Physician Assistant/Pre-PA Internships Abroad | IMA

The program has not only deepened my passion for healthcare, but also opened my eyes to global healthcare disparities, the beauty of community outreach, and the vital role that systemic infrastructure plays in delivering healthcare. In the hospital, I shadowed a range of specialties, giving me the opportunity to watch live births and learn pathology alongside medical students. Our outreach clinics had lasting effects on the community, and we were able to see this in real time. Even after educating and answering questions on menstruation and women’s health for 1.5 hours, girls continued to come up to me with questions on the way to the bus. You could see the relief on children’s faces when they learned about issues involving menstruation or mental health and realized they weren’t alone. Children who had previously attended the hygiene clinic remembered the information and were able to assist in educating their peers. One of the issues Kenya suffers from is poor health literacy. Through these clinics, we were not only able to provide supplies for immediate care but also make a lasting impact through health education. As demonstrated in the hygiene clinic, even educating just one group of students can make a difference as they continue to educate each other. From the second I arrived in Kenya, the IMA staff made it feel like home. I felt safe at all times, and if I ever needed anything, our program mentors were easily accessible. The accommodations were more than comfortable—the food was amazing, and the house and kitchen staff always went out of their way to ensure we were taken care of. I often took naps after a long shift at the hospital, causing me to miss the planned dinner time. However, Joshua always made sure there was a meal left for me to wake up to. Being the only new person to the program during my time in Kenya, I was nervous to go on the safari alone. Thankfully, Vivian was there to accompany me the whole time, and there was no one better I could have asked for. She immediately put me at ease and became a lasting friend in the process. I did not expect to love Kenya as much as I did, and I truly believe the IMA staff played a significant role in that. I will always be grateful for my experience there and hope to come back soon.

From the moment I arrived at the airport to the moment I departed, I felt thoroughly supported and guided by the IMA staff. Their attentiveness made me feel safe and ensured a smooth transition throughout my stay. The accommodations exceeded my expectations—exceptional hospitality that made my time comfortable and enjoyable. I have no complaints about the housing. The kitchen staff and the food were outstanding; the chefs prepared delicious meals, greeted us warmly, and accommodated dietary needs. My experience at the hospital was equally positive. The nurses in OB/GYN were incredibly friendly and welcoming to interns. They were open to teaching and involving us in procedures, and I left each day with new knowledge and skills. One highlight was the community outreach initiatives. Whether participating in women’s health and hygiene clinics or mental health education sessions, I felt privileged to contribute to community well-being. The free medical clinic was particularly impactful. As a first-generation college student, I have often felt unsure about which career path to pursue. During a meeting with my advisor, I discovered the physician assistant role and was immediately captivated. When I told my parents, they laughed—reminding me of my fear of needles and anything to do with blood. Despite that, I was determined to explore the field. With no prior healthcare experience, I knew I needed firsthand exposure. I spent hours researching internships that explored different specialties in a hospital setting. When I received my acceptance to International Medical Aid in Kenya, I couldn’t contain my excitement. I had also heard warnings about challenging conditions, crime, and health risks, and as the departure date approached, I felt a mix of nerves and anticipation. The temptation to cancel crossed my mind, but I was committed to facing my fears. Those three weeks turned out to be an eye-opening journey beyond anything I had imagined. On my first day at Coast General Teaching and Referral Hospital, I was assigned to the accident and emergency department with Dr. Anton, who greeted us with genuine warmth and enthusiasm and gave a comprehensive tour. I noticed differences from what I’d seen in the U.S.—from attire to documentation systems and room layouts that offered limited privacy. I also saw the structured ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) used to triage critically ill or injured patients, which underscored how clinical officers prioritize care. While initial assessments were quick, there were often delays before tests or imaging—something I’ve also observed in U.S. emergency departments. Several cases stood out. One involved a young man injured after a mob incident; another, a patient attacked with a machete who required suturing. As days went by, patterns of trauma were common, which prompted me to learn more about local safety dynamics. Clinical officers—who complete several years of training and gain seniority through experience—performed much of the frontline care. Observing this system deepened my appreciation for the range of professionals who keep high-volume public hospitals running. In the pediatric emergency department, I assisted with gentle immobilization for IV placement, sometimes via jugular or scalp veins when needed. I observed variations in technique and equipment usage, which reinforced for me the importance of adhering to evidence-based protocols to minimize infection risk and ensure patient safety. As a future physician assistant, I’m committed to following best practices to provide safe, compassionate care. During my surgery rotation, I worried about fainting at the sight of blood. I walked into the middle of a knee replacement and, despite initial nerves, became absorbed in the teamwork and precision. Later, I observed a hysterectomy and a salpingectomy. Seeing how surgery could restore mobility and health was inspiring and sparked a deeper interest in operative care. In my second week in OB/GYN, I explored the labor ward, High Dependency Unit (HDU), gynecology ward, antenatal ward, postnatal ward, and the theater. On day one, I joined the oncology team. Many patients had advanced cervical cancer in a setting where HPV vaccination was introduced relatively recently. Treatment planning often occurred alongside other health challenges such as acute kidney injury and anemia. One case that stayed with me was a 12-year-old with a newly diagnosed malignancy who underwent surgery. Despite her age and diagnosis, she showed remarkable strength, even comforting her mother. The experience deepened my understanding of the complexities families face and strengthened my commitment to women’s health in resource-limited settings. I spent time in the labor ward and witnessed both a vaginal birth and a C-section for the first time—an almost surreal experience. The ward is divided into first- and second-stage areas; women are placed based on their presentation at admission. Space constraints limited family presence, and immediate newborn assessments sometimes left little room for early skin-to-skin contact. Learning more about the benefits of skin-to-skin reinforced for me how small changes in practice can have meaningful impact for mothers and babies. In the HDU, I joined nurses on rounds and witnessed their gentle, compassionate care. They shared detailed patient histories and kept me updated on ongoing treatments, creating a supportive, non-toxic learning environment. When a new patient arrived, the team quickly focused on her comfort. Another patient developed severe bleeding; I helped by handing gauze while the team stabilized her. A third patient with eclampsia deteriorated and entered a coma. The nurses continued talking to her and offering reassurance, acting as surrogate family when loved ones couldn’t be present. I brought adult diapers as a small contribution—it reminded me of my grandmother’s struggle with an incurable illness and the importance of simple comforts. As my time wound down, I visited the gynecology unit, where I encountered a range of conditions—ectopic pregnancies, incomplete miscarriages, pelvic inflammatory disease, molar pregnancy, and gynecologic cancers. Throughout this rotation, Dr. Rehma was an invaluable mentor. She broke down complex concepts—from disease mechanisms to treatment protocols—and invited me to intern meetings on labor progress. I learned to graph labor curves and present cases, which fueled my passion for OB/GYN and showed the power of great mentorship. This program shaped my future profoundly. Beyond hospital learning, the people I met made a lasting impact. As a first-generation student, I found peers who also hoped to become physician assistants and generously shared practical advice on preparing strong applications—from clinical volunteering to relevant coursework. I returned home determined to gain more experience, pursue additional learning, and build toward PA school with an OB/GYN focus. With each step, I feel more equipped and more passionate about my goals. Overall, I am deeply grateful for the opportunity to be part of this program. It enhanced my professional skills and allowed me to contribute meaningfully to the community. The support, safety, accommodations, and enriching clinical experiences have left a lasting impression and clarified the kind of clinician I aspire to be.

My experience in Kenya was better than I could have ever imagined. I truly think it was the best experience I have ever had. From the day I arrived, the IMA staff was always friendly and immediately made me feel at home. The residence was always well kept, with staff cleaning our rooms. Additionally, the food was amazing, and the kitchen staff always welcomed our meal requests and would get them to us right away. Our program mentors were amazing and would always happily talk to us. They gave excellent advice and were always willing to help. The program staff was the main reason that my experience was so amazing. We also received a lot of knowledge about the culture of Kenya from them, which helped me to understand the situations of patients I saw at the hospital. I learned so much about different types of health conditions, especially from Dr. Ken in pediatrics, who would give mini-lectures to us between patients so that we gained the most amount of knowledge that we could. Along with shadowing at the hospital, all the community outreach clinics taught me so much about the community in Kenya. The clinics were my favourite part of the internship, as the kids were always so happy to see us, and I felt like I was making a difference to them. Overall, my experience was amazing, and I felt it went so quickly. I never once had any worry about feeling unsafe or alone, as I was surrounded by amazing staff. I will definitely be coming back. Five years ago, I would have never imagined that I would be spending 3 weeks interning as a pre-physician assistant student at the second-largest public hospital in Kenya. From a very young age, the idea of attending medical school was implanted into my head by grandparents, teachers, and even friends’ parents. However, healthcare workers were plenty in my family, and I did not want to do what everybody else wanted of me. It was not until the end of my high school career during the COVID-19 pandemic that I found a real love for the medical field. Throughout the past 3 years of university, I started working towards the goal of attending medical school and working in the healthcare field, yet I was still confused about whether becoming a physician was my calling or whether there was another healthcare profession that I would be interested in. When I learned about physician assistants, it seemed to be a perfect match for what I wanted, yet it also added to my confusion about what healthcare career I should pursue. Coming to Kenya, I had plenty of questions and was unsure of where I stood in my career but came with an open mind. Before my internship in Kenya, the only clinical experience I had was volunteering at the Grace Hospital emergency department in Manitoba, Canada. I had expected that the Kenyan hospital would look much different from the Canadian hospitals and would be severely under-resourced. Additionally, being born in a third-world country myself and having visited back home to Sri Lanka on multiple occasions, I have seen what an underfunded public hospital can look like and thought I had a decent idea of what the Coast General Hospital would look like. However, from the first orientation day in the hospital, I realized how much I truly had to learn about the state of healthcare in Kenya. Much like I imagined, there were outdoor portions of the hospital and cracks were present in the walls and ceilings; what I had not thought about previously was the lack of sanitation at the hospital. I was shocked to see doctors treating patients without gloves and sometimes without masks as well. Blood spills in the emergency department were wiped with a dirty, wet mop that was then used to wipe another spill in a different room. The only time I saw a counter being wiped was in the pediatrics department, but I was saddened to see that there were no actual cleaning products used, and it was only hand sanitizer being wiped down. In Canada, I would have never thought of cleaning products as a privilege, but from that first day, I realized just how much I have taken for granted. My first week was spent in the pediatrics department, where I switched between the outpatient clinic and the in-patient ward. There were two medical students at the in-patient ward who explained to me what the morning would look like, which included changing patient bed sheets, taking vitals of all patients, and then doing rounds with the doctor once she arrived. Right away, I noticed how involved mothers were in the care of their children in the ward. In Canada, it is normal for the nurses and healthcare aides to change bed sheets and clean the baby, yet in this ward it was the mothers changing the bed sheets and getting the baby ready for when the doctor came around. The sense of community between the mothers in the ward was evident, as everyone was helping each other. Even though many things from Western healthcare may be an improvement compared to the healthcare found in Kenya, I think having the mother involved more in their babies’ care is something that Western healthcare should adopt as well. The mothers all seemed so happy to aid in their babies’ care, which is not something you see in Canada, as nurses and healthcare aides do most of the caring. Furthermore, during rounds, I was able to learn about rickets disease and feel a baby’s abdomen for a common swelling symptom of rickets. The doctor explained that vitamin D deficiency is very common in babies who take formula because the formula in Kenya lacks vitamin D, leading to plenty of deficient children. Additionally, a natural source of vitamin D is sunlight; however, it is “imperative for mothers to seek employment very early in the postnatal period [meaning] that infants are often looked after in indoor informal daycare facilities” (Jones, 2017). As much as I would like to think that if we get formula with vitamin D into Kenya the cases of deficiency would decrease, I could see that the problem was much bigger, and therefore the solution would also take years of change. This first case of rickets opened my mind a lot, as I would have never thought that something as simple as access to enough sunlight would be an issue for these children; but with families facing poverty and mothers having to work right away, most of the children are not raised the way we are in North America. Finally, in the outpatient clinic, I learned a lot from Dr. Ken. With every patient that came in, he explained all the symptoms and possible treatments for the child. Between patients, he would also take the extra time to teach us about pneumonia, tuberculosis, and different blood disorders. I will forever be grateful for all the knowledge I received from Dr. Ken and will make sure to keep the notes with me for when I continue into physician assistant school. The biggest lesson that I learned from Coast General that I will be keeping with me throughout my career is how important patient bedside manner is. I was heartbroken to see how some of the nurses and doctors treated the patients. One case in particular that struck me was a boy in his 20s who came in after an accident in a tuk-tuk that resulted in him rolling on the pavement and having multiple large wounds all over his body, as well as a shattered wrist and broken ribs. When taking him for an X-ray, the medical students were pulling his body left and right to get him into position and trying to force the board under him while berating him for screaming in pain. The sounds of his screams were very difficult for me and the other intern to hear and are something I still remember. I could see how much pain he was in when he arrived, and to see him treated so rough at a place that should be caring for him was very difficult to watch and understand. I saw situations similar to this multiple times during my internship where just a little bit of compassion may have helped these patients tremendously. At the labour ward, I saw doctors telling the mothers to stop screaming during labour and saw them get annoyed when mothers tried to hold their hands. I could see that most of the healthcare workers at Coast General were very overworked and exhausted with the conditions they had to work in, causing them to show less compassion. In addition to a lack of resources, the hospital was severely understaffed, with an average of 21 doctors and 100 nurses per 100,000 people compared with the WHO-recommended minimum staffing levels of 36 doctors and 356 nurses per 100,000 people (IMA, 2024). This was especially evident to me in the newborn unit, where I spent one night shift. There was one premature baby whose oxygen saturation level had dropped to 40% because his oxygen tube was not in his nose properly; however, even though the monitor was beeping, no nurses were rushing to fix this. I notified the nurse, who then came to fix it, but when I came back half an hour later, I could see the oxygen saturation at a dangerously low level once again. This time, when I notified the nurses, they did not come to fix it, and I had to tell three nurses before one finally came to help the baby. Even then, this nurse showed no sense of urgency and came only after a few minutes. This was extremely frustrating for me, as all I could do was notify them, but I could not force them to have more urgency. I realized quickly that in the newborn unit, some nurses had the mindset that the premature babies would probably die anyway, which may be the reason for their lack of urgency, as at least 5 babies passed away there every day. An article from the UCLA School of Medicine says that “how physicians, [and] nurses… approach patients and their families can directly affect the overall experience for patients and their willingness to learn… good bedside manner ultimately improves communications and reduces errors” (Geffen, 2016). If there were more staff present, I am sure bedside manner would be much better and would no doubt lead to a decrease in patients’ distress and hopefully even a decrease in this mortality rate. Apart from all I learned at Coast General, I learned a lot from the culture and people of Kenya. I was amazed at how welcoming everyone was and was especially touched by how happy the kids were at the schools we visited. I have truly never felt as happy as I was when I walked into a classroom and had all the young kids come up to hug me and touch my hair, and it only confirmed for me how much I want to work with children during my career. One school we visited for a mental health clinic especially touched me because I got an insight into how hard their lives must be. The classroom was filled with teenagers, and when we asked them to write down their feelings and any questions on paper, I received multiple comments talking about friends who had committed suicide. Within that classroom of about 30 to 40 students, there were six stories of friends who had committed suicide because of physical and/or sexual abuse from family members. It was heartbreaking to hear these stories but was also heartwarming to see how much joy these teenagers portrayed throughout all their struggles. After we had a good conversation on journaling and how to express our feelings, we had a small dance party outside on the field, and it was truly amazing to see how much fun they were all having. They were so welcoming to us and even brought me into the dance circle with them. I will never forget that moment, as they brought me so much joy, and I only hope that we brought them as much joy as well. Every day that I experienced more of the culture, I became more aware that I was extremely lucky to be there. I went to Kenya with an open mind, ready for new experiences and to learn as much as I could. I got so much more out of this internship than I could have ever imagined. My boyfriend has always said he has wanted to come to Africa to live in a village and help the people as much as he can, and this trip led me to start planning this trip for our future, as I honestly fell in love with the culture and people. I also believe that my experience at Coast General helped me to fall in love with medicine just as I had at the beginning of my university career. I no longer have any doubts about what I want to pursue as my career and have decided to apply to a physician assistant program. None of these plans and excitements for myself were present before my experience in Kenya. I will forever be grateful for my life-changing experience and promise to come back to Coast General once I have started my career to help as much as I can.