Rotation at Hospital Central de Maputo
Maputo Central Hospital (HCM) is a 1500-bed public national referral hospital for the Republic of Mozambique and serves as its primary academic teaching facility. It is the largest quaternary hospital in the nation and a large majority of Mozambique’s total number of specialists are on the HCM staff.
The sickest and most complex patients are referred from around the country for care at this facility. Despite being the main teaching and referral hospital resources remain scarce. HCM currently has the only Anesthesia Residency Program in Mozambique. HCM provides Residents with unique educational experiences, including but not limited to, exposure to advanced pathologies, open cases, and managing patient care responsibilities with fewer resources. It’s a 5-year program that trains 5-6 residents per year. The department has 23 Anesthesia Specialist Physicians along with 40 mid-level anesthesia technicians (similar to CRNAs). HCM has an 18 bed ICU, 9 operating rooms in the main OR, 4 operating rooms in the maternity building, 3 operating rooms adjacent to the Emergency room for trauma and ICU cases, as well as, a pain clinic with 4 procedural beds. Rotation at HCM will provide a unique and unparalleled educational experience.
Goals and Objectives of a Global Health rotation:
- To build compassion for the underserved
- To gain an appreciation for how cultural and socioeconomic differences impact medical care in a resource poor setting
- To gain knowledge about the major causes of morbidity and mortality in a low-income country
- To gain clinical experience practicing in a resource poor/limited setting
- To support education, capacity building and/or quality improvement efforts at Hospital Central de Maputo
- To learn strategies for increasing resiliency and adaptability to the unfamiliar.
On-site expectations:
- Visiting residents are ambassadors for Stony Brook University and must strive to uphold and embody the values of Stony Brook as detailed here.
- Visiting residents will be under the direction of the Director for the Stony Brook Center for Global Health Equity or an assigned onsite supervisor.
- Visiting residents are expected to attend onsite orientation, meetings, and activities that are assigned the onsite supervisor.
- Visiting residents will meet weekly with onsite supervisor to evaluate resident well-being.
- Visiting residents are expected to complete onsite reading assignments assigned by the onsite supervisor
- Visiting residents are expected to participate in structured didactic activities set forth by the HCM
- A complete case log must be collected
- All residents must complete a one-page reflection paper to be returned on the last week of the elective rotation (max 1500 words)
Global Health ACGME Competencies
(Applicable ACGME-I competencies included in brackets)
- Provide safe and effective anesthesia and perioperative care in a resource-limited setting. [PC3, PC4, PC7]
- Apply WHO or local clinical guidelines and compare them to U.S. standards. [PC3]
- Demonstrate flexibility in managing patients with limited monitoring, medications, and equipment. [PC4, PC7]
- Respect cultural practices and family roles in care delivery. [PC5]
- Compare the availability and quality of care between technology-rich and resource-limited environments. [PC6]
- Provide patient-centered care to those with limited access to healthcare. [PC1]
- Develop a working Knowledge of diseases prevalent in low-income countries. [MK1, MK2]
- Summarize the relevant issues in anesthesia and critical care in the management of the most common conditions in Mozambique, including malaria, HIV, TB, trauma, obstetric emergencies, eclampsia, severe anemia, malnutrition, sepsis, unsafe abortion. [MK1]
- Understand disparities in health outcomes. [MK2]
- Compare morbidity and mortality patterns in low income countries (LMICs) vs. high-income countries. (HICs). [MK2]
- Explore the impact of delayed presentation and limited resources on outcomes. [SBP3]
- COMPETENCY: SYSTEMS-BASED PRACTICE
- Understand the influence of socioeconomic and structural factors on health. [SBP1, SBP3]
- Reflect on how human rights, gender equity, poverty, and globalization affect health outcomes. [SBP1]
- Compare the roles of healthcare providers in Mozambique and the U.S., including médicos, técnicos, traditional birth attendants (TBAs), and community health workers (CHWs). [SBP2]
- Support local education, capacity building, and quality improvement. [SBP1, SBP2; ICS2; PBLI1]
- Collaborate with local trainees and faculty in teaching, protocol development, or small-scale QI initiatives. [PBLI1]
- Demonstrate awareness of sustainable, bidirectional partnerships in global health. [SBP2]
- Uphold the principles of equitable, bidirectional exchange in global health. [SBP2]
- Enhance self-directed learning and quality improvement in global health contexts. [PBLI1, PBLI2]
- Identify knowledge gaps and actively seek feedback from both U.S. and Mozambican colleagues. [PBLI1]
- Participate in educational exchanges and contribute to institutional quality improvement efforts. [PBLI2]
- Build strategies for maintaining emotional, physical, and professional well-being. [PBLI2]
- Develop resilience and adaptability. [PROF3; PBLI2]
- Reflect on the personal challenges of working in an austere or unfamiliar environment. [PROF3]
- Demonstrate ethical and professional conduct in a global health setting. [PROF1, PROF3]
- Navigate ethical challenges such as informed consent, allocation of scarce resources, and cultural sensitivity. [PROF1]
- Maintain respect, humility, and integrity while serving in a cross-cultural environment. [PROF3]
- Show empathy for underserved populations and acknowledge the value of sustainable, long-term partnerships. [PROF1]
- Recognize ethical challenges unique to practicing in austere environments. [PROF1]
- Communicate effectively across cultures and languages. [ICS1, ICS2]
- Learn basic medical Portuguese and assist Mozambican colleagues in strengthening their medical English. [ICS2]
- Adapt communication styles to local cultural norms and hierarchies. [ICS1]
- Establish trust and rapport with patients, families, and healthcare teams from diverse backgrounds. [ICS1]
- Understand the impact of culture and socioeconomic context on medical care. [ICS1, SBP3]
- Recognize how language, tradition, and socioeconomic status shape clinical decision-making and health-seeking behavior. [ICS1]
- Integrate cultural understanding into patient-centered care. [ICS2]
Required Project
All residents are expected to participate in a capacity building or quality improvement project, to be defined in collaboration with an HCM supervisor and local colleagues. Projects may include protocol development, educational sessions, or small-scale clinical audits.
Residents must also contribute to the education of Mozambican co-residents, such as delivering short lectures or bedside teaching in English.
Pre-Departure Requirements
NOTE: Pre-Departure Requirements and Safety While Abroad are covered in detail in a separate document entitled “Pre-Departure Requirements”
SUMMARY:
- Complete the pre-departure required training modules
- Complete and sign the pre-departure check list
- Attend an in-person pre-departure meeting with the director of international emergency medicine to discuss the goals/objectives of the Resident and of the Host institution
- Video Conference with site director or faculty supervisor via video call (Skype, WhatsApp or Facetime) prior to departure
- Attend a 6-hour course of Medical Portuguese via Skype or with a local Portuguese teacher in New York.
Post-Return Requirements
Attend an in-person debrief with the Director of Global Anesthesia and Critical Care Medicine
Feedback and Evaluation
- Residents will be required to write a one-page reflection paper (max 1500 words) that may be used to promote the Stony Brook Center for Global Health Equity.
- Residents will be required to submit an evaluation of the elective rotation and attending(s) performance.
Resident Well-being While Abroad
The Director of the Stony Brook Center for Global Health Equity will meet with visiting Stony Brook Residents at least once weekly to check-in and debrief about wellbeing. The Director of the Stony Brook Center for Global Health Equity will be the key support person and should the resident need to depart early due to mental health or physical health emergency the Director of the Stony Brook Center for Global Health Equity will be the primary coordinator to ensure Resident wellbeing is maintained at all times.
Residents may also contact Stony Brook Employee Assistance Program. A link to the program is found here: https://www.stonybrook.edu/commcms/eap/. Residents can also utilize the Resident Assistance Program resources.
- Outline the period of Resident/Fellow assignment rotation: (include exact duty hours and responsibilities, specify how many and level of Resident/Fellow and specify time periods to include on-call, weekend call, inpatient or outpatient):
Senior Residents will spend a 4 week elective rotation primarily at Hospital Central de Maputo (HCM), Mozambique. Residents will be paired with a Mozambican resident for the duration of their rotation. The HCM Resident will help guide the Stony Brook resident throughout their elective rotation. The Resident will be expected to perform at least 1 overnight call paired with a Mozambican Resident.
Typical 4-week rotation at Hospital Central de Maputo:
1 Week ICU
1 Week Bloco de SUR/ Cardiac Surgery
1 Week Bloco Central
1 Week Bloco de Maternidade
At the discretion of the Rotation Director, the time allotted on different services may be tailored to suit individual Resident interest. The rotations, goals and objectives, resident expectations and core competencies that are to be achieved are listed below.
- Specify the duration and content of the educational experience:
The Stony Brook Anesthesia Residency Program agreed to herein shall be conducted from January 1, 2026 through December 14, 2027, as well as any other times when a Supervising Physician is in attendance with a Resident while the Resident is on duty, in compliance with the resident work hour limits provided by the Rules and Regulations of the New York State Commissioner of Health Code §405.4(b)(6) and (f)(3).
The policies and procedures that will govern Resident education during the assignment can be viewed on the Renaissance School of Medicine GME website at: http://medicine.stonybrookmedicine.edu/gme/policy.