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In recent years, there has been a surge in the number of global health programs directed by academic institutions. Global health programs take many forms, focusing on different curricular goals such as knowledge attainment of endemic diseases, community service projects, and improved foreign-language skills. This is an expository paper describing the origins and evolution of the medical exchange program between Rhode Island Hospital and Hospital Regional Universitario José María Cabral y Báez. The exchange program is unique because it is trainee- driven and has strived to maintain a bilateral educational exchange over the past 15 years. Future goals for the program include further developing a research curriculum for both institutions and creating a longitudinal relationship with a community-based state-funded clinic in Santiago, Dominican Republic. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 32-year-old mother at 30-weeks of gestation who was referred with preterm labor for a trial of labor after cesarean section. The case shows an interaction of a medical student who felt a professional obligation to address birth control options with the patient despite lack of interest of the latter in a birth control method. The need for the student to focus to the birthing mother and the impact of multiple pregnancies on her health is also explored.