Subject: Clinical Trainee Participation in Kenya

Overview

Delineates the obligations, responsibilities, expectations, and outcomes of visiting trainee participation and involvement in clinical rotations affiliated with AMPATH and Moi University in Kenya.

Audience 

Medical students, residents and fellows (hereafter referred to as trainees) who are affiliated with an AMPATH member institution and are involved in clinical rotations at Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya, hosted by Moi University; and all faculty, staff and partners involved in the coordination of these clinical rotations.

• In order to be eligible for an AMPATH clinical rotation, the trainee must:
• be a medical student, resident or fellow affiliated with an AMPATH member institution;
• have an identified faculty supervisor who meets the supervision requirements below;
• meet all eligibility criteria set by the trainee’s home institution;
• and receive approval from their home institution and from the AMPATH secretariat.
• Trainee supervision must be arranged prior to arrival in Kenya. If a faculty member from the trainee’s home institution is not available, the Assistant Director for Logistics and Education Programs (ADLEP) should be contacted for next steps.
• The trainee must be supervised by a faculty member in the field of the desired rotation, preferably from their home institution; and the faculty member must represent an institution that has established an MOU with the AMPATH consortium through Indiana University.
• Team Leaders should not be contacted directly and asked to supervise trainees.
• If supervision cannot be arranged, the trainee will not be allowed to travel.
• Prior to participating in the elective, the trainee must submit the request through their respective program manager and/or their respective institution’s standard procedures.
• Scheduling of all trainees must be submitted to the ADLEP, who will ensure: that the trainee’s rotation fits into AMPATH-approved parameters, that the trainee will have appropriate supervision, and that there is availability during the requested rotation dates.
• Cases outside the parameters will be reviewed by the Associate Director of Education, in coordination with the Director of Education, Field Director and IUCGH Director.
• Scheduling of trainees from all AMPATH member institutions will be done on a rolling basis with earlier submission given first priority for scheduling.
• The maximum number of trainees per month is determined periodically by the Team Leaders, Field Director, ADLEP and education leadership.

DEVELOPMENT OF NEW TRAINEE OPPORTUNITIES

• If there is interest from a trainee and/or faculty member in developing a new clinical training opportunity at MTRH, the following steps must be completed before any clinical rotation will be approved.
• The interested party must identify at least one faculty member from the relevant specialty that is affiliated with an AMPATH member institution; and when possible, a counterpart faculty member at MTRH. These faculty members will serve as the primary points of contact for the development of this new training opportunity.
• Once faculty have been identified, the interested party must notify the Indiana University Center for Global Health. The IUCGH Director or designee will discuss the following topics with the faculty members to ensure that the training opportunity aligns with the principles of the AMPATH Consortium including:
• principle parties involved
• expectations of the collaboration
• supervisory responsibilities
• participation of Moi University faculty and trainees
• participation of visiting faculty and trainees from the AMPATH Consortium
• long-term vision and goals of the collaboration

• Locally supervised trainees may participate in a clinical elective following strict guidelines relative to expectations and patient interaction (if appropriate).
• The desire of any party to unilaterally establish a relationship shall not be deemed sound justification for the establishment of an “exchange” of trainees or faculty.
• Placements of trainees by any AMPATH consortium member shall not be allowed without the expressed written consent of the AMPATH Executive Field Director.

PRE-ARRIVAL: LOGISTICS

• Once the trainee’s rotation has been approved, the trainee must complete the AMPATH Visitor Information Form at least two months prior to their intended travel date, or as soon as their dates of travel are known. This form is to be completed in addition to any other documents required by the trainee’s home institution.
• Completion of this form is required to reserve lodging at IU House and to apply for a temporary Kenyan medical license, if applicable.
• In order to complete this form, trainees must be able to upload a copy of their passport, as well as a copy of their medical and evacuation insurance card(s) if they are not enrolled in an approved IU plan. Copies of flight itineraries and e- visas are also required prior travel, but may be uploaded after form submission by returning to the form or by emailing them to the ADLEP.
• Prior to travel, trainees must attend an orientation held by their home institution.
• At least two weeks prior to travel, the trainee should inform the Team Leader via email of specific areas of interest.

TRAINEE PARTICIPATION IN KENYA

• The Team Leader coordinates the trainee’s educational experience in Kenya. Trainees are expected to comply with expectations as established by the Team Leader.
• Regarding travel:
• Travel done during a trainee’s rotation must be approved by the Team Leaders.
• Trainees are not permitted to travel to Nairobi (except when unavoidable during transit) or to the Kenyan coast. Trainees may travel elsewhere within Kenya and outside the country but do so with their own full responsibility; they are not under the supervision of IU unless they are on the premises of IU House or performing clinical duties.
• In the event of strikes:
• In many cases, trainees will be expected to continue working, learning, and participating in patient care as long as some members of the Kenyan clinical team are working.
• Trainees are expected to act only within their scope of practice and with appropriate supervision.
• If it is not possible for trainees to work under the conditions as stated above, they will be expected to return to their home institutions at their own cost.
• In the event of other emergencies, trainees will be expected to return to their home institutions at their own cost.

RETURN FROM KENYA

• Each trainee receives an invoice for the cost of their lodging upon check-out from IU House. Payment of this invoice is due 30 days after their check-out date.

• Trainees may be required by their home institution to attend a debriefing or complete additional assignments upon returning home from Kenya in order to receive credit for the rotation.

Reciprocal duties

• AMPATH member institutions must establish appropriate guidelines to allow the exchange of counterpart trainees at their institution.
• Medical students from Kenya routinely visit AMPATH member institutions for a six-week period to observe their medicine practices.
• The costs of this exchange are expected to be borne entirely by the AMPATH consortium member institution including passport and visa fees, airfare, housing, incidental expenses and all food expenses.
• It is also desirable to promote student interaction by establishing regular social and cultural events and activities designed to expose local culture.