Learning through the Community Service.

Aim: To present a model of teaching general practice to medical students as a part of care for refugees in Mostar, Bosnia and Herzegovina.

Method: With an international support, 33 medical students (from the third study year on) participated in a total of 51 field visits to 4 refugee camps near Mostar, Bosnia and Herzegovina, over a period of two years. Some students made more than 30 visits. Together with residents in family medicine at the Mostar University Hospital, the students performed physical examinations and small interventions, and distributed packs of different pharmaceutical agents to refugees. At the end of the project, participants were surveyed to assess the benefits of the program.

Results: Thirty out of 33 participating students responded to the survey. Fourteen students said that "the opportunity to do something, however small, for the people" was the main benefit from the project, whereas 5 thought that meeting "a real patient" early in their medical studies was very beneficial. The students assisted in 1,302 physical examinations, an average of 25-/+8 examinations per visit. The most requested physical examination was blood pressure measurement (52%), followed by chest auscultation (24%) and psychological counseling (16%). They also helped with a total of 320 minor procedures, an average of 6-/+2 per visit. Among the procedures, wound care and dressing were most common (63.4%), followed by nursing care procedures (20%) and minor surgical procedures (suture removal, abscess drainage, and bed sores debridement) in 6.9% of the cases. The students helped distribute 1,917 packs of pharmaceuticals: analgesics (52.5%), antihypertensive drugs (16.1%), antidiabetics (11.2%), cardiovascular drugs (10.9%), vitamins (5.6%), and dermatological remedies (3.6%).

Conclusion: During the first two years of the project, we achieved three objectives. Residents in family medicine had a chance to practice and gain experience as group leaders, health promoters, and teachers. Medical students were exposed to a demanding outpatient environment early in their medical training. Refugees in three camps received health care and attention they needed so much.