CUW physician assistant students participated in the inaugural rotation in Nepal this year.

There is oftentimes an assumption that health care systems outside of the U.S. are inferior, observes Michael Toppe, an assistant professor in Concordia University Wisconsin’s physician assistant program.

Years spent abroad working and learning in the PA field have given Toppe a much different perspective, however. His international resume includes a two-year stint with the Peace Corps, a study abroad experience in Zambia, and three years with the U.S. Department of State working as a medical officer in South Africa, first in Gambia and then South Africa, before he returned to America and eventually was hired as a faculty member at CUW.

“The perception sometimes is that the need is higher in other countries, but when you exit you learn there are actually a lot of great things happening there,” says Toppe. “Often the medical knowledge is there, but structural or resource shortages are the real limitations. You can gain some of these diverse experiences in the U.S., but there’s something different and humbling about being the foreigner in someone else’s home country. Once you’ve had that experience, it just changes how you perceive where someone else is coming from.”

A CUW physician assistant student sutures in South Africa.
Kamie Bailey sutures a patient’s foot in South Africa.

Over the past two years, Toppe—with support from Clinical Program Coordinator Peggy Pfeiffer—have worked to open up international learning opportunities for CUW students, too.

In 2016, Concordia sent its first group of students on rotation to South Africa. This year, four more students returned to South Africa, and an additional four students participated in the inaugural rotation in Nepal. Next year, Toppe says the PA program hopes to add Peru to the list.

All PA students are required to participate in 11, one-month rotations before they graduate. Nine of the rotations are required fields and disciplines, such as family medicine and internal medicine. Two of the rotations are electives and can be used for an international experience.

CUW PA students did a rotation in Nepal this year.
CUW students pose with the internal medicine team at Dhulikhel Hospital.

Shreya Vasavada and Katie Mahoney, Justine Emerson and Britt Bickert chose to use their elective rotation to travel to Nepal. In addition to working in a hospital setting in Nepal, they visited a satellite clinic about four hours away from the main town, where they learned about rural medicine and sat in on a breast cancer awareness education session for local women. They also had the chance to witness the celebration of Holi, the Hindu festival of colors that welcomes the spring season.

“It was amazing to see the care that providers deliver to their patients despite having limited resources,” Vasavada says. “I hope that having an intercultural opportunity like this will also help me think outside of the box and have a different perspective when taking on every day challenges.”

Chelsey Galipeau says her rotation in South Africa helped change her perspective towards medicine and influenced how she will approach procedures in the future.

CUW physician assistant students did a rotation in South Africa
From left: Chelsey Galipeau, Bailey Link, Brittni Strege, and Kamie Bailey

While in South Africa, she and her classmates Bailey Link, Brittni Strege, and Kamie Bailey performed numerous procedures, such as starting IV lines and drawing arterial blood gases. The group would daily participate in ward rounds with a South African doctor to evaluate patients and discuss treatment plans. Once a week, they would also work in the casualty department—the equivalent of an American hospital’s emergency room—reading x-rays and suturing assault wounds.

When they weren’t working in the hospital, they had the chance to go on a couple excursions—a safari in Kruger National Park and a visit to the Christian organization COFA’s orphanage, elementary school, and church.

“In my experience, some of my best learning has happened outside of my comfort zone,” says Galipeau. “My international rotation was just that. It took me to a place where the culture is unique, the language is different, and the opportunities to learn new things are abundant. Working with the South African people helped me fully realize that working in medicine is a gift.”

Learn more about Concordia’s PA program here.

— This story is written by Kali Thiel, director of university communications for Concordia University Wisconsin and Ann Arbor. She may be reached at or 262-243-2149.

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