1. Clinical Education Experience -Dominican Republic
Sophy Paulino

2. Location Country visited: Dominican Republic
City: Cristo Rey, Santo Domingo
Reason behind destination: I was raised in the Dominican Republic and wanted to better understand it’s medical system

3. Location Clinica Dr. Cruz Jiminian
This clinic is located in a low income area and it’s mission is to provide service for Dominican families at little to no cost
Mentor: Dr. Felix Antonio Cruz Jiminian

4. Clinic
Week 1: Enjoyed working at the clinic taking vitals, conducting medical interviews and becoming acquainted with the staff.
Interacted with patients from all over the country who were seeking the expertise of Dr. Cruz Jiminian (a Dominican Icon)
Was exposed to very peculiar cases and experience first hand some of the many barriers in medicine: socioeconomic status, education, distance, etc.

5. Clinic
8 year old boy stepped on a nail 3 months prior and was not taken to the doctor because of financial reasons. The wound covered half of his sole and was bone deep.
Young man with an ulcer on his left arm (caused by a deforming burn a few years ago).

6. Clinic Child with hydrocephalus treated for a cold
Man infected with HPV developed impressive growths on his fingers and genital area.

7. Surgery
Week 2/3: was able to interact with professionals from different surgery specialties
Observed different surgeries, gained experience sterilizing surgical instruments, performing suture work, placing IVs and urinary catheters

8. Surgery Complete hysterectomy
Observed more than a dozen C-sections and was allowed to practice suture work

9. Surgery ALC repair of a 24 year old old man
Removal of hardware due to infection of previous tibial plating

10. Surgery
Young man with a massive lipoma. Surgery lasted several hours and a team of ~15 people assisted in the procedure. The excised tissue weighed about 25lbs.

11. Emergency Room
Week 3 : Experienced the chaotic world of a understaffed emergency room
Gained a deeper understanding of the physical and emotional struggles of working with under-served communities

12. Hemodialysis
Week 4/5: Was able to gain experience working in a dialysis unit. Helped to take vitals and administered oral and IV medications to patients under the instructions of the attending physicians.
Gained insight into the emotional component of chronic, debilitating illnesses

13. Hemodialysis
Heavy air

14. Comparison with the US Lack of resources Jack of all trades Follow up
The clinic survives mostly on donations and many times the proper equipment is not present. Physicians are forced to find creative ways to work around the lack of equipment.
Jack of all trades
Although physicians may work in a specific specialty, doctors will often tend to different health issues to avoid increasing patient cost.
Follow up
Less technology also means that patients are solely responsible for their follow-up, which greatly decreases adherence to treatment.

15. In each mini-rotation I learned much more than I expected
In each mini-rotation I learned much more than I expected. Each day was a different adventure that constantly changed my perspective on health care and life in general. However, the most important take away for me is to “be present.” The only way you can make a difference is if you show up!

16. A special thank you to a truly inspiring person, Dr. Cruz Jiminian!