2018-08-06 MDB Reflection Victoria Boggiano

Mary Duke Biddle scholar, Victoria Boggiano, MD MPH, and colleagues at Children's Hospital 1 (BVND1) In Ho Chi Minh City.
Photos courtesy of Victoria Boggiano

Rotating at Children's Hospital 1 (BVND1) in Ho Chi Minh City, Vietnam was eye-opening, invigorating, and inspiring. It taught me what it means to provide care with limited resources and when patient volumes are extraordinarily high. The doctors at BVND1 see hundreds of patients in a day - this fact alone completely transformed my understanding of what it means to be a clinician and a healer. These physicians are extremely adept at getting to the root of a patient's story, quickly looking at the patient's medical chart and any imaging and lab tests, and coming up with a plan to continue to provide care. Being in this environment greatly increased my desire to provide care in a global setting.

In particular, I learned that primary care is very new in Vietnam and that the field of family medicine (the field that I myself am pursuing) has only been around for 3-4 years there. Working at BVND1 helped me see that there is a great role for increasing partnerships between the USA and Vietnam to help improve their primary care infrastructure and increase community awareness there about the importance of preventive healthcare.

Dr. Boggiano and her mentor Ms. Sa with BVND1 colleagues.

Over the course of my rotation, I saw a wide range of patients with various complaints. The patient story that will remain with me the most closely involved a child who had been in a near-fatal motorbike accident. The patient had not been wearing a helmet, as is common in southeast Asian countries. The patient was quickly transferred to BVND1 and was in critical condition, with CT scan showing a skull fracture and subdural hematoma. The pediatric emergency department at BVND1 quickly consulted both BVND1's neurosurgery service and the neurosurgery team at Children’s Hospital 2 (BVND2) in another part of the city to determine next steps.

It was amazing to watch the Peds ED team triage with the other services, yet at the same time heartbreaking to see that there were certain tools that are so easily at our disposal in the USA to treat such patients that they had difficulty using in this case. The boy was ultimately transferred out of the Peds ED and onto the neurosurgery service at the hospital, to undergo further monitoring and evaluation. This story will stick with me because it also highlights a patient scenario that could have been prevented had the family been educated about the importance of wearing helmets (something that a good primary care infrastructure for families with young children might have been able to help out with). 

Throughout the rotation, I got the chance to rotate both on the pediatric ED, the Respiratory Therapy ward, the Infectious Disease department, and the Nephrology department. Despite how busy each of the services were, the attendings took time to teach whenever they were able. I also learned about the training process by interacting with many medical students and residents (lots of whom I am now Facebook friends with!). I could not imagine a more meaningful experience to cap off my training as a student at Stanford. Global health training is a necessary component of medical education in the United States, and this experience reaffirmed that for me!

Victoria Boggiano, MD, MPH, graduated from Stanford School of Medicine in 2018 and is beginning her residency in family medicine at UNC Chapel Hill. She completed a 6-week clinical rotation at BVND1 through the Mary Duke Biddle Clinical Scholars Program.