Rotation Goals, Requirements, and Application Information


Students and residents can schedule a four-week global health rotation at clinics in San Andrés Itzapa, Guatemala; Tecpan, Guatemala; Chacraseca, Nicaragua; and Ngoswani, Kenya. Rotations include exposure to aspects of patient management in a family medicine practice, and can also include reading, lectures, and community outreach, as well as some application of osteopathic principles.


Guatemala  **Please note that rotations to Guatemala are currently on hold due to the pandemic.**

In Guatemala, students and residents rotate at our partners’ clinics in San Andres and Tecpan. Both focus on under-served, low-income communities where continuity of care is relatively new and preventive medicine is emerging.



The community of Tecpan is located to the east of the Lake Atitlan, an area famous for its natural beauty, and 55 kilometers northwest of Antigua. This rural rotation is at a clinic with two doctors, a caseload of 250 patients a month, and a standing commitment to public health programs. Rotating students and residents will be able to complete a rotation away from an urbanized, Anglophone environment, thereby experiencing immersion in Guatemalan rural life.


San Andres Iztapa

San Andres Iztapa is DOCARE’s first clinic partnership, and it remains one of its most stable. This clinic is close enough to Antigua that rotating students and residents can stay there each night. During clinic hours, the on-site doctor will work closely with the rotating student or resident. In addition, the clinic might arrange occasional community outreach projects and home health visits during rotations.


Nicaragua  **Please note that rotations to Nicaragua are currently on hold.**

Rotation opportunities to Nicaragua are currently suspended due to a US State Department Level 3 Travel Advisory Warning.  

In Chacraseca, Nicaragua — an extremely impoverished area with just one physician and one dentist for 8,000 people — the rotation will expose students and residents to various aspects of patient management in a rural primary care setting. Rotation participants can expect to be in clinic from 7:30 a.m. to 12:30 p.m. most weekdays, to participate in house calls and health outreach programs into the outlying sectors of the community, and to spend most afternoons engaged in reading or volunteering at the community’s nonprofit organizations.


Kenya  **Please note that the Ngoswani clinic is not accepting clinic rotation requests for dates occurring prior to January 2021**

The Ngoswani clinic is located in Narok County, Kenya, not far from the famed Maasai Mara National Reserve. The area is known for its rurality and strong local culture. Rotating students and residents will work closely with doctors and other health professionals at a full-service primary care clinic. Along with weekday clinic hours, visitors can expect an immersive cultural experience and guidance from the clinic’s head physician, Dr. Tonya Hawthorne, a US-trained Doctor of Osteopathic Medicine.

Note that this clinic only accepts students and residents in the primary care discipline and cannot accommodate any special dietary needs.

Educational Goals

  • Provide a fundamental knowledge base in family medicine and assist students in applying this knowledge. (Competency: Medical Knowledge and Application of Medical Knowledge)
  • Introduce the student to basic procedures relevant to the practice of family medicine.
  • Facilitate an understanding of the approach to clinical problem-solving in family medicine, including the appraisal and assimilation of scientific evidence. (Competency: Practice-Based Learning and Improvement)
  • Promote the acquisition of basic skills for the diagnosis, management, and prevention of a variety of chronic and acute conditions. (Competency: Patient Care)
  • Encourage the continued development of the student’s professional attitude and behavior, including adherence to ethical principles and sensitivity to diverse populations. (Competency: Professionalism)
  • Introduce available healthcare resources as well as barriers to coordination of care and expose them to strategies the family physician uses as coordinator of care. (Competency: Systems-Based Practice)
  • Encourage the further development of effective, respectful communication between the student, patient, families, staff, and other healthcare professionals. (Competency: Interpersonal and Communication Skills)
  • Promote the use of a holistic approach to patients that encompasses the psychosocial, biomedical, and biomechanical aspects of health and disease, including the use of manual medicine techniques when appropriate. (Competency: Osteopathic Philosophy and OMT)

Rotation Requirements

  • Program participants must be active DOCARE members ( $50 fee for students/$60 fee for residents, good for the duration of your medical school degree or your residency program).
  • Once a rotation has been approved, program participants must register and pay for an account directly with My Clinical Exchange ($36.50 normally, or $20 – starting January 2020 – for a 6-month subscription), where all required documents must be uploaded.
  • Application documents must be returned 60 days prior to the start date.
  • A non-refundable fee of $400 must be paid to DOCARE at least 60 days prior to your rotation start date.
  • Program participants must be in good academic standing at an academic institution in the United States (students) or graduates of an accredited allopathic or osteopathic medical school in the United States (residents).
  • Program participants must have emergency medical evacuation insurance.
  • Program participants are encouraged to have language skills commensurate with the site they visit; in Guatemala, this involves near-fluent knowledge of Spanish, including medical Spanish; in Nicaragua, optional working knowledge or engagement with a translator for an additional fee; and in Kenya, basic knowledge of key Swahili terms for the purpose of etiquette (information will be provided at the time of registration).
  • All required forms and permission from your school or residency program for global health rotation are the obligation of the program participant.
  • Program Participants may have additional fees to pay directly to the partner organization; please review clinic guidebooks thoroughly to ensure you have completed all necessary registrations.

How to Apply

DOCARE uses myClinicalExchange to manage all rotation requests.  Once your rotation request is approved you must establish an account with them in order to proceed.  The fee for mCE is $36.50 (or $20 – starting January 2020 – for a 6-month subscription), paid directly to them.  You only pay this fee after your rotation has been approved.

Once you have established your account in mCE you will receive all of the compliance documents that must be completed at least 2 weeks prior to your departure.  If you do not establish an account in mCE, then your rotation, while approved, is not considered scheduled and you cannot travel.

        ***Watch a video tutorial on how to use myClinicalExchange.***

When you are ready to apply for a rotation, click here to begin.

Please note that most students and residents will need to seek approval at their home institutions two to four months in advance of travel. We advise all applicants to review their university or healthcare facility’s information on international rotations as they arrange their rotations.

How to Pay for a Rotation

Participants are required to:

  • be a DOCARE member ($50 for students/ $60 for residents), and
  • pay a rotation fee ($400).

If you have been accepted to a DOCARE rotation, please click here to pay your membership and rotation fees.  [Note:  If you are already a member, you only need to pay the rotation fee.  If you are unsure of the status of your membership, please contact]

Grants and Scholarships

**DOCARE is pleased to be able to offer a limited number of travel grants to osteopathic medical students or residents.  Travel grants will be awarded on a rolling basis throughout the year as long as funds are available.  The maximum amount of a travel grant is $1000.

Access the grant application here.

**American Osteopathic Foundation (AOF) has opened its 2019 humanitarian outreach grant application cycle.  These grants can help assist DOCARE members who participate on outreach trips or rotations.  Please check the AOF website for more information.

**Students enrolled at either AZ-COM or ATSU-SOMA are eligible to apply for a grant generously funded by the Arizona Osteopathic Charities. Applications for this grant will be accepted on a rolling basis through May 2020, or until the grant has been expended. To find out more about this opportunity and apply, click here.

**In addition to the link(s) above, we recommend that students contact their university DOCARE chapters, university global health departments, and university grant and scholarship resources centers for information on funding options.