Figure. Medical students Geneva Pantoja (left) and Amanda Wibben (right) alongside urology interns Dr Bhimla Rambaran (middle left) and Dr Dominic Tam (middle right) at San Fernando General Hospital.

Trinidad is not a country to which we had ever intentionally considered traveling, but as daughters of Cuban immigrants and medical students with interests in global health, the opportunity to explore an unfamiliar specialty from the perspective of a Caribbean physician was especially enticing. For first-year medical students, exposure to urology typically consists of 1 or 2 lectures and a vague understanding of benign prostatic hyperplasia and prostate cancer. We each found ourselves particularly drawn to aspects of our preclinical curriculum like renal physiology and sexual health, but we quickly realized that we lacked firsthand knowledge of what a career in urology might entail. Eager to explore urology more closely, we sought out interest groups and faculty and both eventually came across an application for the Urology Care Foundation™ International Student Humanitarian Summer Grant Program. Through the program, we were fortunate to learn from several urologists at San Fernando General Hospital, including Dr Satyendra Persaud, who supervised our research directly.

Our research in Trinidad consisted of collecting clinical data from patients with prostate cancer in an effort to elucidate the disease’s economic impact on the country’s health system. Given that prostate cancer is the second most common type of cancer around the world, with high prevalence among Black men, and estimated to be the fifth most costly cancer for the US health system, understanding prostate cancer expenses specific to Trinidad is crucial for improving the country’s approach to screening and treatment.¹ Despite Trinidad’s incidence and mortality rates from prostate cancer, which are among the highest in the world, there is little existing literature about the burden of cost it generates on the local and national health care systems. Like many Caribbean countries, health care in Trinidad is free to its citizens, but this does not guarantee timely and accessible care. In line with the vision of the AUA’s Urology Care Foundation™, we hope our research leads to improvements in public health and the quality of urological care provided for this underserved population.

As a product of our research and the hospitality of the entire San Fernando General Hospital Urology Department, we were able to see urology in practice both in the clinic and the operating room, or “theater” as it is called in Trinidad. This experience not only allowed us to gather important data for our research on prostate cancer but also exposed us to the day-to-day lives of a diverse group of urologists. From routine visits for benign prostatic hyperplasia to emergency surgeries for testicular torsions, we were exposed to a wide breadth of urological cases. This diversity of cases sparked more excitement about a possible future career in urology. As rising second-year medical students, we are thankful to have learned an abundance of clinical knowledge that many of our peers may not experience until much further in their training. More importantly, however, we were grateful to learn from the unique stories and perspectives of patients in Trinidad. Their personal struggles illuminated the need for more timely care, adequate access to care, and functional resources needed to receive quality care.

Still, the privilege of living and learning in the Global North often colors perceptions of what health care looks like outside of the US. While care in public hospitals in Trinidad was sometimes limited by supplies, cost of drugs, or functionality of surgical equipment, patients were treated by exceptionally competent physicians who were often trained beyond the level of care the hospital infrastructure could provide. Doctors constantly organized, advocated, and researched in order to provide data that could support their departmental funding requests. House officers, a rough equivalent to residents, were both teaching interns and learning from their attendings, who graciously offered their teaching expertise to us as well (Figure). Despite coming from different backgrounds and levels of experience, we were warmly welcomed by all whom we had the fortune of meeting. As our summer in Trinidad came to an end and we began to reflect on our experience, it was clear that although our primary goal was research focused, we left with a more robust appreciation of global health care and the art of medicine as a whole—as well as a new friendship with one another. Our experience on the small twin islands of Trinidad and Tobago will forever shape our practice as future physicians.