Q: I’m a resident physician. Should I get more clinical experience here before I go overseas? What about an MPH? Should I do a fellowship in infectious disease? Can a physician be too trained?

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A: Yes, you can be trained too much formally.

Answer from David, an physician internist who has served for five year in Honduras and coordinates the medical aspects of several community development groups
You probably do NOT need to get more experience in the U.S. Quite to the contrary of what our culture, both medical and otherwise, states, there REALLY is a time to stop training and get started in missions.

The longer you are in the American culture, the more attached to it you will become, and entangled. Look at http://www.medsend.org for funding to pay your student loans. They make the loan payments as long as you are working in a third world country.

Yes, a MPH would be great, but you'll learn more if you get it after you have been on the field for a few years.

Consider taking the Tropical Medicine short course at University of West Virginia, http://www.hsc.wvu.edu/. Costs less than $3,000 for the same course that Johns Hopkins charges $12,000 and London charges $25,000.

A fellowship in Infectious Disease is certainly not necessary. Yes, you CAN be trained too much formally.

Do read every missionary biography/autobiography that you can. Visit http://www.cmdahome.org and to get everything you can by Paul Brand, John Patrick and Tom Hale, and others. That teaching I use every day.

A: Go now and get further training later.

Answer from Harold Adolph MD who served in three Ethiopian hospitals over 30 years performing more than 25,000 operations
You can get your clinical experience in your overseas setting. You don't need a MPH unless you don't like clinical medicine. You can pick up tropical medicine from a book and on line rather than taking a nine month course on the subject. The University of West Virginia has shorter courses in tropic medicine. I have not seen a missionary physician that thought he had had too much training before he went but it is possible to spend your entire life in study.

A: Get broad training and go.

Answer from Jason who is going into overseas medical missions a year from now with the Christian and Missionary Alliance
I almost switched from internal medicine to a family practice residency because I am interested in all of medicine and want to be the most useful in helping a broad range of health issues.

Keep in mind that the purpose of medical missions is MISSIONS and not medicine per se. Some may disagree, but I feel that if you have a strong humanitarian focus, you can be a righteous secular humanist and help with medicine all you want! What makes a medical missionary different is the Holy Spirit empowering and driving one's life to see how God is working, join with Him, and share Jesus with all you meet.

Personally, I did not choose to switch to family practice, nurtured an interest for infectious diseases, got the best a broadest training I could in infectious diseases, public health, tropical medicine, research and tertiary clinical care. I find myself well trained and respected as a young leader in a rural county health department as I prepare to go overseas.

A: Go overseas right after residency.

Answer from Cynthia Hale, MD, MPH. Cynthia and her physician husband Tom served in Nepal under the United Mission to Nepal. For their first twelve years in Nepal they served in a remote rural mission hospital where Tom served as both surgeon and medical director, and Cynthia served as pediatrician and family physician.
Once you complete your residency, plan to get overseas as quickly as possible. Do you know about MedSend? if not, contact them at their website.

All of the possibilities for further training are good ideas, but I strongly advise you to go overseas FIRST, for one term at least, and then decide which additional training and qualification will be most useful and take it on a home leave.

The more training you have, the narrower your options for service, and the greater the temptation to feel you are too highly qualified to "waste" your good education overseas. (Even if you don't think in this way, there are plenty of others who will counsel you in that manner.)

A: Yes, a physician can be too trained.

Answer from Donn, a General Surgeon MD who retired from ABWE (Association of Baptists for World Evangelism) after 26 years in Bangladesh
A physician can be too trained IF he allows that training to limit the scope of what he does. I have seen those who were trained in chest surgery but felt it somehow NOT their domain to do a bowel resection or to rod a femur. As for clinical experience, I frankly feel that you can go straight from residency if it is a good residency. A fellowship in infectious diseases may be helpful almost anywhere you go, but a DTM&H degree from England may be even better.

A: You don’t have to know everything.

Answer from David, an oral surgeon who served in Africa for ten years and has now been in Asia for four years
Mission fields are full of opportunities. You may find yourself being a lecture/trainer and not practicing medicine. If possible it is wise to have a little knowledge about everything. You do not have to know everything. Empowering and training nationals can have a wider and deeper impact on the people you want to serve.