OB/GYN Botswana Elective
BIDMC – Scottish Livingstone Hospital
This elective provides an opportunity for OB/GYN residents to engage in supervised patient care, medical education and quality improvement in a resource-limited setting. The goals of the elective are to:
- Enrich the training and experience of participating residents
- Provide clinical support for Scottish Livingstone Hospital
- Learn how to deliver quality care with limited resources and systems efficiency
- Gain experience in the management of reproductive health of women living with HIV
- Contribute to training of district healthcare staff and local medical trainees
- Model compassionate clinical care
- Participate in quality improvement and implementation science research
- Encourage career paths in global health
- To improve the lives of women in Botswana
Launched by BIDMC's Department of Medicine in 2011, an internal medicine clinical elective program was created to build healthcare capacity through clinical care, medical education, quality improvement and research at the district hospital level in Botswana in collaboration with the Botswana Harvard Partnership (BHP). In collaboration with local partners, the program at SLH provides clinical training to University of Botswana medical students, and Batswana interns, medical officers and other healthcare staff.
The program promotes systems and process improvement efforts through quality improvement and research initiatives within the hospital and surrounding district. In addition, the program regularly provides opportunities for rotating U.S. residents and fellows to participate in clinical, educational, quality improvement and research efforts.
Since January 2016, a full-time BIDMC OB/GYN faculty has been based in Botswana and provides clinical oversight to US-based OB/GYN residents who desire participation in clinical electives at SLH. Clinical oversight of OB/GYN residents is additionally supported by Batswana OB/GYN specialists onsite at SLH.
The Site: Scottish Livingstone Hospital
SLH is a government-run district hospital, located in Molepolole, 60 km (1 hour drive) from Botswana’s capital city, Gaborone. The hospital serves as the secondary referral center for Molepolole (population 70,000) and is in the Kweneng East district (population 190,000). There is an age-adjusted HIV prevalence of 17.5 percent; however, it is close to 30 percent among the female reproductive aged population.
Beyond HIV and AIDS-related complications, commonly encountered medical conditions include TB and chronic diseases which affect the reproductive aged population. The hospital provides both inpatient and outpatient care in internal medicine, pediatrics, OB/GYN, general surgery, critical care, ophthalmology, and outpatient sexual and reproductive health, dentistry and psychiatry. Diagnostic capabilities include X-rays, ultrasound, and a wide range of laboratory capabilities including microbiology, chemistry and hematology. Available allied services include physiotherapy, occupational therapy, psychology and social work.
SLH is relatively well-resourced compared to other sub-Saharan hospitals; nevertheless, critical gaps in knowledge, systems efficiency, and resource utilization remain. The BIDMC-Botswana Program at SLH was created to address these gaps.
Resident Role and Experience
Qualifying OB/GYN residents will spend four or more weeks working at SLH. Residents are integrated into the daily routine of clinical care at the hospital, educational sessions and quality improvement projects through collaboration with hospital medical officers, midwives and nurses, as well as medical students and interns from the University of Botswana Faculty of Medicine.
Interested participants will also have the opportunity to work in the outpatient Sexual and Reproductive Health Department (SRH), where antepartum care, contraception, cervical cancer screening, and specialist gynecologic consultations are conducted. In the inpatient setting, participants are responsible for team rounding on the antepartum, postpartum and female surgical services and serving as consultants for female inpatients with gynecologic issues.
Residents will serve as consultants to their midwife colleagues on Labor and Delivery. Residents will participate in cesarean deliveries and gynecologic surgery, as well as contribute to surgical training and ongoing skills building of interns and medical officers.
The elective provides a valuable opportunity to develop residents’ teaching skills and gain clinician educator experience. Participating residents lead formal educational sessions for medical staff and trainees during their elective. In addition, residents are tasked with helping to develop educational materials, including talks and case reports, as well as contribute to several longitudinal processes and quality improvement projects ongoing at the hospital.
Dr. Rebecca Luckett is the on-site BIDMC faculty clinical mentor at SLH, while Dr. Jennifer Scott directs the Division of Global and Community Health for OB/GYN at BIDMC. Dr. Luckett is supported on-site by a BIDMC internal medicine faculty member, Dr. Tomer Barak, one or two internal medicine-trained clinical global health fellows, and U.S.-based internal medicine residents rotating through SLH on four- to six-week electives (two to three per month).
BHP-affiliated researchers, Drs. Roger Shapiro, Rebecca Zash, Shahin Lockman, and Neo Tapela, are involved in oversight of research and quality improvement projects at SLH. In addition, the program works closely with the hospital superintendent, district health management team and BHP leadership.
Housing/Transportation: Housing (leased by the BIDMC program) in-country is available to rotating residents. Transportation from housing to SLH is provided by the BIDMC program. Housing costs, international travel costs (passport, immunizations, health and evacuation insurance), and non-work related travel in Botswana are the responsibility of the resident.
Preparation/Orientation: Residents will be provided with detailed orientation materials upon acceptance to the program. The program’s dedicated in-country administrator provides administrative support during the pre-travel period as well as throughout residents’ in-country stay.
Eligibility: Eligible candidates for the program are OB/GYN residents entering post-graduate years 2-4 who are comfortable working in low and middle-income countries, able to work with a multi-disciplinary team and lead inpatient rounds, and who possess cultural sensitivity and humility.
Applications and Permissions
- Personal statement (short description of your experience, interests, goals and reasons for applying to this rotation)
- Current CV
- Statement of support from residency/fellowship program director
- Dates of interest
- Proof of malpractice coverage
Note: There is no application deadline; however, we encourage you to apply early as applications are considered in the order in which they are received. Only one to two OB/GYN residents can rotate at SLH concurrently.
Prior to departure, applicants will be required to provide proof of malpractice coverage during the time of intended work at SLH. This is not provided by the BIDMC Global Health program. If your current institutional policy does not provide coverage for rotations outside of your home institution, you will need additional coverage. Previous residents were able to obtain this coverage at low cost from several providers, such as:
Applicants should send application materials and any inquiries to Dr. Rebecca Luckett.
|Global and Community Health Program
Obstetrics and Gynecology
Beth Israel Deaconess Medical Center
Kirstein Building, 3rd Floor
330 Brookline Avenue
Boston, MA 02115