John Cameron / Participant
The tropical medicine in practice course (TMIP) is a 2-4 week course for doctors aimed at providing exposure to pathology and an insight into healthcare provision in a low-income country. It is mainly based in Queen’s Hospital in Blantyre with occasional day trips to other facilities such as the psychiatric hospital, the local university or the hospital’s big research facility.
I attended the course in 2014 along with six others. Four of us were based in the UK, one from Australia, one from Canada and one from Austria. We ranged from newly-qualified doctors to those approaching consultancy. Five of us had recently completed a diploma in tropical medicine which helped with some of the basics, whilst the others had either done courses previously or spent some time working or volunteering in the tropics.
We rotated between the medical department and the paediatric department for a fortnight each. The bulk of the mornings and afternoons were spent either on the wards or in clinics. We were given a list of different things going on for different days and invited to attend which ever we wanted. I found the consultant medical ward rounds most interesting along with some of the specialist clinics. Most days there would also be a teaching session or two on a variety of topics to ensure we got a rounded picture of how all the departments in the hospital worked, what conditions they dealt with and how this fitted into Malawi’s healthcare system.
1) Walking onto the hot, crowded medical ward for the first time was an experience I will not forget. I vividly remember being taken aback by the scale of destitution and suffering.
2) A morning spent on the paediatric malnutrition ward for the same reasons
3) The teaching sessions organised by Dr Banda (one of the medical consultants) who found interesting medical cases and did some in-depth bedside teaching
4) A day trip to a community healthcare outpost in Blantyre which involved shadowing health visitors as they went around town seeing patients in their homes.
The structure is very flexible and the facilitators work hard to make sure everyone gets what they want from the course and will organise extra teaching sessions and activities based on feedback.
Another positive aspect of the course is the chance to meet lots of like-minded medical professionals either as fellow attendees of the course or those already working in Malawi. I found it extremely interesting to get first-hand accounts of the problems faced whilst working in Malawi and to find out how people were going about trying to improve the system around them. All the hospital staff were extremely welcoming and we were made to feel part of the hospital community.
Queen’s Hospital is large and busy. At any given moment there are around 200-250 medical patients with similar numbers in paediatrics, obstetrics and surgery. There are plenty of nearby cafés to buy a bit of lunch and also a small street vendors on the roads outside selling fruit and veg, cold(ish) drinks and mobile phone credit, and you can also get wifi in the educational annexes of the different departments. The popular hostels and guesthouses are a 30 min walk or 10 min taxi away. I stayed in Kabula lodge where there was a big expat community and a daily shuttle to the hospital for the 20 or so staff members, researchers and elective students based there.
Malawi itself is an incredible place to visit. Whilst there we spent most of our weekends visiting different tourist attractions. I would be hard pressed to choose my favourite between climbing Mount Mulanje (2-3 day trek) or visiting Lake Malawi but both were fantastic. We also went to visit some of the country’s developing safari parks and nature reserves. There were certainly ample opportunities for filling your spare time whilst in the country.
Overall I had a great time in Malawi and learnt a great deal. Being on the course is a bit like being a medical student again in that the more you put in the more you will get out. The price is currently £900 for the whole four weeks and £550 for a fortnight. Certainly the exposure to pathology and first-hand experience of being there is hard to beat. Many of the patients I saw have stuck with me and my understanding of tropical diseases and healthcare provision has vastly improved. As someone keen to practice in a tropical country in the future I am sure this course will stand me in good stead.
To learn more about the course, or to sign up yourself, please visit their website.