Recent Botswana-based CHOP David N. Pincus Global Health Fellow, Dr. Meredith Hickson (2021-24), shares her global health journey and offered advice for aspiring fellows seeking to build a career in global health.
Immediately after graduating from college, Meredith Hickson, MD, signed on as a Peace Corps volunteer in Senegal, where she spent two years living in a rural community and working with community health workers to provide health education. This was the spark that ignited her desire to pursue a career in global health. By the time she became a pediatric resident at the Children’s Hospital of Philadelphia (CHOP), she had completed a one-year Fogarty Research Fellowship in Uganda and had remotely supported a research study on iron-deficiency anemia in Chile.
Despite limited opportunities for global health rotations during residency training due to the COVID-19 pandemic, Dr. Hickson found ways to engage with the global health community at CHOP and worked with Dr. Elizabeth Lowenthal, MD, MSCE, on projects in Botswana and the Dominican Republic. She doubled down on her local-global health work as a primary care provider at CHOP’s Cobbs Creek site, which serves a significant West African immigrant community. In the background, she was already researching global health fellowship opportunities. Even before discussing her interests with CHOP Global Health Center Medical Director, Dr. Andrew Steenhoff, the CHOP David N. Pincus Fellowship Program stood out. CHOP’s program was the only fully immersive one, allowing fellows to live and work overseas for 3 years. Additionally, the program would cover tuition for a master's program that aligned with each fellow’s professional goals.
Dr. Hickson was accepted into the CHOP David N. Pincus Global Health Fellowship Program in 2021. Even though the world was still grappling with the COVID-19 pandemic, Dr. Hickson didn’t find it daunting to move to Botswana for fellowship training. In some ways, it was easier than being in the US, as there was a more cohesive national response despite limited resources and delayed vaccine access.
For those interested in pursuing a global health fellowship, Dr. Hickson advises going in with a clear personal and professional development plan. It’s important to ask yourself, “Why am I doing this? Why is living in another country important for me? Why is learning how to practice medicine in another country important for the things that I'm interested in?” She emphasizes that clarity about your goals is tremendously important because the CHOP David N. Pincus Global Health Fellowship is based abroad for 3 years— “Three years is a long time to be away from your family; sometimes you may have to be away from your partner for the whole time, and at other times only part of the time. If you have children, then you're relocating them for that period of time, and so you have to be really clear about what you're getting out of the experience.” She also notes that integrating into a new community can be challenging, but the key is to be willing to meet new people.
Dr. Hickson encourages taking the first year of fellowship to learn about the health system and the community or population you will be serving. Doing this well to understand the community's needs requires being a good listener and a good colleague— “You don't have to come in knowing what's going to happen for the entire fellowship.” Clinically, Dr. Hickson knew she was interested in caring for critically ill children. How that would translate into an academic project beneficial to colleagues in Botswana emerged after she had settled into her new life there and after several conversations with faculty at CHOP, the University of Botswana (UB), and Princess Marina Hospital (PMH), including Dr. Elizabeth Lowenthal, Dr. Dipesalema Joel, Dr. Britt Nakstad, and Dr. Una Mulale. It soon became evident that developing a pediatric early warning system (PEWS) would be ideal, and it could feasibly be completed during the fellowship.
PEWS provides a standardized approach for clinicians to identify hospitalized patients at risk of clinical deterioration, prompting them to escalate care to prevent or reduce serious adverse events. For Dr. Hickson and her research team, this meant updating the nursing documentation to include the PEWS scoring system. This was followed by facilitating training for nurses on using the scoring system, explaining its importance and how it would help them, and securing their buy-in. With support from Dr. Sam Matula, PhD, faculty in the University of Botswana's School of Nursing and one of the nursing educators at PMH, Dr. Hickson tested and refined the scoring system through an iterative process, collecting feedback from nurses who used it. Once the program had been implemented, she met with hospital administration to share lessons learned and explore opportunities to advance the work. She also presented her findings to the Ministry of Health to explore the project's implications for other health facilities in Botswana. Dr. Hickson is proud of the work she and her colleagues accomplished by implementing PEWS.
I think the breadth of things I learned - how to manage a case, how to diagnose, is wider than it would have been if I hadn't left the U.S. I got incredible hands-on training in managing patients with socioeconomic disparities or how come from different cultures. - Dr. Meredith Hickson
Dr. Hickson has since completed her Fellowship training and also earned a Master of Science degree in Epidemiology, which she credits as “having added to my toolbox of skills in epidemiology and public health, tools I look forward to using throughout my career.” She is now an assistant clinical professor of pediatrics at Michigan State University and Helen DeVos Children’s Hospital in Grand Rapids, Michigan. Helen Devos Children’s has a smaller global health program that Dr. Hickson currently leads. She teaches and mentors pediatric residents using a didactic curriculum that covers common diseases and conditions that may be more prevalent in low-resource settings, such as malaria, HIV, and TB. Residents also discuss and explore the intersection of public and global health, global health ethics, the history of high-income country involvement in other countries, and what has worked well and what hasn’t. Additionally, Dr. Hickson is helping develop more formalized, bi-directional partnerships between the Global Health program and international sites.
Learn more about Dr. Hickson’s PEWS findings published in BMJ Paediatrics Open.
Featured in this article
Specialties & Programs
Recent Botswana-based CHOP David N. Pincus Global Health Fellow, Dr. Meredith Hickson (2021-24), shares her global health journey and offered advice for aspiring fellows seeking to build a career in global health.
Immediately after graduating from college, Meredith Hickson, MD, signed on as a Peace Corps volunteer in Senegal, where she spent two years living in a rural community and working with community health workers to provide health education. This was the spark that ignited her desire to pursue a career in global health. By the time she became a pediatric resident at the Children’s Hospital of Philadelphia (CHOP), she had completed a one-year Fogarty Research Fellowship in Uganda and had remotely supported a research study on iron-deficiency anemia in Chile.
Despite limited opportunities for global health rotations during residency training due to the COVID-19 pandemic, Dr. Hickson found ways to engage with the global health community at CHOP and worked with Dr. Elizabeth Lowenthal, MD, MSCE, on projects in Botswana and the Dominican Republic. She doubled down on her local-global health work as a primary care provider at CHOP’s Cobbs Creek site, which serves a significant West African immigrant community. In the background, she was already researching global health fellowship opportunities. Even before discussing her interests with CHOP Global Health Center Medical Director, Dr. Andrew Steenhoff, the CHOP David N. Pincus Fellowship Program stood out. CHOP’s program was the only fully immersive one, allowing fellows to live and work overseas for 3 years. Additionally, the program would cover tuition for a master's program that aligned with each fellow’s professional goals.
Dr. Hickson was accepted into the CHOP David N. Pincus Global Health Fellowship Program in 2021. Even though the world was still grappling with the COVID-19 pandemic, Dr. Hickson didn’t find it daunting to move to Botswana for fellowship training. In some ways, it was easier than being in the US, as there was a more cohesive national response despite limited resources and delayed vaccine access.
For those interested in pursuing a global health fellowship, Dr. Hickson advises going in with a clear personal and professional development plan. It’s important to ask yourself, “Why am I doing this? Why is living in another country important for me? Why is learning how to practice medicine in another country important for the things that I'm interested in?” She emphasizes that clarity about your goals is tremendously important because the CHOP David N. Pincus Global Health Fellowship is based abroad for 3 years— “Three years is a long time to be away from your family; sometimes you may have to be away from your partner for the whole time, and at other times only part of the time. If you have children, then you're relocating them for that period of time, and so you have to be really clear about what you're getting out of the experience.” She also notes that integrating into a new community can be challenging, but the key is to be willing to meet new people.
Dr. Hickson encourages taking the first year of fellowship to learn about the health system and the community or population you will be serving. Doing this well to understand the community's needs requires being a good listener and a good colleague— “You don't have to come in knowing what's going to happen for the entire fellowship.” Clinically, Dr. Hickson knew she was interested in caring for critically ill children. How that would translate into an academic project beneficial to colleagues in Botswana emerged after she had settled into her new life there and after several conversations with faculty at CHOP, the University of Botswana (UB), and Princess Marina Hospital (PMH), including Dr. Elizabeth Lowenthal, Dr. Dipesalema Joel, Dr. Britt Nakstad, and Dr. Una Mulale. It soon became evident that developing a pediatric early warning system (PEWS) would be ideal, and it could feasibly be completed during the fellowship.
PEWS provides a standardized approach for clinicians to identify hospitalized patients at risk of clinical deterioration, prompting them to escalate care to prevent or reduce serious adverse events. For Dr. Hickson and her research team, this meant updating the nursing documentation to include the PEWS scoring system. This was followed by facilitating training for nurses on using the scoring system, explaining its importance and how it would help them, and securing their buy-in. With support from Dr. Sam Matula, PhD, faculty in the University of Botswana's School of Nursing and one of the nursing educators at PMH, Dr. Hickson tested and refined the scoring system through an iterative process, collecting feedback from nurses who used it. Once the program had been implemented, she met with hospital administration to share lessons learned and explore opportunities to advance the work. She also presented her findings to the Ministry of Health to explore the project's implications for other health facilities in Botswana. Dr. Hickson is proud of the work she and her colleagues accomplished by implementing PEWS.
I think the breadth of things I learned - how to manage a case, how to diagnose, is wider than it would have been if I hadn't left the U.S. I got incredible hands-on training in managing patients with socioeconomic disparities or how come from different cultures. - Dr. Meredith Hickson
Dr. Hickson has since completed her Fellowship training and also earned a Master of Science degree in Epidemiology, which she credits as “having added to my toolbox of skills in epidemiology and public health, tools I look forward to using throughout my career.” She is now an assistant clinical professor of pediatrics at Michigan State University and Helen DeVos Children’s Hospital in Grand Rapids, Michigan. Helen Devos Children’s has a smaller global health program that Dr. Hickson currently leads. She teaches and mentors pediatric residents using a didactic curriculum that covers common diseases and conditions that may be more prevalent in low-resource settings, such as malaria, HIV, and TB. Residents also discuss and explore the intersection of public and global health, global health ethics, the history of high-income country involvement in other countries, and what has worked well and what hasn’t. Additionally, Dr. Hickson is helping develop more formalized, bi-directional partnerships between the Global Health program and international sites.
Learn more about Dr. Hickson’s PEWS findings published in BMJ Paediatrics Open.
Contact us
Global Health Center