P01: International Medical Students Clinical Rotation

The goal of the International Health Elective is to offer students an opportunity to learn about health and healing with a more global perspective by living and working in another country. Students will have the opportunity to live in a new and different culture, usually with little of the technical and medical facilities he or she is accustomed to using. The student will have a chance to see a different way of organizing health care to achieve good results in the health situation of the population, as is the case in Costa Rica. The resources that are taken for granted in the developed countries like USA, Canada and Europe may be lacking at times. The students have an opportunity to be of service to the community and to broaden their thinking about future medical practice.

Click HERE to apply for this program!

1. Overview

The goal of the International Health Elective is to offer students an opportunity to learn about health and healing with a more global perspective by living and working in another country. Students will have the opportunity to live in a new and different culture, usually with little of the technical and medical facilities he or she is accustomed to using. The student will have a chance to see a different way of organizing health care to achieve good results in the health situation of the population, as is the case in Costa Rica.

2. Rotation Identification

This rotation is designed to give the student the opportunity to participate in the activities of the health team from the first to the third level of care of Costa Rican Health System (Caja Costarricense de Seguro Social – CCSS).

The participant will only work directly with patients according to the country regulations for medical care, and the international regulations on bioethics for medical care for health professionals and students.

In the first level, preventative services are emphasized, including immunizations, maternal child services, prenatal care, growth and development of children, nutrition, community education, community sanitation and environment, as well as continuity of care in cases chronic diseases.

In USA, Canada and others countries, the Spanish speaking population represents an important number of people to whom the health professional must give appropriate care. To promote competence based medical education means to prepare the professional to face the reality of working, understanding, and communicating with this group. This rotation is competence based to expose the student to work with Hispanic populations, learn, and accept the culture differences as an important scientific and ethical principle of the medical practice.

3. Who is eligible to participate?

IHCAI Program P01 is for students in their last year at their home medical school.

4. Duration

This program may be adjusted to the participant’s home institution’s requirements. However, the minimum time to earn three credits is four weeks and the maximum is eight weeks which awards five credits to the participant. In order to receive the credits the student needs to fulfill all the requirements of the rotation and must obtain a passing grade.

Harvard Medical School (Harvard Elective Catalog ME518) must complete the eight week program in order to receive the credits required by their home institution. Harvard students applying for the ME 518 elective Rural Medicine and Nutrition in Latin America must complete the application form on line specifically for this program = IHCAI P017A. LINK PENDING.

5. Where are the locations?

There are several locations to work in:

  1. Urban metropolitan areas.
  2. Suburban areas.
  3. Other cities than the Metropolitan areas.

IHCAI Foundation offer rotations at:

  • Clínica Carlos Durán
  • Área de Salud Goicoechea I
  • Área de Salud Goicoechea II
  • Hospital de la Mujer CARIT
  • Hospital Nacional de Niños
  • Hospital Blanco Cervantes para el Adulto Mayor
  • Hospital Regional de Grecia
  • And others.

After submitting the application and send their records, students will be assigned to a health center based on availability, according to the regulations of the health system of Costa Rica.

6. IHCAI FOUNDATION policy for locations assigning

In the most of the cases IHCAI Foundation tries to give a position in the locations according to students’ choices. However, the spaces are matched according to the registration completion date and space availability in the different areas of the Costa Rican Health System.

When completing the application form, it will match to next position available in any of the areas or clinics where IHCAI Foundation runs the program.

7. How is time organized?  What are students’ activities during the clerkship?

Students in the program IHCAI P01 will work for patients who normally visit the clinic. According to Costa Rica regulations and IHCAI Foundation ethics for Medical practice and Medical Students Work, this is only possible under direct supervision of an entitled physician.

Students receive support about the organization of the Health System, about medical Spanish, cultural issues, in accordance to the country where the student is doing the program. Of course that this has some variations and emphasis in different topics according to the country and area where the student is working.

Working hours are from Monday through Friday from 7am to 12pm and 1pm to 4pm. This schedule may vary according to the customs of the health site. It also depends on IHCAI Foundation and agreements with the students. In general, all students participate in the Health Team community work such as home visits for immunization, assessment of child growth and development, as well as monitoring and detection of chronic diseases.

Friday afternoons are off, in order to give the student an opportunity to travel or to undertake other activities. When the students are in the Hospitals they may have access to outpatient clinics in the afternoon as well as the emergency room this applies in some areas or countries and according to the local preceptor authorization.

8. Application dates and special requirements

According to space availability, the application deadline is 3 months prior to the rotation starting date. The starting date may be anytime during the year. IHCAI Foundation is in recess from December 15th to January 1st. Given the high demand between January and April, students are advised to complete their registration at their earliest convenience. IHCAI Foundation cannot guarantee space to those students who did not complete the registration process, even if they complete the online application and do not complete all the registration requirements.

It is mandatory to fulfill all the requirements stated as well as any others that IHCAI Foundation considers necessary in individual cases. IHCAI Foundation may request a recommendation letter from a faculty member or an advisor if it deems it necessary.

9. Spanish Proficiency

Students must have intermediate Spanish proficiency (Level 3 of 5). If you do not fulfill this requirement, please contact the main IHCAI Foundation office for more information at info@ihcai.org. An intermediate level of Spanish is primordial to guarantee patient respect as well as for ethical reasons.

During the rotation, IHCAI Foundation offers medical Spanish tutorials with a tutor, assistance, and multimedia support, but this is not a Spanish course. The tutorials are oriented towards improving your skills in medical Spanish. Please note that IHCAI Foundation offers other options for students with a very small or no Spanish knowledge. The IHCAI Foundation Program P010A is an alternative to a rotation for students with very limited or no Spanish knowledge. If you need more information, please visit our web site at:

P010A: The Latin Spanish Patient in the Environment of Tropical Medicine

10. Are there any fees for this program? Where will I live?

Tuition Fee = $ 450 US (4 to 8 weeks program)
Accomodation fee: $ 160 per week.

Home Family stay (Accomodation)

As part of the training program and the cultural immersion, student will stay with a Costa Rican middle class family. The family will be providing a single room, breakfast and dinner, laundry service and a moderate amount of local (Costa Rica or other Country territory) telephone calls (local phone calls are not free like in the USA), and other miscellaneous services. As a complementary service airport transportation is provided at arrival 24 hours and also gives transportation from the host family to the airport at departure.

11. Registration

The application form is available online at our homepage. Please read the information on the form carefully and make sure you fulfill all the requirements as indicated. Please submit your application registration form once you are sure that you will be doing the program. If you need more information please contact us at info@ihcai.org we will be very pleased to assist you.

After complete your application you go to be oriented by the IHCAI Foundation Staff about the documents you need to present before your arrival according to the Costa Rican Health System regulations, like a copy of your passport, your personal resume, Immunization proof and others.

The application form can be completed online at: P01: International Medical Students Clinical Rotation for Senior Medical Students

When the student completes the online application, IHCAI Foundation system would send a confirmation message. Please read this message very carefully because some changes may occur.

More information about How to Apply at: How to Apply

12. Course format and educational model

The IHCAI Foundation programs use a problem and competence based learning model (PBL/PBI/CB). These approaches place great emphasis on self-directed learning. The students are expected to find the necessary information to solve clinical problems with the guidance of a system of tutors and to acquire the appropriate competences to work with their patients and community according to their necessities and cultural background. Students are expected to work with the problem solving method for developing competences to work with patients using the Spanish language and to function in a different culture.

The student will participate in the everyday clinical rounds in the Internal Medicine or Pediatrics services  for example, and health post in the clinics or hospitals. Sometimes the participant will have to work in the EBAIS (Spanish acronym for Basic Team of Health Care, this is the smallest health care unit in the Costa Rican health service). At the hospitals, students have access to the emergency room or at the service where the student is assigned. Students working at Clinics will do clinical work with the local physician and the health team.

An important component of the rotation is the work place, School, or home visits or for immunization, child growth and development, prenatal care, and control of patients with Chronic diseases or prevention and education activities. When the student works at the clinic he or she will participate in these activities at least once a week when they are scheduled.

The rotation will necessarily contain an important emphasis on language skills for comprehending, speaking, writing, and reading Spanish in order to assure an appropriate communication with the patient. It is important to us to improve the new physician’s competences when working with Hispanic minorities in the home country. It is also primordial that a new physician can understand the inequalities and the determinant role of poverty in the prevalence and incidence of diseases and their burden in the developing countries. The community component as the space-population where the burden of disease has its origin and solution is an essential component of the rotation.

13. Tutorial

Students will have a three-hour medical Spanish tutorial at least once a week. The schedule may vary according to the student’s needs. In addition there is a one-hour tutorial every week to discuss health problems. During this tutorial the student will do the case presentation in the last week of the rotation. The schedule will vary according to the IHCAI Tutor and/ or the local preceptor.

14. Evaluation and grading

IHCAI Foundation faculty of the Affiliate Hospital and Clinics will evaluate the student’s work during the entire rotation and other optional and mandatory activities IHCAI Foundation will add the IHCAI seal and the Director’s signature to all evaluations. A student’s initiative will be recognized and highly appreciated in the final evaluation. IHCAI Foundation may use the evaluation form of the student’s home institution or the IHCAI Foundation evaluation form. The students are advised to handle the Home School evaluation form to the IHCAI Foundation staff at arrival or within the next 2 days after the arriving day.

15. Health advice and insurance

Students are covered by a basic health insurance while in Costa Rica.  If you want a more extensive coverage you may contact IHCAI Foundation for other health insurance options. The student must present a reasonable proof that he/she possesses travel health insurance protection.

You can get an online insurance quote for extending your travel health insurance protection. Find an online quote and information about the IHCAI Foundation insurance company for health insurance at: https://www.worldtrips.com/quotes/default.asp?referid=99690

Costa Rica is safe for malaria, yellow fever and other tropical diseases. However, in some rural areas of the country the water is not completely safe. IHCAI Foundation advises all participants to take precautions and to drink bottled water when traveling outside of San José. The water is safe only in San José, but if you have a fragile stomach, you might want to drink bottled water as well.