Abigail McRea, MD: UNC Chapel Hill Pediatrics PGY2

Kenya: February 2022

 My name is Abigail McRea and I am a second-year pediatric resident at UNC Chapel Hill. I recently traveled to Bomet, Kenya to provide clinical care in Tenwek Hospital for one month. While there, I supervised Kenyan interns on the pediatric wards, PICU, and NICU. We would round in the morning, discuss the plan for the day, and then spend the afternoon coordinating admissions as well as following up on pending tasks from the morning. I also intermittently would take call shifts, which would involve the need to be available for any emergencies or admissions that occurred during the nighttime in the pediatric hospital. The breadth of diagnoses I made was wide and included viral illnesses, septic shock, rabies, malaria, meningitis, malnutrition, rheumatic heart disease, and many congenital cardiac disorders. Having a variety of pathophysiology provided me the opportunity to improve my clinical acumen, think through complex patients with unique diagnoses, and work closely with the local interns to care for these patients to the best of our ability. One challenge I encountered was the ethical conundrum that arises when finances and insurance limit what care we are able to provide. Due to the limitations of the national insurance system, our team had to be very selective in what orders we placed so that we would not unnecessarily bankrupt families. Overall, this trip was very formative and provided excellent learning opportunities as I continue to pursue a career in global health throughout residency, fellowship, and beyond.