Harrington Training Programs Enrich Medicine in Latin America

hallenge and fine-tune young medical minds, then return them to Latin America to advance the health care systems in their home countries. To some this may sound like an ambitious goal. The University of Miami School of Medicine has been doing it for over 30 years. The medical school’s Division of Internal Medicine recently marked the 33rd anniversary of the highly successful William J. Harrington Training Programs for Latin America. William J. Harrington, M.D., late professor of medicine and blood specialist at the University of Miami, established the program in 1967. His primary goal was to expand the training of medical students and graduates from Latin America—who then take this knowledge back to their home countries to enhance medical care.

“Long before Miami evolved into today’s bridge between Latin America and the U.S., Dr. Harrington had become aware of the differences in health care delivery and medical education between the two areas,” says Don Temple, M.D., program director and associate professor of medicine in the Division of Hematology/Oncology. “He felt strongly that the University of Miami could play a huge role in helping his Latin American colleagues improve health care in their home countries through education and leadership. It took a number of years to develop, but the Harrington programs are truly a testament to his perseverance and to the strong relationships he developed with physicians throughout Central and South America and the Caribbean.”

The Harrington programs are comprised of three subdivisions, including the Medical Student Program, which offers qualified students enrolled in Central and South American and Caribbean medical schools the opportunity to study for up to a year at the University of Miami/Jackson Memorial Medical Center. Participants in the Internal Medicine Residency Program complete a three-year residency at Jackson Memorial Hospital, and the Post-Graduate Elective Program participants observe and learn alongside specific University faculty members.

The cornerstone of the Harrington programs is an international network of physicians throughout Latin America and the Caribbean who act as advisors to the program. This group, many of whom are alumni of the programs, recommends candidates, interviews applicants, and keeps University faculty aware of local educational and political changes.

illustrationThere are a number of reasons why Latin American medical students and physicians want to come to the United States for continued study. Unlike students attending most American medical schools and academic medical centers, Latin American students typically do not have access to unlimited resources. A good example is that medical libraries in Central and South American schools are largely inadequate and out-of-date, without the current journals and texts American students take for granted. The programs also put them in touch with technologies and procedures they otherwise only read about. In addition, University of Miami students learn how medicine is practiced in other parts of the world.

“Unlike here in the States, where specialty fields have been preferred for decades, training in primary care remains the principle direction most medical students and physicians take in Latin American countries,” says Dr. Temple. “Consequently, their training in primary care, coupled with a lot less diagnostic testing equipment, means South American physicians and medical students are very skilled at physical diagnosis. They have sharply honed those skills, which they pass on to our UM students and medical residents.”

Such limitations of Central and South American health care systems also have led physicians to focus on the personal side of practicing medicine, seeing each patient as an individual and forming close relationships. “The patient who knows you care is the one who’s going to trust you,” says Juan Pablo Zambrano, M.D., alumnus of the Harrington Medical Student Program who is currently enrolled in the Internal Medicine Residency Program. Interpersonal skills like this, says Dr. Zambrano, are what foreign students in the Harrington programs bring from their own experiences to offer their American counterparts.

Dr. Zambrano began his medical studies at Santiago de Guaquil in Ecuador and heard about the Harrington programs through word of mouth. Many alumni and interested students praised the programs, which stimulated his interest and fueled his motivation to seek out the best possible education. “Being a doctor in our country is not an easy task,” says Dr. Zambrano. “You have to aim for excellence. In terms of training, the best you could get would be here.” He enrolled in one of the Harrington programs in 1994 and studied for one year at the medical center, where he was struck by the teamwork of faculty, residents, and students.

He returned home to Ecuador and put his newly acquired skills into practice, continuing to grow as a physician by garnering the most out of each case and counseling students. After two years of practice, Dr. Zambrano began to research options for his residency in internal medicine. The Harrington programs, along with South Florida’s multicultural patient pool, once again sparked Dr. Zambrano’s interest, and he enrolled in the Internal Medicine Residency Program at Jackson Memorial Hospital.

Because of the skills he gained as a student in his first year in the Medical Student Program, Dr. Zambrano says he was well-equipped to begin his residency. He better understood academic medicine and the structure of the United States health care system and found himself to be a mentor to new students from Central and South America.

The reputation of the Harrington programs rubbed off, and he was well respected by his colleagues. A few months ago, at the end of his second year of residency, Dr. Zambrano was chosen as chief medical resident for the Miami Veterans Affairs Medical Center, following in the footsteps of the Harrington programs’ accomplished alumni.

“It was really a very productive experience,” Dr. Zambrano says of his participation in two of the three elements that make up the Harrington programs. “I feel lucky that I found and went through the program. It has changed and will continue to change what my future is going to be.” That future includes a second residency in cardiology at UM/Jackson and returning to Ecuador for continued work in academic medicine, training future doctors in South America to prepare for medical developments already in progress here in the United States.

Like Dr. Zambrano, program participants typically earn high praise for their performance and eagerness to learn. Most of these students and physicians continue their rising career paths after returning to Latin America, rapidly attaining positions of leadership in their local medical schools, hospitals, and medical societies. “This is a testament to the quality of people who have gone and are going through the program,” says Dr. Temple.

Since the Harrington programs’ inception, approximately 800 medical students, 300 internal medicine residents, and 500 Latin American physicians have participated. Virtually all countries in South and Central America have been represented, although Brazil, Colombia, Peru, and Ecuador have contributed the majority of participants.

Deborah Phillips

University of Miami Medicine Online
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