1. Resident Training in La Pintana Chile Paige Thiermann M.D.

2. 2 Activity Disclaimer ACTIVITY DISCLAIMER It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest (COI), and if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. Paige Thiermann has indicated she has no relevant financial relationships to disclose.

3. Chile 2700 miles long and 110 miles wide Andes to East, Pacific to West Varied climate: Atacama desert to glaciers 17 million people: majority age 15-64 3

4. Santiago Capital of Chile Founded by Pedro de Valdivia 1541 Industrial and Financial center: 45% GDP 5 million people (1/3 of population) 37 Comunes 4

5. La Pintana Initially agricultural region Eviction and relocation program 1979-1985 Over 30,000 people relocated Not enough jobs for population 45% of population under 19 5

6. La Pintana Lower life expectancy Higher infant mortality Higher crime rate Higher rate of illiteracy Higher rate of poverty Problems with violence, alcoholism and drug abuse 6

7. Centro de Salud Familiar Juan Pablo II Government sponsored health center Primary training site for Family Medicine residents Universidad Católica 7

8. Centro de Salud Familiar Juan Pablo II Available services: Primary care: children through geriatrics Women’s health Mental health Dental care Vaccinations Formula Home health services- oxygen, hospice 8

9. Centro de Salud Familiar Juan Pablo II Free care for patients that live within the community Medications are free but limited –NPH insulin –No narcotics Limited specialty care Some imaging studies are free- CXR 9

10. My Schedule MondayTuesdayWednesdayThursdayFriday Adult ClinicPeds ClinicPoli AdultFeria/Home visits Minor surgery Peds clinicPoli ChildAdult ClinicFreeDidactics 10

11. Poli de Choque Urgent care Patients with only 1 medical concern 6 minutes per patient UTI, abdominal pain, cough, conjunctivitis, rash, minor trauma 11

12. Minor Surgery Procedure room in clinic Performed minor surgery on lipomas, cysts, toenail removals, atypical nevi. 12

13. La Feria Twice weekly- outdoor market Performed health screening: Weight, height, abdominal girth, BMI Blood sugar/Cholesterol screen Blood pressure screen 13

14. La Feria Pt education: obesity, diabetes, HTN Opportunity to introduce patients to clinic and services provided Case of C.G 14

15. Home Visits 15 Accompanied SW –Explored safety of home environment –Assessed medical needs –Supported care givers

16. Common Medical Conditions Obesity Diabetes Hypertension Depression Domestic violence Substance abuse Gallbladder cancer –Most common cancer death women 16

17. Family Medicine Residents Residency lasts for 3 years Residents decide to specialize in adults or children No prenatal care No inpatient rotations No overnight call Committed to preventative care, community outreach and psychosocial aspects of care 17

18. Family Medicine and Global Health Can provide full spectrum care to all ages Emphasis on preventative care, patient education and empowerment Population management Build lasting relationship with community 18

19. Why residents should go abroad? Learn to provide quality care with limited resources Learn language and communication skills Increase cultural competency –Case of A.R. Expand scope of practice and clinical skills 19

20. Thank you 20

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