The fourth delay

I was talking with one of the residents yesterday in amazement of how few residents they have covering one whole hospital: for about 120 patients in a women's hospital, overnight there is one PGY4 and two PGY2s.  No attending on site!  Then I realized that there were several interns milling about, and said, oh, you have several interns (turns out there were 5), so that makes a big difference right?

And he said, "You know the three delays model?"

 (Global maternal health people might recognize this as the factors that increase maternal mortality in developing countries: 1- Delay in recognizing that advanced medical care is needed; 2- Delay in reaching a qualified health facility; 3- Delay in accessing a qualified medical provider once the facility is reached.)

"My interns are the fourth delay."

If at least one person reading this blog appreciates this joke, it will have been worth retelling.  I myself have been laughing about it ever since.

Today was full of educational activities: I went to the resident conference in the morning to hear a case presentation about steroid administration for preterm deliveries.  Then I myself conducted real old-fashioned bedside teaching rounds for the medical students.  It was the first time I had taught in that style, and it was fun!  Look forward to doing more of that.  Then I went to an ultrasound workshop put on by Norwegian maternal-fetal medicine specialists (so far, there has been a constant presence of foreigners helping with resident education.)  Now I'm preparing a short proposal that might be taken to the Ethiopian Ministry of Health since they have interest in our experience with training in cervical cancer screening, to consider it for a country-wide screening policy.  May be going to the Ethiopian MOH... no big deal.

My trip is half-way over already.  I can hardly believe it.