End scene

Astounded, that’s the first word that comes to mind when I think of Thailand. For any person thinking to themselves should I do this APPE rotation, is it worth it, can I afford it, will I be able to cope with being in a foreign country for an entire month? My answer will always be yes. Take the leap of faith, let go of your fears and do this APPE rotation. I will be the first to say that I signed on to this rotation at the very last minute. I was completely unsure of myself and if this was really something I wanted to do. I ended up convincing my best friend to do it with me and to say the least, this was the most beautiful opportunity I’ve had since P1 year. 

Thailand has allowed me to grow so much more than I even realized. I have gained more patience, more understanding and greater appreciate for all that I have. Personal lessons I learned on this trip was firstly to walk away, secondly to be grateful and lastly to take the time to enjoy every moment. Walking away from anything that will allows yourself to compromise below what you believe is worth it is surprisingly difficult. None the less I learned this lesson in the Markets of Chang Mai. I have never been one to bargain but when thrown into that situation, I learned a lot about myself and my abilities. Second lesson learned was to be more grateful for the simple things in life like clean air, clean water and having a fundamental support system of people who truly care about you. I can say that on this trip I made new friends that are one in a lifetime. I will never truly be able express how appreciative I am for the supportive friends I had on this trip. 

Thailand will definitely push you to get outside of your comfort zone, it will allow you to open your mind to a different lifestyle which in turn will allow you to grow. For me Thailand was so much more than just books, the drugs and the hospital but it was an experience that allowed me to truly see how advance we are medically. How fortune we are to have the state-of-the-art hospitals, outstanding care and amazing medical personnel. This APPE is one that is all encompassing, so much that I wish it were required. If you were like me and are borderline between going and not going, GO! Take the leap of faith, I promise you won’t regret it. 

Fairwell Thailand

Spending a month in Thailand has been such an amazing experience that I surely will never forget. I learned about pharmacy and the public health system as well as many cultural customs. Learning about Thailand's universal healthcare system and how every person in Thailand has insurance was interesting since that is not the case for people living in the United States. I found it interesting that people have one hospital that they can go to to receive care and how the must be referred by a doctor at their assigned hospital in order to receive free care at another hospital in the country. Otherwise, receiving care from another hospital will cost them money. They also only have a certain drugs that are covered by this universal healthcare coverage. This makes sense to keep prices down. However, I learned that what is considered first line in the United States might not be offered/covered in Thailand because they have chosen a cheaper option to start with first. Then only if the other therapies fail will they go to better and more expensive option. It is great that every person in Thailand has health insurance but the downside of this is that waiting times for important medical tests such as and MRI might be as long as 30 days. In the United States if you need an MRI you usually get it with in a couple days. 

Some cultural things I learned about are that Thai people often take their shoes off before entering a house or small building. They also bow when saying thank you and toilet paper is not always provided in the bathrooms.

I would recommend this APPE rotation to anyone who is lookin to learn something new and get out of their comfort zone!

Gone but Not Forgotten

Well Thailand, you've taken my money and sense of what the word "hot" means, but you've given me an amazing cultural experience with memories that will last a lifetime.  This experience has allow me to learn so much about Thai culture, the Thai healthcare system, and how my friends and I can improve our viewpoints of the healthcare system in the United States. The culture in Thai is so welcoming no matter what hospital or clinic we got to visit. Every person we got to meet was so excited to see us and show off what their place of work had to offer to the people of Thailand. This was a big shock to me because it is an idea that is going away in the United States. Most people, not all, look at their place of work as just a job that pays the bills, but in Thailand, they are proud of where they work and couldn't wait to show us every aspect of it.

When I decided to go to Thailand, I thought it was a third world country that didn't really have much to offer or didn't have the capabilities to offer great healthcare to the people of Thailand. Boy was I wrong. Some of the hospitals and clinics we got to visit were even up to the standards of the United States. Some hospitals had an ambulatory clinic, some had more than just 3 pharmacists working in the entire building, and some even did research that, at one point, was almost bought by a US company for millions of dollars. It was a complete shock to me how advanced Thailand is in their healthcare. As far as their Universal Coverage goes, Thailand is an example of it working. This is something that is debated in the United States all the time and it is a topic in which I believe Thailand is more advanced than we are. We just haven't come up with the right way to implement it into our society. Maybe, it is where Thailand can help us learn and grow.

As far as what I have learned about me from Thailand, I have learned I need to be way more patient and understanding, I'm smarter and more confident than I give myself credit for, and you always learn something new everyday. Thailand was a culture shock for me with so many new foods to try, places to see whether they were clean or not, and so many people to meet. We learned that people wait hours and hours in waiting rooms to receive healthcare and yet, people in the US can't wait 5 minutes to receive their prescriptions in a pharmacy. Thailand taught me I need to be more patient with things I do along with more patient when dealing with patients and physicians. As far as going out of my comfort zone, I had the opportunity to eat a scorpion and even teach Thai students about residency programs in the United States. Both experiences, along with others, were things I never thought I'd be able to get to do and are things I will never forget.

In conclusion, Thailand is a once in a lifetime trip. It is a place that may not be one of the cleanest places, but offers so many life experiences I will never forget. Anyone thinking about taking this experience in years to come, all the advice I have to offer is do it and give it all you got. Be open-minded, be willing to experience things even if you're scared or nervous, and be willing to learn and make memories that will last a lifetime.

4 Weeks Come and Gone...

Wow. I never expected four weeks time to go by so fast. In that time I was able to explore a unique country while learning about my profession in an area of the world that differs so much from our own. In this post I will attempt to convey some of what I learned along the way.

This rotation has allowed me to learn about the healthcare system utilized in Thailand. They operate with a universal healthcare system that allows all Thai citizens to receive healthcare at no cost. Patients will wait for hours a day to see a doctor and pick up prescriptions. Generally all of this can be completed at one facility in one trip, which differs from our system in that prescriptions are sent to an outside pharmacy (in most cases) and picked up at a later time. Community pharmacies also use prescriptions very differently than we do in the United States. Pharmacists are able to essentially prescribe and dispense drugs based on patient symptoms and presentation. However, this has resulted in high antibiotic resistance rates. They also have a large number of fraudulent pharmacies in which the owner purchases a license from an actual pharmacist to open a store and distribute medications. They have started to implement measures that allow patients to recognize which pharmacies are legitimate and which ones are phony.

I have also been able to make myself more aware of cultural factors that influence some people's decision making as it pertains to their healthcare. Traditional Thai medicine as well as Chinese medicine are huge components of treatment of diseases and conditions in Thailand. We were able to visit traditional Thai medicine wards as well as an entire facility that provides services such as massage and acupuncture to name a couple. This is useful in the way that I practice because it may help me understand a patient's decision making in the future and allow me to better empathize with my patients.

As time goes on I will periodically do some self reflecting on my time in Thailand and how my experiences will change me or how they may already have changed me. Traveling has always been a great way for me to push my comfort zone so that I may grow as a person. This trip certainly did that for me and I found that I had plenty to ponder on throughout the entire trip.

To any students considering this as a rotation in the future, it is well worth it. Be aware that, unfortunately, life in Thailand is not glamorous for many people; however, if you approach it with an open mind and with the intentions of fully exploring this opportunity and all that it has to offer, you will be royally rewarded with an experience you will never forget. 10/10 would recommend this elective rotation.

Goodbye Thailand!

After spending this past month in Thailand, all I can say is I’m very grateful for this experience. I’ve learned so much about Thai culture, their healthcare, and way of life. Additionally I’ve learned so much about myself through this journey. I think one of my favorite visits on this trip was at Ramithibodi Hospital in Bangkok. The head pharmacist Nani and her entire staff were very welcoming and embodied what it meant to be a pharmacist at Ramithibodi. I took so much away from the two days we spent with them (ie. approach to care for difficult to treat patients). Throughout this journey I noticed a lot of what the healthcare providers do is for the Thai people and they are really culturally tied to their roots. They look at treating patients with more natural remedies like herbals before resorting to conventional drug regimens. This experience has made me more culturally aware of others and has made me realize how much of an impact one’s beliefs/ faith can have on their health. 

As for myself, looking back this journey was definitely a growing experience. Living in a different country for an entire month can be challenging and rewarding. I’ve learned how to quickly adapt to another’s way of life, different food and cultural experiences. I’ve learned how important it is to take care of yourself and to always stay positive, no matter how challenging the situation may seem. I’ve learned how important it is to have a support system and building friendships along the way because everyone needs someone to lean on every once in awhile. This experience has given me the strength to go outside of my comfort zone more often. I will certainly be taking these life lessons I’ve learned along the way and implementing them in my future practice as a pharmacist. With that being said, I don’t think I would’ve learned these things about myself if I did spend four weeks in Thailand. I’m leaving this place with a sense of pride and new found confidence, knowing I was able to experience living and learning in Thailand this past month. 

Farewell Thailand!

It has truly been an amazing month in Thailand, filled with unique educational and cultural experiences that have taught me so much. The Thai health care system is a great example of how universal health care can be utilized along with the pros and cons compared to a private payer system such as the U.S. Before traveling here, I did not expect Thai pharmacists to have as big of a role on the health care team as the U.S. I was quickly proven wrong as pharmacists have many of the same responsibilities, such as patient consultation at outpatient clinics and interprofessional collaboration with other health care professionals. Many medications in Thailand do not require a prescription and can be bought at a local pharmacy, such as antibiotics for an infection. Because of this, community pharmacists play a crucial role in drug selection and counseling to make sure the patient is being appropriately treated.

Throughout the trip we did many cultural activities and visited some amazing places. We visited several temples, traveled to the floating market, attended a Thai cultural show, and enjoyed a variety of delicious food. In addition to our planned activities, I spent a lot of time exploring the cities we were staying in, finding lots of markets and places to eat. One of the main takeaways I have from this trip is a sense of adventure and a willingness to go outside my comfort zone more. I hope to continue these traits in both my personal and professional lives upon my return to the U.S.

That's a wrap Thailand

As Thailand APPE comes to an end, I wanted to take the time to reflect on the last 4 weeks of this experience. I had a great opportunity to visit various hospital and clinics both in Bangkok and Chiang Mai. They were many modern and up to date hospitals in Thailand, but others made me feel so fortunate to live in the United States. Hospitals here in the US -- despite local have a certain standard. I am not only talking about standard of care, but the upkeep of the hospitals. We are very lucky to have hospitals were they are for the most part clean and tidy.

On a different note, I have learn that you do not need a lot to be happy. Some of the people that I have meet on this trip have so little, but yet are some of the happiest people I have ever seen. It is almost unfair how much we have back home while others have so little. This trip has taught me to be more thankful than ever for the life that I am fortunate enough to live. 

My Thailand Experience

Spending the past 4 weeks in Thailand has been one of the most incredible experiences of my life. I am so grateful to have had this opportunity and I will always remember this rotation as being one of the highlights of my entire time at UNE. This Thailand rotation has allowed me to learn a lot about the Thai healthcare system, Thai culture, my peers, and myself. This experience was truly amazing and a once in a lifetime opportunity to live in a different country for a month and have many academic and cultural experiences.

Throughout this rotation I was able to learn a lot about the Thai healthcare system and how they have universal health coverage. I also have a much better understanding about the similarities and differences between hospital and community pharmacies in the United States vs. Thailand. I really enjoyed being able to have these kinds of discussions with Thai pharmacists and pharmacy students, as well as being able to tour many different hospitals throughout Bangkok and Chiang Mai. I have also learned a lot about different diseases that are not as common in the United States, such as dengue fever, leprosy, or tuberculosis. It was a great opportunity to learn about these disease states and then observe the interaction between a doctor and a patient that had the disease.

I have also really enjoyed our cultural activities and I have learned a lot about Thai culture in general. Visiting the temples, going to the floating market, doing the cooking class, and trying many new foods has made this rotation not only academic but a cultural experience as well. Throughout this Thailand rotation, I have also learned a lot about myself. This trip has given me a lot more confidence and independence. I have realized how important it is to push myself and go outside of my comfort zone, and I am so glad I decided to do this rotation. I am very grateful and have a deeper appreciation for everything we have in the U.S. (the opportunities, technology, care, living, etc), and I truly believe this whole experience will positively affect how I work and care for patients when I become a pharmacist.

Thailand Summary

On this trip, I have learned a lot about different healthcare systems, tropical diseases, and culture. I have also learned a lot about traveling and exploring foreign places. We certainly spent a lot of time out of our comfort zone.

Since being here, I discovered I have a new favorite food, khao soi (a curry and noodle dish from northern Thailand). I have been thrilled with all of the food I have learned to love here.  It has been interesting to compare authentic Thai food to the Thai food sold in Maine. 

The most beneficial knowledge I gained from this trip is the knowledge of their healthcare system. Since Thailand has universal coverage for all Thai citizens, it was enlightening to see the benefits and challenges of it first hand. Since this is a pivotal time for healthcare in the US, this was convenient timing. With only 1/5 of the GDP of the US, Thailand makes universal healthcare work, although we saw many sacrifices that had to be made by the Thai people and healthcare providers. 

Although all of this taught me a lot, the most valuable experiences I have had in Thailand are those I experienced with my friends. We explored everywhere (including where we were advised not to) and laughed every step of the way. They made even  nights in so much fun and were always up for any adventure. I will look back at this trip fondly, missing the warm Thailand heat as we go back to the cold winter in Maine. 

What I Learned In Thailand

Before leaving for Thailand I was often asked what I was going to learn and what I’d be doing in terms of pharmacy. Though I had viewed the schedule and syllabus I wasn’t quite sure myself. Entering the 4th week of rotation I can say that I have learned a lot more than I thought I would both culturally and medically. 

First of all, I knew Thailand was poor but I didn’t know how poor. I have realized that there are some people that literally do not have any value and make a living from selling handmade gifts at the market. What really struck me was when my friend was trying to barter and the lady said “I need food, I can’t discount.” 

One particularly enjoyable day was sitting in on a Thai Pharmacy class at Chiang Mai University. We were given an

opportunity to present to the Thai students about pharmacy in the United States depending on the field we were interested in. Here's a photo of me giving a presentation on residency! 

We have visited many pharmacies in Thailand including primary, secondary and tertiary hospitals. Some of the primary care hospitals seem very outdated compared to America but the tertiary hospitals are very advanced and are actually a lot nicer than some hospitals I’ve been to in America. I have learned that the Thai pharmacists follow mostly the same guidelines as Americans with the exception of drug choice. 80% of Thai drugs are brand name because of the universal coverage system and theories of the patients. Furthermore, I have learned a lot about the universal coverage system allowing access to all patients no matter their financial status. This creates chaos in the hospitals which are almost always flooded with waiting patients.

ภาพสะท้อนของประเทศไทย

The time we spent in Thailand was a wonderful experience to learn from. While here we spent much time learning about their healthcare system and how in some ways it surpasses our own. With the implementation of universal healthcare, many people can get the care that they need without being stopped by the extravagant costs of treatment that many Americans face. Its implementation seems to have been well done and is something I hope to see implemented in the states within my lifetime. However, it was surprising to see that in most hospitals all patient records are in paper form as opposed to being electronic. Having seen this in practice, I feel that I've taken our use of electronic patient records for granted. 

I was also impressed by the large scale use of traditional medication in the healthcare setting, such as message, acupuncture, and cupping. Coming to Thailand I'd expected to see some traditional treatment in practice, for example as a specialized clinic like one we visited in Chiang Mai that was dedicated to this. However, I was surprised to learn that this was supported in major hospitals and by the universal healthcare. Coming from America, where there's such a push to immediately treat using medication, it was refreshing to see this as an accepted treatment option. 

 

Our Last Weekend:(

As our trip starts to come to an end, we have been able to kick back and relax on the nice Sai Kaew beach resort. Here, we have been soaking up the sun, playing pool, swimming, and so much more. It has been our weekend getaway after all of our hard work here in Thailand. The resort offers so many cool things to do and see along with providing great food and drinks to enjoy. Overall, it has been a great weekend with some great people to wrap up our trip here in Thailand.