Overcoming Obstacles To Medical Missions 2: Can I Get A Job When I Come Back?

In my last post, I addressed the first of two common barriers to pursuing medical missions, the large debt students incur throughout their training.  This time, I address a back-end issue, the challenge of finding a suitable position after you return from years on the field.

A career in medical missions has many benefits, but at some point most missionaries are called to return from the field.  The problem (among other things) is that, while you’re away, your clinical skill set may become quite different from what is required back in the States.  This may create an irrelevance, real or merely perceived, that makes re-entry difficult.

After his presentation on global health at Temple University Medical School, I took the opportunity to ask Dr. John Tarpley about ways to make this process less painful.  Dr. Tarpley, a general surgeon, spent fifteen years in Nigeria before returning to the States and currently serves in an academic position at Vanderbilt University Medical Center.

While his remarks are geared especially to an academic medical context, many of them will also hold relevance more generally.

  • Relationships are a somewhat ethereal, but important, part of the bigger picture.  It’s important to treat everyone well, remembering that your resident or fellow may someday be your boss!  Keeping in touch with key contacts while you’re abroad may also prove to be beneficial, allowing you to stay current on what positions may be opening up.  A good word from someone in the right position can make all the difference.
  • Use your furloughs wisely.  Most missionaries come back from the field temporarily, typically for a year, every so often.  While there are many things to do while home, you can also opt to work clinically during that time if you plan ahead.  Many universities have, or can create, positions that will last for the time you’re home, especially if you’re willing to do something less desirable.  Dr. Tarpley, for example, took extra call.  While he worked harder than his colleagues, he worked far less than he did while abroad.
  • Keep your certifications current.  There are often ways to maintain your credentials while abroad.  If you do this, you’ll be more prepared for re-entry if it comes upon you suddenly.
  • There is a certain cost to serving internationally.  While there are many things, such as the above, you can do to make a homeward transition more palatable, it won’t be entirely smooth.  This is simply part of serving Christ.  After all, we serve a Savior whose transition from heaven to earth was anything but easy.  It may take time to be (or return) to where you want to be after coming back, but you can trust that your are on God’s time-table.
  • Trust in what God was doing.  Although at first you may appear less relevant to your American colleagues, while you’re away God will give you the exact experiences and skills He wants you to have for the next leg of the journey.  Eventually, your new colleagues will see the value and wisdom in this, even if they can’t quite articulate that.

So, there are definitely barriers to serving internationally both before and after.  At the same time, God’s love for the world is greater than those barriers, and if He’s calling you away from home, He will make a way.

Tell us your story of God’s provision in the comments section!

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Serving In Academic Medicine

In a previous post, I said I’d share some takeaways from our two speakers at our local healthcare retreat.  This is the first of those two posts, and it concerns the message given by Dr. Smith (name changed to keep a lower profile), who works at a local teaching hospital.  I think you’ll find his comments helpful as you think about serving Christ in an academic environment.

To begin with, Dr. Smith emphasized that he strives to be, first and foremost, a Christian rather a physician who’s also a Christian.  In an environment where everybody has a title, simply bearing the name of Christ well – and finding your identity there – is what really counts.  This is also in contrast to being a Christian Nice Guy, a (genuine) believer who smiles and does whatever you ask him to, but fails to live courageously and clearly for Christ.  In both cases, the courage to live distinctively comes from finding our value and security in what God, not the people around us, say.  This is much easier said than done, and something we need to come back to routinely as we preach the gospel to ourselves moment-to-moment.

Dr. Smith has also found the academy to be a great place for sharing his faith, both directly and indirectly.  Physicians serving in this environment typically wear a number of hats, which affords opportunity for interactions not only with other Christians, but also with patients, students and residents, colleagues and staff who do not share his faith perspective.

Here are a few specifics that I found insightful:

  • In general, working hard and being competent (not necessarily the brightest or best) are important.  This not only honors God, but gives you a platform for talking about God when the opportunities arise.  No one will want to hear about Who you serve if they don’t respect how you serve.
  • Patients.  Patients are often at a place of physical vulnerability, which often creates an openness to spiritual discussion.  Physicians should be ready to discuss these things with permission and respect, but also boldness.  Spiritual histories (see below) are often a great starting point in this regard.
  • Students, residents.  While on service, Dr. Smith often has medical students and residents with him as he sees patients, presenting key opportunities to offer not only clinical, but spiritual, instruction.  He always takes a simple spiritual history, something he is ready to justify by pointing to the scientific literature, which shows that dealing with spirituality results in better health outcomes, is desired by most patients, and is in accordance with medical “best practices.”  Dr. Smith also uses specific teaching times to talk about these matters, and will invite students/residents to pray with/for patients who show interest in spiritual matters.
  • Colleagues, supervisors.  Again, character and competency are especially important here since respect won’t come through being further along in your training.  Boldness and risk are required since academic physicians have a reputation for being negatively inclined toward faith.  As an example, Dr. Smith shared how he’s going to hand out an appropriate Christian book to one of his colleagues and see what God does with that.
  • Staff.  Often, you’ll find other believers among staff who can challenge and encourage you.  Dr. Smith, for instance, learned that two janitors were already sharing Christ with some of his patients, which really spurred him on to be more straightforward himself.

The specifics of any particular calling within academic medicine vary greatly, so these tips are starting points that need to be thoughtfully applied.  At the same time, they are great guidelines that should be relevant in most situations.  If God is calling you to serve in the academy, He can use you there to make a powerful impact.

Following God Into The Future

As we think about our future, the examples of those who’ve gone before us can be powerful.  During my time in seminary, I can remember wanting to be like our senior minister, a great scholar who seemed like he could do it all.  So, during my final year in school, I started applying to PhD programs abroad.

A few days ago our local healthcare students organized a half-day retreat we call “Intermed.”   We didn’t advertise it this way, but our informal theme was something like “Academia, Foreign Missions & Everything In Between: Finding Your Future in Healthcare.”  To that end, we had two terrific speakers – Dr. Smith (name changed to keep a lower profile), who works at a local teaching hospital, and Gary Klein, a modern-day Indiana Jones providing primary care and training future pastors in the Dominican Republic.

So, what did we learn about pursuing God’s calling for our lives?

I’m going to write a post about the key takeaways from each of their talks, but first I want to take a step back and think about what we learned by looking at our speakers more generally.

As I did in my seminary days, it seems to me that we often romanticize the idea of calling, looking at others “ahead” of us as a sort of ideal.  Part of that is good: we see in others what we hope to see someday in ourselves.  Part of it, though, can come from our distance to their situation: we see the joys and successes with little real sense of the hardships that come with it.

More specific to the callings of our speakers, we can idealize both academic medicine and frontier missions.  Academics are the brilliant ones, well-respected, on the cutting edge of medicine.  Foreign medical missionaries have boundless faith, and do more with less as they serve the poorest of the poor.  Though these callings are worlds apart, they both have an aura that is almost surreal, alluring and unattainable at the same time.  We imagine that people like this must have it all together.

In light of this, our speakers did two things that were absolutely priceless.

First, they both affirmed that there are a million different ways to serve God in medicine.  They both said, multiple times, that their present callings are just two examples of entirely legitimate paths to serve the King.  At the end of the day, they are meant to be windows – we’re meant to see through them to God’s particular calling for our own lives.  That requires deep reflection, prayer and insight from others.

Second, both our speakers were humble and vulnerable.  They let us in on their shortcomings and failures.  Ironically, that was much more inspiring than if they had taken a more polished approach.  Sadly, even among Christians, this is all too rare, and it leaves us with a sense that we can’t be like the people we want to follow.

As for me, I never did make it overseas for doctoral work.  My wife became pregnant with our first child at just the “wrong” time to make it work.  With ten years of hindsight, I can see now that I was pursuing an image of what I thought I should be rather than what God had called me to be.  The story He has written for me is so much better than anything I could have authored.

So, back to you.  As you look forward to where God may be leading you, who are your heroes?  Do you have a realistic, balanced view of who they are, and what their life is really like?

Based on this weekend, I want to encourage you to do three things:

  • Make sure that you’re following God first and foremost as you make career decisions.
  • Get close to another Christian who’s doing what you want to do.  Find someone who’s willing to “let you in” on who they really are and what their life is actually  like.  This will benefit you (both) in ways that go way beyond medicine.
  • Commit to being this kind of person for others.  Start now, even if it’s small, by being an example worthy of following, yet equally real about your need for Christ.

May God direct your path as you lean on Him!