You might be able to imagine how it feels to see the USNS Comfort anchored in a harbor, especially if you live in a part of the world that requires the services it provides.
With a length of 894 feet, the ship is only a few feet shorter than the R.M.S. Queen Elizabeth 2. Stood on its end, the ship would tower over the Golden Gate Bridge and the Space Needle. In short: It’s big. Painted white, with large red crosses, it certainly makes an impression.
The 1,000-bed hospital ship has 15 wards and 12 operating rooms and provides medical services that support U.S. disaster relief and humanitarian efforts across the globe. This fall, it traveled to Guatemala, Honduras, Columbia, Dominican Republic and Haiti as part of its Continuing Promise 2022 mission and 12 VCOM students were able to spend time on the ship—nine went to the Dominican Republic and three to Honduras.
We often think of VCOM’s mission as providing medical care to underserved communities in the Delta and Appalachian areas of the United States. But international outreach has long been part of the College’s work. A new memorandum of understanding with the U.S. Southern Command—SOUTHCOM, for short—has added further opportunities for VCOM and its students. Trips on the Comfort are part of the MOU, but it also allows for joint activities with U.S. and in-country military related to humanitarian efforts as well as joint educational and health care outreach.
“VCOM built a relationship with SOUTHCOM that is good for both organizations,” says Dean Sutphin, vice provost for international and Appalachian outreach at VCOM. “Our permanent clinics abroad and relationships with commanders and agencies around the world made us a logical and attractive partner. We’re already providing continuous care in many of the countries that SOUTHCOM is supporting through their missions.”
Of course, the relationship with SOUTHCOM is also a natural fit for VCOM given how many of its students participate in the Health Professions Scholarship Program (HPSP). HPSP is a scholarship program that helps students pay for their medical degrees and prepares them to serve in the United States Army, Navy or Air Force. Currently, there are more than 140 HPSP students across VCOM’s four campuses.
VCOM’s commitment to international outreach is a powerful recruiting tool. “We’re attracting students with a humanitarian interest and our international program enriches the students’ medical experiences,” Sutphin says. “We are a leader in global health opportunities and prospective students know it.”
Merwan Faraj, a member of the Class of 2023 at VCOM-Carolinas who spent a week on the Comfort, says VCOM’s international outreach was a big factor in his decision to attend. “The way VCOM does international outreach is different than other schools,” he explains.
“It’s year-round support. To me that says something about the type of people who run the College. VCOM is not doing quick mission trips where they get in and get out. I wanted to be part of that kind of family.” Despite their desire for medical care, patients can be overwhelmed when they come to the Comfort, Merwan says. There are people everywhere, many in military uniforms, and it can be loud and disorienting for people who need help. He remembers a scenario that happened several times while he was on the Comfort. “A mother would come into the tent with her kids, and you could tell that they wanted help,” he remembers. “I learned to take care of the kids first and with the language barrier, I had to use nonverbal communication to gain trust. I’d give the kids a stethoscope so they could try it on me. When they could hear my heartbeat, their eyes would light up.” Merwan learned quickly that if he could help the children, it was easier to help their mothers.
Jacob Harrison, Class of 2023 at VCOM’s Auburn campus, was also inspired to choose VCOM because of its international outreach program. When he stepped aboard the Comfort this fall, it turned out to be an unexpected opportunity for him to get into the operating room. “We performed primarily laparoscopic cholecystectomies and open inguinal hernia repairs,” Jacob says. “These procedures have a relatively quick recovery time and substantially impact the patient’s health and ability to get back to work, thus benefiting the economy. Being able to perform several of the same cases in a row enhanced my knowledge of the procedures, anatomy and anatomical variations that may be seen.”
Just as important as getting into the operating room was the chance to get to know patients. Unlike in the U.S., patients on the Comfort completed the process of prescreening, pre-operation, surgery and post-operation on three consecutive days. “On the first day, we were all strangers, but after seeing them three days in a row, we were all very familiar with each other,” Jacob recalls. “You could tell a dramatic shift from timid and nervous, to excited and appreciative. I think their time on the Comfort was just as much of an experience for them as it was for me.”
Jacob says such an experience is one way to set yourself apart if you’re planning to apply for military residencies. But it is a unique and valuable experience for any medical student. “Experiencing a new culture, in addition to military culture, while learning how to navigate patient care in light of limited resources and a language barrier is truly invaluable,” he observes.
“Don’t be afraid to go,” Merwan offers. “It is truly an honor and a privilege to do things like this for other people. It’s also humbling. It’s easy to get bogged down in grades and tests and this will remind you how amazing the career is that we chose and will push you to keep moving forward.”
Ron Januchowski, DO, who serves as associate dean for curriculum, assessment and medical education at VCOM-Carolinas, was in the United States Army and retired as a colonel after 31 years of active and reserve status. He accompanied VCOM students on the Comfort and knows what a valuable experience it was for them. He notes that meeting the military personnel is helpful in the residency match process because students are able to directly interact with program faculty from different military residency programs. But more than that, the trip is an opportunity for personal growth. “The students were able to function in an austere environment, seamlessly involve interpreters in patient care and function as a part of the military medical team,” Dr. Januchowski says.
Fred Rawlins III, DO, is co-chair for internal medicine and co-director clinical medicine course at VCOM-Virginia. He is a member of the VCOM-Virginia Class of 2010 and served for 10 years in the Air Force and was an instructor for Critical Care Air Transport (CCAT) while overseas. He agrees with Dr. Januchowski that the experience on the Comfort is a meaningful opportunity for VCOM’s students. Dr. Rawlins participated in the trip to the Dominican Republic and says that the experience reinforces good physical exam skills in a resource-limited environment. For example, his students were able to hear and diagnose abdominal bruits in suspected aortic aneurysms. They also saw a patient exhibiting early diastolic decrescendo murmurs with de Musset’s sign, suggesting severe aortic insufficiency. It’s meaningful for the students to not only see these issues outside of a classroom, but also to help improve the quality of life for patients in the real world.
Clearly, trips like these are valuable experiences for doctors and patients alike. Sutphin gets emotional talking about the work he and the VCOM students are doing. “Many of the people in-country lack water, electricity and live on less than $1 a day,” he says. “We’re here to be of service where the host country says they need the help. Patients tell us that we bring them hope.”
