Graded pass/fail only.

The Centrol De Salud of Sta. Clotilde has 20 beds and is located on the Napo River in Peru's Amazon region. The clerkship is a four week elective concentrating on inpatient and outpatient international health care at that hospital. Students act as subinterns on either Pediatrics, Internal Medicine or Surgical floors, under the direct supervision of the supervising attending. Students will assist in the operating room as well as preoperative and postoperative care. Students will take call, not more than every fourth night, which will maintain coverage of the wards and Emergency Room. They also spend a minimum of three hours per day in the outpatient clinic seeing a variety of surgical, internal medicine, pediatric and obstetrical problems. Emphasis is placed on the skills of history and physical examination which enable the student to arrive at a diagnosis and plan treatment. Students are expected to actively participate in rounds and become familiar with the various diseases of the population. He/she will also be required to do a formal case presentation at the Centro De Salud.

OBJECTIVES:
1. To increase the student's knowledge of Pediatrics, Internal
Medicine, Surgical, and Outpatient Obstetrics illnesses and problems.

2. To enable the student to become acquainted with health care
delivery in a Third World country and in serving a needy population.

3. To develop an interest on the part of the student in health
care delivery to a Third World nation with the intent that the
student would return to such a nation at the completion of
his or her medical training. 

A subjective evaluation is written by an attending physician at the site upon
completion of the four week rotation.

Grade will be based on evaluation of the three clinical areas of focus:

1. Ward and/or pre-op or post-op management.
2. Outpatient management.
3. P.M. coverage on call and/or Emergency Room.

Students are required to submit a statement describing their experiences during the elective.

A log book containing the student's patient care and follow-up procedures is also required.

A formal case presentation is required.