Physician Assistant/Pre-PA Internships Abroad | IMA

This trip was truly life-changing and inspiring, and I am very thankful for all of the staff for their amazing support through the process. I loved everything—the food and culture were beyond amazing. I want to give a shout out to my bestie Janet; she accompanied me through my weekend treks. I had a blast with her, and I’m so glad she’s the one that went with me. I never felt unsafe during my time in Kenya, and for that I am so appreciative. I think one of the most positive experiences I made on this trip were the friendships I made, but also the community outreach events we had. There was nothing more eye-opening than going to underprivileged communities and providing the extra support that they desperately needed, which is proper healthcare. I am so blessed to have been able to experience something like this with such a well rounded program. Thank you!! The first time I heard about IMA, I was immediately intrigued. I remember seeing the program, and it fueled my curiosity that had been growing ever since I thought about doing an internship. The idea of actually getting accepted into such a program felt almost far-fetched. I have never taken the time to apply to anything like this before, so the idea of stepping into this opportunity was so thrilling yet nerve wracking. I was lucky enough to have a supportive circle around me—people that encouraged and reminded me that I was capable of doing anything I set my mind to. With enough convincing, I applied. In my mind, I thought, “What’s the worst that could happen? I don’t get accepted—or I could end up having the craziest experience in Kenya.” Fast forward a couple months, and I find myself at the Royal Suites residence, staring in awe at what the next three weeks of my life would hold. I was greeted by a wonderful group of peers and staff, and from that moment, I knew I would be in good hands. Walking into this program, I had some experience as a medical assistant in a neurology office. However, that was completely different from what I encountered at Coast General Teaching and Referral Hospital. I vividly recollect the first day I arrived at the hospital, knowing I would encounter far more striking cases than those back home. During my time there, I rotated through the Emergency, Pediatrics, and Surgery departments, and I also participated in night rotations at least once a week in other departments. Before beginning, I received an orientation that included discussions on what to expect in terms of medical cases, as well as the local culture and customs. I was told that healthcare in Kenya was severely understaffed and poorly supplied due to location and financial reasons (Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Kenyan, n.d.). I was also informed that many patients present with advanced stages of illness, often as a result of financial constraints or religious beliefs. During my time in the Emergency Room, I saw many patients that would arrive with advanced cancers, severe infections, and untreated wounds. When asked about the situation, the most common response was that they simply did not have the money for treatment. Others would say the nearest medical facility was too far from their homes, requiring them to strategically plan when they could make the trip. One response in particular really struck me: a patient’s family explained that they were relying on prayer to heal their loved one, believing it was best to let God provide the cure. As a believer myself, I was impacted and inspired by that statement. However, it was hard to reconcile because many of the situations I saw needed urgent attention. In those moments, it felt challenging to accept that faith alone was being relied upon in circumstances where timely medical care was critical. There are many traditions of healing and medicine that Kenyans use. Various natural remedies are commonly used such as African potatoes, rooibos, and the hoodia cactus. Additionally, there are rituals that are performed for spiritual healing. For example, shells, bones, and stones are used to communicate with ancestors or spirits to learn more about the patient’s health condition (Brooke, 2023). When I was in the hospital I never encountered someone that firmly believed in these practices, but I heard from the nurses around that it was used by many patients. In terms of patient care, I witnessed a wide range of cases. Being in a public hospital, I observed severe understaffing as well as lack of essential tools equipment. There were many moments when I would instinctively look for an instrument we would normally have back home, only to find it unavailable. In those situations, we often had to improvise and make do with what was already on hand. I vividly recall one night during a shift a patient began coding. One of the nurses was desperately searching for a BVM (bag valve mask), going drawer by drawer in an attempt to find one. The search took four or five minutes, and by the time the mask was finally located, the patient had already been declared deceased. I don’t know if the patient would have survived had the mask been found and used sooner; regardless, the situation highlighted the critical lack of necessary resources. Another example of improvisation was when gloves were used as tourniquets, which led to supplies running out more quickly. I remember one shift in the PICU, I was reminded that one of the mothers that gave birth to two beautiful boys was in intensive care due to birthing complications. One of the nurses approached me and one of my peers, asking if we were interested in feeding the babies. Without hesitation, we both agreed. I have never fed a premature baby before, so I was incredibly nervous and assumed there would be a machine of some sort. I was wrong. We had to use a syringe, carefully letting the milk independently go through the tube. This process was time-consuming, as we had to hold the syringe up in the air to allow the milk to flow, which took roughly ten to fifteen minutes. At times, the milk would get stuck in the tubes or even harden, creating additional challenges. I remember hearing that these methods were used back in the day, so it wasn’t uncommon—just time-consuming and requiring extra attention. Typically, Nairobi and the Central Province are considered to offer the best public healthcare, while the North Eastern Provinces are generally more underdeveloped in terms of medical infrastructure and resources. There are private hospitals in Nairobi that are very respected and known to be top tier (Healthcare in Kenya, n.d.). After all that I have learned during this trip, I returned home with a deep sense of appreciation for the healthcare providers I had worked alongside, as well as a strong desire to continue learning more about global healthcare practices and the challenges faced in resource-limited settings. Witnessing the dedication of the healthcare providers who worked tirelessly despite limited supplies and overwhelming patient needs gave me a deep sense of respect and admiration for their commitment to their patients. I recall all of the conversations I had with the providers and students—one thing was clear: they all shared a deep love for the field. They acknowledged that their work could be challenging and frustrating at times, yet none could imagine doing anything else. There was genuine passion and grit behind every single provider, evident in the care they provided and the dedication they showed to their patients. I witnessed what it was like to think quickly on my feet and rely on the limited skills I had. These experiences taught me that healthcare isn’t just about medicine—it’s about human connection, understanding, and trust. I will be sure to bring these lessons into my career by prioritizing empathy, effective communication, and cultural sensitivity. I’ve always had a deep passion for healthcare, shaped both by my childhood interests and personal experiences. This trip has only intensified my passion, leaving me with a strong desire to learn and do even more in the field. I fully plan to return to Kenya and work at Coast General once I am a certified Physician Assistant, so that I can gain more practical experience while contributing to the healthcare system and properly helping patients in need. My time in Kenya was transformative. It exposed me to the realities of healthcare in resource limiting settings, challenged me to develop critical thinking skills and adaptability, reignited my passion for healthcare, and strengthened my commitment to pursuing a career as a Physician Assistant. I am determined to apply all that I have learned in every aspect of my future practice—fully dedicated to serving patients with compassion and cultural competency while continuing to seek opportunities to learn and grow as a healthcare professional. Beyond the clinical skills, this experience taught me the importance of patience and resiliency. This applies to myself and the patients. I learned how small gestures like listening, showing empathy, and providing reassurance can have a profound impact on the patient’s wellbeing and steps to recovery. Allowing myself to see how other providers navigate such a challenging system inspired me to think of more solutions and think proactively about improving healthcare, even in similar situations where resources are limited. I have gained an appreciation for proper teamwork and collaboration. It was refreshing to see how providers rely on one another to manage heavy workloads and ensure the patients’ comfortability—some demonstrated it better than others. This experience has diligently motivated me to approach my future career with a humbled mindset of service, humility, and continuous growth. Every patient encounter is an opportunity to make a meaningful difference. I am now more committed than ever to properly advocating for patients, embracing diverse perspectives, and integrating proper cultural competency in all aspects of my future practice.

My experience in Kenya with International Medical Aid was incredible. The in-country support was excellent, and I always felt safe thanks to clear guidance and protocols. Accommodations were comfortable, and the food was a wonderful introduction to Kenyan cuisine. The clinical experience was invaluable. I got to shadow PAs and physicians, learning how they provide compassionate care even with limited resources. My mentors Mitchel, Margaret, Benson, and Hilda were especially amazing; they guided me, answered questions, and made the experience meaningful and inspiring. Overall, this program deepened my understanding of healthcare, strengthened my communication and cultural awareness, and reinforced my commitment to becoming a healthcare provider. It was a truly memorable and transformative experience. I came to Mombasa, Kenya, with a curiosity about global healthcare. What I left with was far more than observation—I left with a deeper understanding of resilience, compassion, and the creativity required of healthcare providers in resource-limited settings. My two weeks at Coast General Teaching and Referral Hospital through International Medical Aid shaped not only my perspective on medicine, but also the kind of provider I aspire to become. The resource-limited setting of a Kenyan referral hospital highlighted the importance of adaptability, clinical judgment, and teamwork in medicine. It also deepened my appreciation for cultural competence and reinforced my desire to pursue a career that bridges patient care with compassion, equity, and access. I reflected throughout my internship on how these lessons shaped my personal and professional goals, and how I plan to apply this knowledge to my future career in healthcare. My first week at the hospital was spent in pediatrics, including the High Dependency Unit, the inpatient ward, and the outpatient clinic. Each area exposed me to different aspects of pediatric medicine and highlighted the challenges of providing care in a resource-limited setting. In the High Dependency Unit, I saw children critically ill with conditions such as malaria, pneumonia, and severe dehydration. With limited monitoring equipment, providers relied heavily on careful physical exams and clinical judgment. Watching physicians and nurses act with such precision reminded me that medicine depends as much on knowledge and presence as it does on technology. I also noticed how central families were to care—mothers and caregivers often stayed at the bedside, feeding and comforting their children. It underscored for me that treating a child means supporting the entire family. The inpatient ward was crowded but full of resilience. Children admitted for longer-term care still found ways to laugh, play, and smile, even while battling illness. This reminded me that pediatrics requires not only medical skill but also creativity, optimism, and patience. The outpatient clinic emphasized communication and trust. I shadowed physicians and medical students as they diagnosed fevers and infections, counseled parents, and provided follow-up care. One memorable encounter was a mother worried about her child’s persistent cough. The physician took time not only to examine the child but to reassure her and explain how to monitor symptoms. That interaction showed me how powerful reassurance and education can be. That week in pediatrics taught me that medicine is not only about addressing immediate illness but also about building trust, supporting families, and adapting to circumstances. The lack of abundant resources revealed how powerful strong clinical reasoning, communication, and compassion can be. As an aspiring PA, I want to carry these lessons forward by becoming a provider who combines medical expertise with cultural sensitivity and emotional intelligence. In the United States, I may not always encounter the same level of resource scarcity, but disparities still exist. This experience showed me that effective providers don’t just treat patients; they meet them where they are, partner with their families, and offer care that is both competent and compassionate. During the second week of my internship, I rotated through the emergency department, including both adult and pediatric units. The emergency department was fast-paced, unpredictable, and often chaotic—a contrast to the structured environment of the outpatient clinic. I witnessed cases ranging from acute infections to trauma. One case that stayed with me was a toddler with severe malaria whose rapid deterioration required immediate intervention. Observing how the team coordinated care under pressure highlighted the importance of quick decision-making and clear communication. Another case involved a man who was involved in a street traffic accident and sustained a significant injury to his face, including a compound fracture and mandible dislocation. The attending physician quickly assessed the situation, coordinated imaging, and explained the care plan to the anxious patient. Observing this interaction, I realized how crucial clear communication is—not just with the patient but also with the family. Every word mattered in building trust and helping the family feel involved in care decisions, and it made me feel content with how everything was handled. The adult ED presented different challenges. Patients often arrived with complex conditions, and resources were limited compared to what I have seen in U.S. hospitals. I saw providers rely on careful observation, prioritization, and creative problem-solving to stabilize patients efficiently. Overcrowding was common, and staff had to make rapid decisions about who required immediate intervention versus who could wait. I had the opportunity to observe the triage process firsthand, watching nurses and physicians quickly assess vital signs, symptoms, and overall condition to determine urgency. This experience emphasized the importance of staying calm under pressure, making swift decisions, and trusting one’s clinical judgment—skills I hope to carry forward as a future physician assistant. Beyond clinical skills, the ED also highlighted the human side of medicine. Many patients were in distress not only from illness or injury but also from fear, uncertainty, or socioeconomic stressors. I observed how providers offered reassurance, listened attentively, and made patients feel heard even in brief interactions. This reinforced a lesson I had learned in pediatrics: effective care is not just about diagnosis and treatment, but about empathy, communication, and emotional support. Experiencing this firsthand strengthened my desire to pursue a career where I can provide competent and compassionate care, especially in moments when patients are most vulnerable. During my overnight shift in the Labor and Delivery ward, I witnessed the intensity, urgency, and profound humanity of bringing new life into the world. Even though my time there was brief, I observed the critical teamwork between medical officers, nurses, and midwives, and how every decision carried weight for both mother and child. I was shocked to learn that epidurals were generally not offered unless the mother was undergoing a C-section, and I felt for the women laboring without this form of pain relief. Seeing their strength and resilience firsthand was both humbling and inspiring. I also had the opportunity to view a C-section, which was an eye-opening experience. Observing the surgical team’s coordination and focus, as well as the immediate transition of the newborn to care, highlighted the precision and teamwork required in critical situations. This experience reinforced lessons I had already begun to understand in pediatrics and the emergency department: medicine is not just about technical skill, but also about empathy, communication, and presence. Providers balanced clinical urgency with compassion, comforting patients and offering reassurance even in high-stress moments. Being in the ward overnight gave me a deep appreciation for the emotional and human side of healthcare and reminded me that being a provider is as much about supporting people through life’s most vulnerable moments as it is about treating disease. These lessons strengthened my aspiration to become a physician assistant who can deliver competent care while also connecting with patients on a human level. Mombasa County has a higher HIV prevalence than the national average, and that statistic became profoundly real during my time at the hospital. I encountered numerous patients—both adults and children—whose lives were directly affected by HIV. The emotional weight of these encounters was palpable, especially when discussing treatment plans and the challenges of medication adherence. One particularly memorable interaction involved a mother in the pediatric ward, deeply concerned about her child’s health. The physician took extra time to explain the child’s condition, the importance of antiretroviral therapy, and the need for consistent follow-up care. Witnessing this compassionate communication underscored the significance of not only medical treatment but also emotional support and education in managing chronic conditions like HIV. My two weeks in Mombasa were transformative, offering lessons that extended far beyond clinical knowledge. From pediatrics, I learned the power of observation, clinical reasoning, and compassion. The emergency department taught me adaptability, rapid decision-making, and the importance of clear communication under pressure. Labor and Delivery showed me the courage and resilience of patients and the teamwork required in critical moments. Encountering patients affected by HIV deepened my appreciation for the intersection of medical care, patient education, and emotional support. I realized that effective healthcare requires not only knowledge and skill but also cultural sensitivity and the ability to support patients through their most vulnerable moments. Together, these rotations solidified my desire to become a physician assistant who can provide competent, compassionate care in a variety of settings. I am inspired to carry forward the lessons I learned in Kenya—the importance of empathy, communication, adaptability, and partnership with patients and families. This internship has not only reinforced my commitment to healthcare but has also shaped my vision for the kind of PA I aspire to be.

My time in Cusco was amazing, and I really appreciated everything and all the staff who took care of us. Juda, Manuela, and Surabhi were all very helpful when it came to asking them questions about the program, and they were equally helpful when we asked questions about Cusco, such as restaurant or shop recommendations and how to navigate around the city. I have no complaints with any of the doctors; all of them were super nice and answered any of our questions. Particularly, Dr. Silva and Dra. Yadhira stood out to me, and I really liked their approach to medicine. Lastly, I participated in the Machu Picchu trek, and I want to shout out Hans and Raul, who were our guides. They were amazing and very accommodating. I am a slow hiker, so Raul stayed back with me and my friend so that we wouldn't get lost or be unsafe. They were also very fun and did karaoke with a few of us after the trek, which is forever going to be memorable for me. Overall, I have no complaints with any staff. I also want to shout out Victor for being the best driver, and all of the staff in the hotel for all their hard work. My experience being a pre-Physician Assistant intern through International Medical Aid (IMA) in Cusco, Peru is an experience I will be eternally grateful for—not only because it was a determining factor in why I want to pursue medicine, but also because I learned so much from the social and medical culture in Peru. A reason I applied specifically to the Peru location is because I never hear much about South America as a whole in U.S. media, and if I do hear about it, they only mention the “dangers.” However, the three weeks I have spent here gave me so much growth and knowledge about Peru. I was able to connect deeply with the mentors and other locals in the city of Cusco, and getting to talk to the doctors about their experience in the medical field was eye-opening. Coming to Peru was like finally understanding the expression, “Don’t knock it till you try it,” because all my preconceptions were erased and replaced with true knowledge of the culture and the socioeconomic structure. Ever since I was younger, I was always interested in the medical field, and as I grew up, I started to become more and more aware of how medicine is run in the U.S. I am lucky to have grown up in a household where we are able to afford sufficient insurance, so personally, I have never dealt with the hardship of large medical bills, but through personal research, I have learned how difficult it is for people of low socioeconomic status to get proper insurance and medical care. In the United States, healthcare is not free, but as I learned in Peru through our cultural presentation sessions, all Peruvians have the right to universal healthcare. Though I did not know this before coming to Peru, I was not shocked. It is rarer to see countries that do not provide free healthcare, such as the United States. One of the largest ongoing debates is whether the U.S. should pivot to a universal healthcare plan; some of the disadvantages include “significant upfront costs and logistical challenges,” while the advantages could create “a healthier populace and thus, in the long-term, help to mitigate the economic costs of an unhealthy nation” (Zieff et al., 2020). Due to the U.S. having an extremely advanced healthcare system that can offer some of the best care and procedures for extremely unique cases, many people disagree with the idea of offering a universal plan because it will create more complications in how healthcare should be divided. However, the latter perspective suggests that having an option of universal healthcare will create a healthier America and illness in our population will decrease. Furthermore, in Peru, the way healthcare works is that everyone has access to universal healthcare, but if they are employed, they can opt in to affordable insurance that gives them access to more advanced hospitals such as EsSalud, which is a division 3-1 center. The level of care there is not entirely comparable to the advanced care in the U.S.; however, these hospitals provide general and some specialized care, which is considered high level. The highest level of care in Peru is division 3-2. These centers contain sub-specialized fields and are only found in the capital, Lima, because it is the most populated city (International Medical Aid, 2025). This is unfortunate because if someone were to have a unique medical emergency, they would have to be rushed to Lima to get quality care, while in the U.S., it is common to live closer to hospitals with specialized care. During our time with IMA in Cusco, we also made a short trip to a nearby rural city called Casacunca, where we held a community clinic to help and provide medical attention to the citizens of the city. As we learned in our clinical debriefing sessions, most of Peru’s population is in the large cities such as Lima and Cusco, but there are a vast number of rural cities that, unfortunately, rarely get medical attention, so it was amazing that we were able to assist those who deal with this misfortune. Through my American perspective, I initially thought it was so unfair that people who live far from major cities hardly ever seek medical attention from doctors, and I believed it was almost diabolical that the government hasn’t expanded and created more large hospitals in these regions. However, as I learned by being in the rural cities in Peru, a lot of the citizens do not go to physicians and/or do not believe in Western science and instead prefer herbal medicines and advice from shamans/healers. This is because they strongly believe in the powers of traditional medicine, and access to it is more proximal (van Soeren & Aragon, 2016). In contrast, in Cusco, more people tend to turn to Western medicine because they have access to it, and the EsSalud hospital and many clinics we shadowed at are examples. In an even larger contrast, in the United States, we are the pinnacle of Western medicine—so much so that we try to cure anything and everything with medicine or medical treatment. The U.S. also spends the most out of all wealthy countries on healthcare, which allows us to have many advanced hospitals and medical technology throughout the country. However, we still see a lot of problems with the health of our citizens (PFPG, 2022). Even with this level of spending, we see high infant mortality rates, unmanaged diabetes, and more (PFPG, 2022). This shows that maybe Western medicine is not always the cure for medical problems, and instead there should be a balance between traditional and Western medicine. In one of my classes in college, I learned how if someone is pre-diabetic, instead of instantly starting insulin doses, they should invest in caring for their diet by cutting out artificial sugars and eating more protein. Ultimately, from my knowledge of Western and traditional medicine, I believe that they are both valuable and people should research both when they are looking for a “cure” to what they have. Additionally, through the IMA program, we had weekly presentation sessions, and in one session we specifically discussed the disease burden in Peru. One large takeaway I had from this presentation was that many people die from disease annually in Peru, and some of the main diseases that are killers in Peru are completely managed here in the United States. From the lecture, we learned about the most common communicable and non-communicable diseases found in Peru. Communicable diseases are transmitted between people or other organisms, and the common ones in Peru are malaria, dengue, tuberculosis, and acute respiratory infections (International Medical Aid, 2025). Non-communicable diseases are not spread from person to person, yet they arise due to the individual’s behavior, and the most widespread ones in Peru are hypertension, diabetes, and COPD in adults and anemia and malnutrition in infants/children (International Medical Aid, 2025). Two diseases that stood out to me from being in the lecture and staying in Peru for three weeks were tuberculosis and anemia. According to the lecture, there are about 27,000 cases of tuberculosis (TB) annually in Peru. In the U.S., we have less than half that rate annually, at around 10,347 cases reported by the CDC in 2024 (CDC, 2025). One possible reason that could explain why the U.S. does not experience as many TB cases compared to other countries like Peru is because of our widespread healthcare system. Again, as I have mentioned earlier, U.S. healthcare is considered to be one of the most technologically advanced and is well known for having extremely specialized care. This is most likely the reason why we do not see as many cases of TB, and if we do see them, there is less chance of it leading to mortality. In Peru, healthcare is not as widespread, and what I mean by this is that large hospitals with specialized or sub-specialized care are only seen in the most populated cities. If people are diagnosed with TB in a rural city, they will have to travel long distances to get specialized care in a hospital, and if they can’t afford the travel or do not have access to travel, they have to treat themselves the best they can. This is why TB is extremely prevalent in Peru specifically, and the reason why TB is one of the most deadly diseases in Peru, causing an estimated couple thousand deaths annually (International Medical Aid, 2025). This is why Peruvian healthcare should be more accessible, and this can start with the government allocating more funds to build more division 3 hospitals throughout the country, not just in major cities. Anemia was another disease that I became more familiar with through this internship. Working alongside the doctors and nurses in the EsSalud hospital, I learned that anemia has a different detection threshold in Cusco, Peru in comparison to the U.S. and even other cities in Peru, such as Lima, due to the high altitude. In Cusco, Peru, a detection of 11 mg/dL or below in the hemoglobin is considered anemic, but in the U.S. it is 13.5 mg/dL for men and 12 mg/dL for women (International Medical Aid, 2025; American Society of Hematology, 2025). The high altitude causes there to naturally be less oxygen in your blood because there is less oxygen in the atmosphere, and that is why anemia has a lower threshold in Cusco than in other cities/countries—because Cusco stands at about 12,000 ft, being one of the tallest cities in the world. Anemia is also highly prevalent in infants and children in Cusco, and this is due to malnutrition. Children in Cusco do not eat enough red meat and, in general, have poor nutrition, and I was able to actually see this while shadowing in the pediatric and nutrition departments. Fortunately, most of the doctors I worked with explained that anemia usually goes away after about 3–4 years of age, so it is able to be managed, but they did explain that malnutrition is something that is very common in infants throughout all of Peru, and this is the larger problem. Malnutrition comes with a lot more problems than anemia such as irregular bowel movements, thermal issues, dehydration, and even mortality. Chronic malnutrition in infants in Peru is at levels of 11.5%, and in the U.S. it is about 1%, which shows that our government has more control over infant malnutrition. However, according to the USDA, 1 out of 5 children in the U.S. lack food security, so the statistics on chronic malnutrition could be fluctuating regularly depending on the state of the economy (International Medical Aid, 2025; USDA, 2025). Ultimately, infant malnutrition should not be something prevalent in any country, and it should always be a priority that children have access to sufficient nutrition and meals. To conclude, my pre-Physician Assistant internship with International Medical Aid was life changing and taught me more about medicine and myself. I learned exactly how passionate I am about medicine, and I am grateful that I was able to learn in a new environment where I experienced medicine in ways that I have never seen or heard of before. Now, as I pursue my future career, my perspective on medicine and patient care has broadened, and this is for the better because I can approach medicine with the structured U.S. mindset and also the more interactive Peruvian mindset. I will always remember my time in Cusco, and I cherish it. Thank you for giving me this outstanding opportunity.