities during the rotations.

Opportunities to develop teaching skills and gain clinician-educator experience are ample. Participants lead formal didactic sessions and teach on complex clinical cases, providing close clinical mentorship to local medical officers, medical students, interns and residents. In addition, participants may be asked to assist in developing educational materials, including talks and case-reports, and to contribute to ongoing longitudinal quality improvement and research projects at the hospital and across the district.

Formal workday hours at the hospital are Monday to Friday, 7:30 a.m. to 4:30 p.m. Opportunities to participate in call and weekend coverage depends on the Program Directors’ discretion and the participant’s level of comfort.

Participants are encouraged to seek accommodations in recommended comfortable and secure housing located a short walk away from the hospital. Housing includes kitchen facilities, cleaning/laundry services and WiFi. Amenities include modern grocery shops and restaurants.

Participants will receive detailed orientation materials upon acceptance to the program. The program’s in-country administrator provides logistical support prior to travel and throughout the rotation, including airport pick-up.

Eligible candidates for the program are residents and fellows who are comfortable working in a developing world setting; are able to work with a multi-disciplinary team and lead inpatient rounds; and possess cultural sensitivity and humility. In recent years, residents from over 15 residency programs across the U.S. have participated in this elective.

 

Internal Medicine, Med/Peds, Family Medicine, Anesthesia and OBGYN residents as well as fellows in Critical Care, Infectious Disease and other subspecialties are welcome to apply for this rotation.

Program activities are thoughtfully and purposefully intended to ethically engage participants in local healthcare capacity building efforts. Onsite mentorship with relative independence gives participants an opportunity to step fully into the role of clinician-educators and to recognize how much they have to offer. The bidirectional nature of the clinical and educational exchange is fundamental to the program’s success. While contributing to the education of local trainees, participants’ own training is enhanced by what they learn from local healthcare providers and trainees about patients’ clinical and cultural context, navigating local healthcare systems, and discerning resourceful strategies to overcome system constraints and challenges. Immersion in a resource-challenged setting will call upon participants to fully engage, both personally and professionally, and contribute to meaningful work that addresses healthcare disparities.