Getting into international public health

[melrose85]

Hello! I was in an accelerated BSN program, but I left in order to pursue medical school. Now I'm questioning my decision.

I want to go into international public health, providing some clinical care but mainly working to design and implement various public health projects such as immunization campaigns, antimalarial programs, managing a health clinic in a refugee camp, etc. In the US, I could see myself as a public health nurse along the border or in American Indian reservations.

However, I am worried that it may be hard to obtain the kind of jobs I want overseas with an RN/MPH and not an MD/MPH. Also, I feel like MD's have much more credibility overseas than RN's. And I wanted the ability to diagnose. I also didn't really like the idea of being a floor nurse in a hospital. That's why I switched to a premed program.

But now I"m thinking that medicine isn't the best field for me. I feel like it is too long of a program (7 years) and will take me away from working in the field w/ the people. I like patient education and caring for patients, which is a HUGE part of nursing, but I also like the pathophys/diagnosing stuff. And I want time for a life outside of my career.

Aaah. so to make a long story/question short- do you all know any nurses who are doing the kind of international work I want to do? How long did it take them to get there? Would it be harder in today's job market? How are US trained nurses perceived overseas?

Thanks!!!

[aeauooo]

Greetings,

I'm currently working on my MPH&TM (tropical medicine). In 2000 I completed a diploma in tropical medicine at Tulane and spent a year volunteering in Ethiopia. I plan to go back to Africa when I finish my MPH.

You really don't need an MPH to do some of the things you've mentioned, but if I didn't think it was a good idea, I wouldn't be here now.

You might want to look into Doctors Without Borders and other NGOs if you're interested in relatively short-term assignments. There are a lot of NGOs that you can volunteer with, but many of them expect you to pay your own way.

If you're interested in working on an Indian reservation, look no further than Indian Health Services (www.ihs.gov), it's a branch of the DHHS. I've looked into it, and as I recall, there are great benefits, but my heart is in Africa.

As far as the scope of practice of practice of nurses in international health, I can tell you that in Africa there is a severe shortage of doctors, so much of the work usually done by MDs is delegated to non-medical personnel. In Ethiopia, nurses are the senior staff of health centers. Nurses diagnose, prescribe, and treat. I was once asked if I wanted to do an LP. I declined, but Ethiopian nurses, with far less training than we have in the U.S., are trained to perform that and other tasks usually performed by MDs in this country.

If you decide to go with a smaller NGO, make sure your job description is well described. I worked for a small NGO and there was a lot of friction between the expatriate MDs and me - they perceived themselves to be my superiors and tried to assign a lot of scut work to me because I was "just a nurse." That wasn't my job, and they thought that what they wanted me to do took precedence over what I had been sent there to do.

I applaud you for wanting to go into international health. I suspect without an MPH you'll probably have to prove yourself by doing volunteer work before you can find a paying gig.

Where do you live? There are some good school of international health in the U.S. I lived in Seattle, but returned to Tulane for the tropical medicine program. Once my wife and I moved here, U.S. New & World Reports rated the University of Washington as one of the best schools of international health in the U.S., with a much higher rating than Tulane! I love New Orleans, and this semester I'm taking the malaria course at Tulane, so I'm glad I'm back.

Good luck, and let me know what you end up doing.

[jjjoy, LPN]

Medical education and nursing education are quite different. If you started the ABSN program, you've had a taste of it. Personally, I have to learn things in depth to 'get' them, so I found nursing school rather frustrating at times because I have a hard time retaining information at that level. So I'd suggest reflecting on your learning style and learning goals when considering what path to take.

Maybe you could consider finding some work or study program that will take you more directly to international/public health work even without the nursing or medical degree. Working with such programs then might help you gauge which path (if either) would suit your goals better. It may not be worth investing in a clinical degree - at least not initially, when you're not sure what you'll be doing with it anyway. You can always take some advanced first aid and/or EMT classes to learn some basic hands-on skills.

If I were you, I'd start by finding organizations doing something I'm interested in and then try to contact someone in the organization to find out more about professional roles, volunteer opportunities, etc.

It can be frustrating to have so many goals and visions and not knowing how to get there and being afraid it will take forever. But you can only take one step at a time. Good luck!