Dr. T. Paul Tran wanted to return to his native Vietnam to share what he knew about how the U.S. trains future physicians, and he won a grant to do that. But he was diagnosed with stage 4 lung cancer before he could make the trip.
Tran died in September 2012, about six months after his diagnosis and five months after he was awarded the grant from the Vietnam Education Foundation's U.S. Faculty Scholar Program. He was 56.
The foundation withdrew the money after Tran's death. The outreach effort could have died with him.
But Tran's colleagues in the Department of Emergency Medicine at the University of Nebraska Medical Center had told him they would continue his work. They reapplied for and received the $33,000 grant. They flew to Vietnam earlier this month.
“I committed to Paul that we'd make sure we'd do whatever we could to make it happen,” said Dr. Robert Muelleman, department chairman.
Muelleman, Drs. Michael Wadman and Wes Zeger and Thang Nguyen, a clinical research nurse, traveled to Thai Binh, a city of more than 200,000 people in northern Vietnam where Tran's parents had once lived. In 1954, the family moved to what then was South Vietnam. In 1975, they came to the United States.
Tran and his wife, Christine Nguyen, visited Thai Binh in 1998 and saw how physicians were trained. Nguyen said her husband decided then to someday return to help improve medical education there.
The UNMC group went to Thai Binh Medical University, bringing with them an ultrasound simulator to teach bedside diagnostic methods.
Training for emergency medicine isn't as advanced in Vietnam as it is in the U.S., said Muelleman and Wadman, who is an associate professor of emergency medicine. The subject is taught as a specialty in only one Vietnamese medical school, Muelleman said.
“More generalists are assigned to the emergency departments,” Wadman said. “There's a lot of on-the-job training. That's really the way it used to be here in the United States.”
Classes are more traditional in Vietnam, the two said, with professors lecturing and students taking notes. In the U.S., they said, lectures incorporate more discussion.
If a lecturer asks a question in a Vietnamese classroom, Wadman said, “the most senior person is expected to answer first. You don't get the give and take.”
The UNMC team lectures, Wadman said, addressed emergency skills, airway management and the use of ultrasound machines. Throughout the lectures, he said, the UNMC team referenced Tran's style of teaching and asked the question Tran often would ask students: “How can it be? How can it be that this patient presented this way or is not responding the way we expected him to?”
Students took to the discussion format and started to participate more. Eventually, students from other classrooms started coming to the Americans' presentations.
Even though they had to sit through the English-language lectures being translated into Vietnamese, Muelleman said, the students were very attentive. “I can imagine sitting through a lecture in Vietnamese being translated into English. I'd be checking my cellphone.”
“You could see some of the traits in those students that you saw in Paul,” Muelleman said. “Hard work, kind of thirsting for knowledge.”
Since they returned from their 10-day trip, the UNMC team has been discussing cases with the Vietnamese students via teleconference. In January, what may be a slightly reconfigured UNMC team will return to teach more hands-on skills.
Christine Nguyen said she hopes an academic and cultural exchange program can be established between UNMC and the Thai Binh med school. The UNMC team's work, she said, represented more than finishing her husband's project.
“It's fulfilling a promise,” she said. “They're fulfilling a dream Paul had.”