One of the most important parts of my Primeros Pasos experience was unexpected. I knew that Primeros Pasos was a teaching site, but I did not realize what a wonderful learning opportunity it would be to work alongside medical trainees from Guatemala and around the world. As near peers we were friends, we taught each other (they taught me Spanish words and about Guatemala, and I taught them some clinical skills as I was at the end of my clinical years of medical school, and they were at the very beginning), and we learned together from our patients, the physician, and more senior trainees, in an environment designed for education.
One particularly memorable moment was a conversation between myself, a Guatemalan student and a British student, about a difficult patient case. This woman had serious symptoms of heart or lung problems, but it was unclear why. The three of us thought about the case both very similarly and very differently from each other. We all had the same list of possible diagnoses, using similar reasoning. But to narrow it down, we needed a test. The British student wanted the most expensive, yet most conclusive test, because patients are not charged for tests in the UK. The Guatemalan student wanted the least costly test, understanding the cheaper test may not provide a diagnosis, but that cost presented a significant barrier for this patient. I fell somewhere in between, thinking we could use the cheaper test for now, but if it was inconclusive we would navigate the barriers and obtain the costly test (in the end the most expensive option, requiring 2 tests). The conversation opened my eyes to new perspectives influenced by training environments different than my own, and was humbling because there was not one right answer.
Before coming to Primeros Pasos, I looked forward to this rotation as a unique opportunity to learn clinical medicine and give back, by providing high-quality medical services to patients who otherwise have very little access to health care. That was certainly true—along with the health care team I was able to help patients who otherwise may have gone without treatment recover from diseases that we rarely encounter at home, such as parasitic infections and malnutrition. But to do so alongside learners from around the world helped broaden my perspective as a medical provider, opening my mind to different ways of practice. This more open mind helped my Primeros Pasos patients, and I will carry it forward to help my future patients in Guatemala and around the world.