Thank you for your interest in Selian Lutheran Hospital and/or the Arusha Lutheran Medical Centre. If you decide to participate, we will offer you an experience in which you will be exposed to:

1) Tanzania and the Swahili language

2) Clinical tropical medicine (clinical parasitology and AIDS in particular)

3) Primary Health Care in a third world country

4) The rewards of medical missionary work

If this sounds like the kind of program which interests you, you need to apply to the Evangelical Lutheran Church in Tanzania – North Central Diocese  for acceptance into our program. Your application should be emailed to Dr. Mark Jacobson, coordinator of medical student and resident rotations. Your application should address the following points:

1. Why you want to participate in our program
   
   
2. What you expect to gain from the rotation
   
   
3. What you feel you can contribute to our work
   
   
4. Any experiences or studies that have helped prepare you for such a rotation
   
   
5. A statement of approval of the Selian externship or residency rotation from your medical school
   
   
6. Your plan to read about Africa and study tropical medicine under the supervision a faculty member of your program prior to coming to Arusha
   
   
7. Your resume or CV
   
   
8. A photocopy of the first pages of your passport

The minimum externship at Selian is eight weeks and the minimum residency rotation is four weeks. We typically have four students and one or two residents doing rotations at the same time in order to maximize and individualize the experience.

SELIAN LUTHERAN HOSPITAL AND ARUSHA LUTHERAN MEDICAL CENTRE

Selian Lutheran Hospital is a 125 bed hospital in northern Tanzania. The hospital and the affiliated Arusha Lutheran Medical Centre  serve 100,000 outpatients per year, perform 200 surgical procedures per month, and do over 30 deliveries per month. Bed occupancy averages 60 to 90 patients. Common medical and pediatric diagnoses are malaria, AIDS, TB, upper respiratory infections, pneumonia, diarrhea, and amebiasis. The Community Health Project is the community outreach and preventive component of Selian's and the Lutheran Diocese's health work. It serves in AIDS, Tuberculosis, Nutrition, School Health Education, AIDS Education, and Home Based Hospice Care (click here to see slideshow), and has a working relationship with the Traditional Birth Attendants of the surrounding villages.

Externship: The externship consists of working on the wards with a team that may include Advanced Medical Officer students, interns, residents and an attending physician. Externs may also do outpatient medicine in one of the hospitals' clinics and have opportunities in rural medicine at one of the remote dispensaries. Some students may choose to go to remote health care settings with the Flying Medical Services of the Catholic Church (click here to see slideshow).

Residency rotations: Residency rotations are similar to the externships except for an increased level of responsibility on the wards, especially teaching.
At the present time  externs and residency rotations are based at Selian with some possibilities of following consultants into the new Arusha Lutheran Medical Center; www.almc.habari.co.tz

Expectations
Rotation:

1. Be present at rotation site 5 work days per week.
2. Be present for morning chapel and report.
3. Generally hours are from 8:15 until 3:30 pm
4. Attend patients on your service as part of the team of care providers.
5. Take leadership for the care of some patients on your service.
6. Review treatments for patients in the National Standard Treatment Guidelines.
7. Participate in “In House” call overnight twice during your rotation.
8. Participate in the hospital CME and the newly created clinical CME (for students, interns, and AMO students).  Present one CME session based on a case you cared for during your stay.
9. When rounds are finished early in the afternoon, you are encouraged to gain other experiences.  Helping in the OPD or AIDS clinic,scrubbing for surgery, and assisting with deliveries are options. 
10. We really would like you to do some observational review while here.  Look at what is coming through the door, look at outcomes or complications, compare current treatment guidelines to say WHO Standards.  We have a “Medical Newsletter” that we would like your review submitted to.
11. Fill out an evaluation concerning your rotation and discuss with Dr. Eggert, Wagener or Jacobson.

General:

1. Dr. Kipuyo is responsible for Selian Hospital, but as students or residents, you work directly with the “In Charge” of your service.  Dr. Amon is effectively the “Director of Clinical Services” and very approachable on issues of patient care.  Drs. Jenny Wagener and Ron Eggert will help you in getting oriented and adjusting to hospital routines and procedures.
2. Safari time is encouraged yet it is normally considered to be at outside the counted weeks of your rotation.  We are flexible though as opportunities can arise on short notice.  Approval for significant time away from the rotation should be obtained from Dr. Wagener or Dr. Eggert with notification to Dr. Jacobson.
3. Generally, while you are learning how and why things are being done the way they are here, you want to be assessing practices based on your own learning and books.  Where there are clear differences, they should be discussed with the rest of the team and the doctor in charge of the service. 
4. There are other opportunities which can arise while you are here.  Flying Medical Service will take students to help with their rural clinics when they are short staffed -- Sarah Rejman can help to arrange these trips.  Mrs. Jacobson takes students to help teach and care for students in some of the special needs schools and university programs around Arusha.  Plaster House can always use assistance.  Spending time with the Hospice team is highly recommended. The outpatient clinic at Mto wa Mbu (near Lake Manyara) accepts students and residents for several days to a week – Dr. Kipuyo will help with that arrangement.