The educational effect of clinical rotations in nonindustrialized countries.

Background: Rotations by American medical students in foreign countries have been common in US medical schools for nearly half a century. Although anecdotal literature makes claims for the significant educational value of these foreign rotations, neither the nature and educational consequences of these experiences, nor the students' impressions, have been thoroughly documented.

Methods: To document the educational impact of clinical rotations in developing countries, all 30 students at the University of Buffalo who participated in such rotations during a period of 7 years were given a questionnaire to complete. Completed questionnaires (n = 28) were analyzed using content analysis.

Results: Students reported increased skill and confidence in the use of knowledge, personal history, and physical as the primary means of diagnosis; students also reported that the rotations contributed to outcomes such as enhanced sensitivity to cost issues, heightened awareness of the importance of public health and preventive medicine, greater appreciation for the role of the family and culture in health and disease, and decreased reliance on technology.

Conclusions: Students who completed clinical rotations in Third World countries reported gaining knowledge and skills in areas which, while important in all medical fields, are of particular concern to the family physician. While no causative relationship can be adduced from this study, the fact that 70% of the students who completed these rotations entered primary care careers suggests at least a reinforcing effect.