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Cacha Medical Spanish Institute – Brittany Kausen, MD

Written by Brittany Kausen, MD, PGY2 at Kaiser Permanente San Francisco OB/GYN Residency Program while on Global Health rotation with Cacha Medical Spanish Institute (CACHAMSI) in Riobamba, Ecuador from April-May 2016.

My first two days were spent in the Ob unit that carries all postpartum (12 cs beds, 12 vag delivery beds), antepartum (alto riesgo 6 beds), and early laboring patients. There are also separate rooms for pre-eclamptic patients that have big black curtains to make them dark with little stimulation – so as not to piss off the pre-eclampsia. Days start with table rounds at 7am followed by walking around seeing patients with the whole team which is a small army. There are approximately 6 interns, 2 resident doctors, one junior attending and Dr. Lino who is the chief. Dr. Lino quizzes everyone — on everything. From pre-eclampsia to doses of antibiotics to units on lab values. The level of training is very different here; interns are more like medical students on their first year of clinical rotations and the residents are more like interns. As a second year resident from the US, my depth of knowledge is probably greater than theirs especially on topics like pre-eclampsia, but having to answer questions in Spanish is a whole new challenge. My first day he quizzed me all about pre-eclampsia – questions I actually knew – but translating it into Spanish was difficult. I somehow got through

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