Introducing the student forum

From the editorial board

In this new section of MTb, we welcome contributions from (medical) students who at some point during their studies have written a thesis or a paper, for instance as part of a course in tropical medicine or global health, or after an elective, internship or research period abroad. Only abstracts will be published, while the full report will be made available on the NVTG website. Contributions should have a maximum of 300 words including title, name, affiliation and e-mail address; see also Author Instructions (www.nvtg.org). All contributions will be subject to review by the Editorial Board and selected on the basis of excellence, relevance and style.

In developing countries, hospitals and their patients hardly profit from international medical students doing internships

ANNE VLAK
1ST YEAR STUDENT ERASMUS MC, ROTTERDAM, THE NETHERLANDS
ANNEVLAK@LIVE.NL

Report for STOLA course on Tropical Medicine 2016

Abstract

A short-term medical internship is popular amongst medical students. The benefits for students include a chance to experience another culture, learn a new language and gain some practical experience. Unfortunately, the advantages to the receiving hospital and their patients are less clear, and there are many downsides to these internships. Students are often underprepared for the circumstances in which they will work and problems they will face, such as ethical dilemmas that arise in a low-resource setting, obtaining informed consent in another language or diagnosing locally endemic diseases. Additionally, students are sometimes asked to carry out treatment independently that they are not yet qualified for in their home country. This leads to higher risks for the patient. Finally, medical staff need a lot of time to explain procedures to incoming students, while they are busy with other tasks. Some recommendations for solving these problems are: abolishing short-term internships in favour of longer lasting internships; offering internships abroad later on in the study, when students are more experienced; offering internships in the form of exchanges, so that foreign medical students will get a chance to gain experience in the Netherlands; and explicitly prohibiting students from doing procedures for which they are not qualified. More awareness regarding the downsides to medical internships abroad is needed.

[Image: Silhouette of a person with a graduation cap]

The need for mental health screening of refugee children in the Netherlands

Report for STOLA course on Tropical Medicine 2016

Abstract

Sixty thousand refugees applied for asylum in the Netherlands in 2015. Roughly one third of them are children. A lot of these children have fled from a warzone and may have experienced traumatic events. These children therefore have an increased risk of developing psychological problems. In this article, I advocate for mental health screening of all refugee children based on questionnaires, based on the following arguments.

Mental health screening is necessary because all children are entitled to the best medical help regardless of their nationality, financial situation or residence permit, under the Children’s Convention of the United Nations and the reception standards for under-age refugees in the European Union.

This screening will enable an earlier detection and treatment of the psychological problems that refugee children might have. This will not only result in a reduction of subsequent consequences for the refugee children, but also in a reduction of financial costs for Dutch society.

Finally, psychometrical research shows that questionnaires are reliable as a first step in the detection of psychological problems. Questionnaires also have the advantage that they cause fewer communication problems, involve multiple respondents in the investigation, thereby improving their validity, and are cheaper than conducting interviews.

I also address the controversy in academic literature about the cross-cultural validity of psychiatric diagnoses worldwide, as this might present a counterargument against my thesis that mental health screenings should be performed. I point to a recent review of Hinton et al. which concludes that, based on biomarkers, epidemiological studies and factor analysis, the diagnosis of PTSD is valid worldwide.

My recommendation is to implement mental health screening for all refugee children. Questionnaires can be downloaded for free from: http://www.childrenandwar.org.

FULL ARTICLES (IN DUTCH) AT WWW.NVTG.ORG