Feature Story | 5-Jun-2024

Dermatology goes “global”

Unique program gives dermatology residents a chance to work internationally

Michigan Medicine - University of Michigan

Daniel Nadelman, M.D., a University of Michigan dermatology resident, has an interest in infectious diseases involving the skin and wanted to gain experience in treating diseases that are typically uncommon in the United States.

When he discovered Global Dermatology, he jumped at the program’s opportunity to head to India where many of the illnesses he was interested in studying exist. 

“We are excited to offer this international away rotation to our dermatology residents and to support their interest in global health and neglected tropical diseases,” said Trilokraj Tejasvi, MBBS, clinical associate professor of dermatology and director of the Global Dermatology Committee. 

“Dr. Nadelman’s Global Dermatology experience was meaningful and beneficial both to him and the University of Michigan Dermatology program and to colleagues at AII India Institute of Medical Sciences, New Delhi in India.” 

Nadelman and his fellow residents worked Monday through Saturday, with an hour for lectures in the morning and the remainder of the day for working in clinics. 

Their only break during the day was for lunch (which consisted, of course, of home cooked Indian food.) 

Residents from India would pair up with Nadelman to see patients in both inpatient and outpatient settings, then review biopsy slides at the end of the day to support pathologists. 

Nadelman worked at a public University hospital that provided patients with care nearly free of charge. 

He saw patients from all walks of life, including those who otherwise would be unable to afford the high grade care provided by this hospital.

“I always wanted to see the workings of a healthcare system that's different from that of the U.S. It was really interesting to see the clinic flow and how things work differently there,” he said. 

“We had only paper charts and no prescriptions are required. Doctors will tell the patient their diagnosis and what they need, and the patient will go to the pharmacy and pick it up.” 

Nadelman worked with patients suffering from autoimmune diseases, cutaneous tuberculosis, atypical mycobacterial infections, vitiligo, severe fungal infections, and more. 

One of the illnesses he witnessed most often was leprosy, which many Americans mistakenly believe to be nearly eradicated despite its continued prevalence in many nations across the globe. 

“There were dozens, if not hundreds of leprosy cases that I saw during my time in India,” Nadelman said. 

“I feel like I developed a proficiency in being able to recognize the signs and symptoms of leprosy, and be able to then understand treatment options.”

Nadelman notes that leprosy has high morbidity and stigma in India – many patients won’t seek care until the disease has progressed to a point where treatment options are limited. 

He and his colleagues followed World Health Organization guidelines to treat these patients. 

Nadelman also learned novel surgical techniques that were unique to his place of work, and gained a better understanding of how skin diseases present differently in darker skin tones. 

He hopes to carry over the things he learned into his future practice, and plans to do more medical travel internationally in the future. 

Nadelman says anyone interested in participating in the Global Dermatology Program should be prepared for hard work, but recommends taking part. 

“It's not going to be a vacation. You're going to be very busy. But all in all, it was completely worth it,” Nadelman said. “I would do it a thousand times over. I would recommend it to anyone interested in Global Dermatology and up for traveling internationally.”

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