Educational Survey of Bidirectional Physician Exchange between St. Damien Pediatric Hospital in Haiti and US Medical Centers

Objective To evaluate Haitian and U.S. resident experience with the bidirectional resident physician exchange program between St. Damien Pediatric Hospital in Haiti and partner U.S. medical centers. Methods A cross-sectional study was carried out among 23 Haitian residents and 51 U.S. residents who participated in the bidirectional resident physician clinical rotation exchange program since its inception. Unique electronic surveys were created and distributed to each group, and quantitative and qualitative analysis of responses was performed. Results Thirty one responses were obtained; 14 Haitian residents and 17 U.S. residents responded. Several significant differences emerged between the Haitian residents’ and U.S. residents’ experiences. These included motivation for participating in the exchange, perspectives on the most beneficial learning components of the exchange, perceived challenges, and experience with teaching methodology and feedback. Specifically, Haitian residents were more likely to encounter a lack of clinical hands-on experiences than U.S. residents and U.S. residents were more likely to experience language related communication challenges. Conclusion This survey demonstrates that the bidirectional resident physician clinical rotation exchange experience is a useful vehicle for collaborative learning between residency programs in high- and low-resource settings which benefit both groups, and that the experience is different in key ways for each group. These observations suggest that incorporation of these findings into bilateral exchange programs will strengthen the residency educational partnership between hospitals in low- and high-resource settings, resulting in better trained physicians in both settings. Lay Summary Haiti is the lowest-income country in the Western Hemisphere with the highest rates of infant and maternal mortality, malnutrition and persons living with HIV/AIDS. The shortage of healthcare professionals, specifically pediatric trained physicians, is a root cause of health disparities in Haiti. The bidirectional residency exchange program between St. Damien Pediatric Hospital in Haiti and its partner US medical centers, which comprise the St. Damien Collaborative, endeavors to help address the pediatrician shortage in Haiti. Through this program, Haitian pediatric residents complete rotations at partner US medical centers, gaining exposure to more technologically advanced subspecialties, while US pediatric residents complete rotations in Haiti, learning about medical cases that are more common in resource-limited settings. This research demonstrated that the exchange experience is different in key ways for Haitian residents visiting US hospitals compared to US residents visiting Haiti, and suggests that the program can be further tailored to reflect these differences in order to strengthen the program, resulting in better trained physicians who will combat the shortage of healthcare professionals in Haiti. These results also provide a roadmap for developing mutually fruitful bidirectional residency exchange partnerships between other high- and low-resource residency training programs.