Thirty Kenyan medical students left the University of Nairobi in October 2011. Though traveling by land, their purpose held all the consequence of a maiden voyage.

The 30 students represented the school’s first investment in enriching medical education through clinical experiences in less-populated areas. If this sounds familiar, it is because Nairobi is tacking to a course begun 40 years ago at the University of Washington: the WWAMI program, a five-state partnership in medical education.

Almost immediately, the Kenyan students’ feedback was validating.

“It’s fantastic. They say this is giving them real, hands-on experiences that they’re not able to get at Kenyatta National Hospital, the main tertiarycare hospital,” says Carey Farquhar, M.D., Res. ’97, MPH, Fel. ’03. Farquhar is a UW associate professor in the departments of medicine, epidemiology and global health.

“I just found out they’re having weekly, case-based discussions through distance learning. They connect the four sites — in Garissa, Naivasha, Mbagathi and Mombasa — on a video conference, and one of the sites presents a case, which is then discussed by the students and a faculty member at the University of Nairobi,” she says.

Farquhar has been integral to the university’s vision: expanding clinical training beyond the capitol. She and the University of Nairobi’s Dr. James Kiarie (a UW affiliate associate professor in global health and epidemiology) are principal investigators of a $9.5 million grant that supports that goal.

Over two weeks in May 2011, Farquhar was on point when a delegation of Nairobi medical-school leaders visited for an immersion in the WWAMI program, the immensely fruitful partnership of UW Medicine and the states of Washington, Wyoming, Alaska, Montana and Idaho. A core WWAMI tenet is that medical students need to learn medicine where it is practiced — in the community, not just in academic hospital settings.

The visiting delegation from Nairobi saw facilities in Boise, Idaho, and Spokane, Wash. During the Spokane tour, simulation lab director Kevin Stevens (left) explains the use of simulators in training health professionals. From the University of Nairobi are (left to right) Drs. Grace Thoithi, Charles Omwandho, Dalton Wamalwa and Erastus Amayo.

The Kenyan contingent learned how WWAMI nurtures stakeholder relationships, how faculty receive training at rural clinics, and which nuts-and-bolts issues require routine attention. Along with attending myriad presentations in Seattle, the visitors met with residents and students in Spokane, Wash., and Boise, Idaho, and visited rural clinic sites, simulation labs and classrooms.

“Students come to study in Nairobi and then they don’t want to go back to the rural areas. If we give them opportunities to do rotations as interns in those rural areas, they may actually feel like working there. That’s the major takeaway for me,” says Dr. Isaac O. Kibwage, principal of the College of Health Sciences at the University of Nairobi, after the visit.

The group — which included deans of medicine, nursing, dentistry, pharmacy and public health, among others from Nairobi — was impressed. Equally important, they were empowered to set desired changes in motion back home.

For instance, a telemedicine presentation they saw in Seattle informed the weekly videoconference in which remote students and Nairobi faculty discuss patient cases.

“Distance learning with webinars is a great way to keep students feeling anchored and connected when they’re in rural sites by themselves. It gives them a chance to check in, ask ‘What’s going on at your site?’ and exchange lessons about patient cases,” says Suzanne Allen, M.D., MPH.

As the UW School of Medicine’s vice dean for regional affairs, Allen oversees the WWAMI program. She wasn’t surprised to hear Farquhar’s account of Kenyan students’ initial feedback. It resembles the feedback she hears from students in WWAMI.

“The amount of experience they get, whether it’s helping with a surgery or delivering a baby or being with a family through a difficult time — it’s more hands-on than they might get here in Seattle,” says Allen.

“Students really feel the impact they can have on patients’ lives out in these smaller communities.”

By Brian Donohue