OCEANA

The Pacific Basin is huge. Even the thin rim aroun it and the scattered islands within it contain more opportunity than anyone serious about applying to several spots within it could exhaust.

If an example would help describe unique health problems presented by the geographic realities played out in communication and transportation problems in mid-Pacific, consider Micronesia. Micronesians live in densely populated parts of the island of Moen in Chuuk (formerly Truk, before the 50 year UN Trust Territory relationship with the US ended and they became one of four states in the Federated States of Micronesia) where they have one of the world's highest population growth rates in what is already one of the highest density populations. The island of Weno is inside the world's largest lagoon--1000 square miles of water in the lagoon (on the bottom of which lies the Japanes fleet sent down by Operation Hailstorm by the US Navy 52 years ago)--but there is only 50 square miles of mountainous land and coral atolls on which the people live scattered over this vast space. And the FSM of which Chuuk is a part, occupies proportinally less land area scattered in a watery area bigger than the US contiguous 48 states!

This would be a unique site for distance learning, telemedicine and any number of student initiatives--and fortunately, we at GWU are close to the Micronesia Institute on whose Board of Directors I sit. We have had several students on a regular basis cap their medical school careers with this site as a learning experience; they, and I, would be happy to tell you more and try to get you to follow in a similar experience!

There has been a unique medical education experiment called "The Pacific Basin Medical Officers' Training Program" which is closing down in its required "sunset" 10 year term of producing medical undergraduates, for the present residency training in all the areas from which the students had come. The PBMOTP is located in Pohnpei, the capital of the FSM, and we have had close connections with the development of the program. GWU students have remarked about how much they were able to learn in diagnostic skills simply from thorough physical examination, since that is the strongest art practiced where the technology is limited.

Northern Marianas: the Commonwealth of the Northern Marianas lies adjacent to the Marianas Trench, the world's deepest ocean (it would swallow Everest without a ripple) that divides the Phillipine Sea from the Pacific Ocean. Scene of some of the most bitterly fought amphibian assaults of World War II in a fifty year anniversary just celebrated, the stranded tanks of US Marines are still out in the surf, and the Suicide Cliff is still visited by Japanese pilgrims to Saipan, the CMNI capital. On another of the islands, Tinian, Enola Gay took off from Pit Number Two on her flight to Hiroshima, carrying Fat Boy, which was just delivered by the USS Indianapolis sailing in radio silence, the day before it was sunk after the delivery.

Besides the history around these islands, they also happen to be US Commonwealth, the same status as Puerto Rico, and are covered by Health Servic Corps; a beautiful new hospital is running with all the facilities of home--which troubles me a bit, with a CT scanner facing the surf making it seem more like Malibu than the kind of experience I would recommend such as the PBMOTP have gained in the diagnostic skill level achieved with their fingers, eyes and ears.

Each of the "'nesias" are open to students: Mela-, Poly-, Indo-, Micro- but some are more easily accessed than others, American Samoa being one of the latter. There are also good connections to be made through such groups as the East-West Center in the University of Hawaii, and the military such as Tripler Army Medical Center for those of you with committments in the service.

Australia/New Zeeland: life Down Under is rather much a first world environment, so that unless someone had compelling cultural reasons to want to do some rotation in ANZ, (the Great Barrier Reef not being among them, but certainly worthwhile as a vacation visit, and a must for any certified scuba divers), it would be akin to pleading your case to do missionary service along the French Riviera. I have traveled through the Antipodes often, and as exciting as many features are about it, it is less foreign than Europe. Yes, it--and quite a number of other areas around the world--are very interesting, but this irrplaceable time in your medical school experience should be dedicated to something unique, not the same medical practice in a different system setting as the less challenging yield from this opportunity.