Student Training Education Program (STEP)

The FACES training program for medical students, health professional students, and residents is a collaboration between the Kenya Medical Research Institute, the University of Nairobi, the University of California San Francisco, and the University of British Columbia.

Clinical Electives

Clinical electives are available to medical students who are in their clerkship year/s of study, and to residents.  To benefit both the participant and the program, clinical electives must be at least 6-8 weeks.  However, it is recommended that elective students stay for a minimum of 8 weeks to include more than one site. Learners who join FACES for a clinical elective at any of our sites will be involved in the following activities:

  • Patient Care: Clinical care of HIV positive adults and children in a family-centered outpatient clinic.
  • Home visits: Follow-up of patients in the community.
  • Hospital visits: Hospital visits to our patients who require inpatient care.
  • Multidisciplinary team meetings: In-depth discussions to develop or modify care plans for particular patients and their families.
  • Clinical team meetings: Weekly case-based clinical discussions.
  • Internal CME program: Weekly CMEs on various relevant topics.  Learners will be required to present at least once during their rotation (if space is available), as well as present a case during M&M rounds (held monthly).  Each site also hosts a full-day Saturday staff training on alternate months.
  • Student/Resident projects: Learners will be assigned one or two projects to complete during their elective.  The projects are chosen based on program needs and learner interests.  Learners are encouraged to think of potential projects when they apply.
  • Residents will assist with the clinical supervision of medical students, as well as run “physical examination skills” sessions for staff.

Site-specific opportunities:

Nairobi

  • Attend to patients at the Comprehensive Care Clinic.
  • Home visits in some of the largest urban slums in Sub-Saharan Africa.
  • Visits to Orphans and Vulnerable Children (OVC) centers.
  • Weekly CMEs with ID and Paeds consultants.
  • TB updates – laboratory and community projects.

Kisumu
Have the unique opportunity to work in two of the busiest HIV clinics in Kisumu, the third largest city in Kenya: Lumumba and Kisumu East District Hospital (KEDH).

  • Join the clinical teams as they visit different facilities within Kisumu East District and gain an understanding of the diversity of the HIV program in the district (a mix of rural and urban).
  • Attend weekly CMEs on Thursdays as well as multidisciplinary meetings.
  • Conduct home visits with members of social sciences department as they trace clinic defaulters and attend to patients with special needs.
  • Attend regular Journal Clubs to discuss HIV-related articles.
  • Attend ward rounds at the busy Kisumu East District Hospital.

Suba
Suba, a district bordered by Lake Victoria, has many islands with friendly and welcoming members of staff and the community.

  • Participate in scheduled clinical visits to peripheral facilities on the mainland e.g. Kisaku, Tomboya, Kitare, Nyandiwa.
  • Conduct ward rounds at the District Hospitals (Mbita and Suba District Hospitals).
  • Participate in CMEs and Case Discussions at the hub and peripheral sites.
  • Participate in the weekly staff meeting.
  • Visit the islands: Mfangano any day of the week, Ringiti mobile clinic every Tuesday, and Remba mobile clinic every Thursday.
  • Be a mentor and mentee as we strive to learn from each other.

Migori
Experience a rural environment that is slowly becoming urbanized in a town situated near the Kenyan and Tanzanian border (Sirare) where you will:

  • Work in a busy Comprehensive Care Clinic Mondays through Thursdays at Migori District Hospital. The hospital provides HIV/ART care, family planning, Prevention with Positives (PWP), Provider-Initiated Testing and Counseling (PITC), and counseling services.
  • Conduct daily inpatient rounds in Maternity, Pediatric and Adult Wards.
  • Rotate in outpatient departments: maternal and child health clinics, TB clinic, Gynae Clinic, and Medical Outpatient Clinic.
  • Participate in activities within the maternity unit, eg. conducting deliveries and postnatal care.
  • Take part in visits to 24 peripheral clinics within the district accompanied by district technical team; these include Ogwedhi, Nyamaraga, and GodJope with very busy HIV clinics.
  • Participate in Community Strategy activities: dialogue and action days, defaulter tracing, home visits, children’s clubs, and support groups.
  • Perform Voluntary Medical Male Circumcision at the District Hospital.
  • Attend and participate in weekly CMEs, case discussions and multidisciplinary team meetings.

Rongo
Experience a true African rural environment in Rongo District, strategically situated between the three large towns of Kisii, Migori and Homa Bay where you will:

  • Conduct regular ward rounds at the district hospital.
  • Mobile teams: Make visits to satellite sites of Ongo, Oyani, Othoro and Lwala in one of Kenya’s largest sugarcane growing areas.
  • Attend weekly CMEs at the Rongo District Hospital.
  • Attend to patients at the Patient Support Centre / Comprehensive Care Clinic.
  • Perform male circumcision both at the district hospital and peripheral sites.

Project and Research Electives

Research and project electives are available to students and residents at any level of training, for a minimum of 8 weeks.  Projects are usually specific program-related tasks that the learner will see completed from start to finish, whereas research electives generally involve taking on a specific role in a study that is underway.  Students that are coming for long-term electives (6 months or more) are encouraged to work with the research team to develop and conduct new studies.

FACES and its associated research projects currently have ongoing studies focused on sexually transmitted infections and HIV treatment and prevention.  Current investigations include HSV-2 suppression with acyclovir to prevent HIV transmission in discordant couples, the acceptability and efficacy of a microbicide among young women and adolescent girls, and the impact of antiretroviral therapy scale-up on sexual risk behaviours. The Nairobi site currently has a research project on ART adherence.  Future studies may include immunologic and virological evaluation of ART response, resistance to ART and evaluation of smear negative tuberculosis among HIV infected adults.  There are also many operational research questions to be addressed within FACES.

  • Learners will generally start working on the project or study before arriving on site, and may need to continue their involvement upon return to their home institution.  We encourage these electives to be undertaken as a partnership between Kenyan medical students and North American medical students and residents.
  • Research or project electives can not be combined with clinical electives except for during long-term electives.

Supervision

Trainees who are self-motivated, flexible, and able to work independently will thrive on STEP electives. STEP participants will always have someone available to mentor, assist, and refer to but should not anticipate 100% one-on-one supervision.

Clinical electives are usually supervised by the assistant program coordinator at each site. Clinical mentoring is provided by on-site staff, including medical officers and clinical officers, as well as by residents on elective when appropriate.

Research electives include remote and direct supervision. Off-site staff are available through e-mail and conference calls, and may be available for face-to-face discussions at the learner’s home institution before and after the elective.

Craig Cohen, MD, MPH
Principal Investigator, FACES
Professor, UCSF Department of Obstetrics, Gynecology, and Reproductive Sciences
On-site at UCSF for pre-elective planning and post-elective write-up. Off-site support through e-mail and telephone, and approximately 10% time in Kenya.

Elizabeth Bukusi, MBCHB, MPH, MMed (OB/GYN), PhD
Co-Principal Investigator, FACES
Honorary Lecturer, U of Nairobi Department of Obstetrics and Gynaecology
Chief Research Officer, Centre for Microbiology Research, KEMRI
Off-site support through e-mail and telephone, and on-site support in Kisumu approximately 20% time.

Christina Mwachari, MBCHB, MPH, PhD
Co-Principal Investigator, FACES
Senior Research Officer, Centre for Respiratory Disease Research, KEMRI
On-site full time in Nairobi.

Patrick Oyaro, MBCHB
Country Director, FACES
On-site full time in Nyanza Province.

Lisa Dillabaugh, MD
FACES Program Adviser
Instructor of Pediatrics
University of Colorado, Denver
Primarily based in U.S.

Julie Kadima, MBCHB
Program Coordinator/Medical Officer/STEP Coordinator, FACES Nyanza
On-site full time in Nyanza Province.

Lucy Sanguli, MBA
M & E Coordinator, FACES Nairobi
Centre for Respiratory Disease Research, KEMRI
On-site full time in Nairobi.

Costs

There are no application or elective fees, but students are responsible for all of their own expenses including international and local travel, food, and accommodations.  Discounted student housing may be available.

Application Procedure

Electives with FACES are open to medical students and residents from any institution, however priority will be given to those from University of Nairobi, University of California San Francisco, and University of British Columbia. We will also consider applications from people in other health-related fields of study.

Requests for clinical electives will be reviewed on the following schedule:

January 10, for UCSF Global Health Fellows Resident Program
February 1, for elective requests from June through until end of September (and any slots that have remained vacant for the period between February and June)
June 15, for elective requests from October through until end of January (and any slots that have remained vacant for the period between June and October)
October 1, for elective requests from February through until end of May (and any slots that have remained vacant for the period between October and May)
Requests for summer projects (non-clinical) will be reviewed March 1st each year.

Requests for research electives will be reviewed on an ongoing basis.

The following application material must be submitted electronically to Kimberly Bale, at: BaleK@globalhealth.ucsf.edu

  • Letter of Interest: A letter outlining reasons for interest in the elective, including relevance to future career goals. This should include the type of elective you are requesting (clinical or non-clinical), your site preference, and the dates you would like to come (maximum 1 page) Save document as: lastname.firstname.letter.doc
  • Statement of Objectives: Your general and specific objectives for the elective (maximum 1 page). Save document as: lastname.firstname.objectives.doc
  • Curriculum Vitae: Save document as: lastname.firstname.CV.doc

You will receive e-mail confirmation of receipt of your application, and will be contacted with a decision within 1 month of the application review date. If you would like more information about elective opportunities with FACES, please contact:

Kenya:
Dr. Elizabeth Bukusi, at ebukusi@rctp.or.ke

USA:
Dr. Craig Cohen, at CCohen@globalhealth.ucsf.edu
Kimberly Bale, at BaleK@globalhealth.ucsf.edu

Other countries: contact any of the above

Orientation Materials

Evaluation Forms

Students and residents are required to complete a participant evaluation at the end of their elective, as well as be evaluated by their primary mentors. Click the links below to access the participant and supervisor evaluation forms: