Abstract. In 2008, the UCLA Department of Medicine established a three-week clinical elective in Malawi, Africa, for Medicine and Medicine/Pediatrics residents. We sought to determine whether the elective resulted in improved medical knowledge, alterations in career trajectory, and whether the opportunity for the elective influenced selection of UCLA for residency. A 29-question survey was distributed to all graduates of the elective from 2009-2013. Surveys were distributed to 40 individuals, with 33 responses (82.5%). Thirty-one participants (93.9%) reported increased medical knowledge and 24 participants (72.7%) reported the rotation altered their career trajectory. Among the 23 residents who came to UCLA after the elective was established, 13 (56.5%) stated it had an influential role in their selection of UCLA for residency. The Malawi elective resulted in self-reported increases in medical knowledge, alterations in career trajectory, and has played an important role in attracting individuals to UCLA for residency.

The approach to clinical conundrums by an expert clinician is revealed through the presentation of an actual patient's case in an approach typical of a morning report. Similarly to patient care, sequential pieces of information are provided to the clinician, who is unfamiliar with the case. The focus is on the thought processes of both the clinical team caring for the patient and the discussant. This icon represents the patient's case. Each paragraph that follows represents the discussant's thoughts.

Malawi has the highest incidence of and mortality rate due to cervical cancer in the world. This is largely because of inadequate screening and high rates of human immunodeficiency virus (HIV) infection, which greatly increases cervical cancer risk. We describe the implementation of a quality improvement program to increase use of cervical cancer screening at a non-government medical center in Lilongwe, Malawi. The intervention, developed and launched from March to August 2017, aimed to promote education among patients and clinicians about the importance of cervical cancer screening and improve accessibility of screening information within medical records. Visual inspection with acetic acid (VIA) was used to screen for cervical cancer. Women with a positive VIA were offered treatment using thermocoagulation. The number of VIA screenings conducted in 2016 (pre-intervention), 2017 (intervention), and 2018 (post-intervention) was 125, 234 and 456, respectively. Of the 815 women screened during this period, 36 (4.4%) had a VIA-positive result and 12 (1.5%) had suspect cancer. Of the VIA-positive women, 13 (36.1%) received same-day treatment with thermocoagulation. An interrupted time series regression revealed that there was a sustained increase in monthly screenings between the pre- and post-intervention period ( β = 30.84; p = 0.006; 95% CI 9.72–51.97), suggesting that the intervention likely was effective in increasing cervical cancer screening. Our results demonstrate that focusing on developing sustainable solutions and improving system processes, without additional equipment or funding, significantly increased the number of women screened and should be considered in other settings to enhance cervical cancer prevention services.