Public Health Science Abroad

by Lauren Hall

After a week in the south of France, we have really been able to experience most of Aix-en-Provence’s sights and activities. Whether it’s the beautiful markets with fresh produce or a cafe tucked into the corner of a plaza, Aix has proved to be a wonderful city. We have already covered a lot of ground in our understanding of international health systems, beginning with the United States. On our first day in class, we gained a broader understanding of how our system works, including financing, coverage, and medical education. We also learned about the French healthcare system, which strongly prioritizes equitable access for all its citizens. In this lecture, I learned that France provides universal healthcare coverage for all people within its borders, and that additional coverage can be purchased through a mutuelle. We were also able to zoom in specifically to women’s healthcare in the country by listening to our guest speaker, Emmanuelle Hartman. Some of the most shocking differences in the French healthcare system are that women typically get around four months of paid maternity leave, and they are also mandated to get screened for common diseases such as cervical or breast cancer.

To wrap up our first week in France, our group took a day trip to explore some of the other sights the south of France has to offer. We began our day with the typical French breakfast consisting of a cappuccino, fresh jams, and my favorite – pain au chocolate. We then reached our first destination, Pont du Gard. This structure is considered one of the best-preserved Roman aqueducts, dating back almost 2,000 years. As we walked across the main bridge, it was incredible to consider how talented the architects must have been to build something of that size with a fraction of today’s technology. The beaches at the base of the structure provided a great view and opportunity to take some pictures (like these!). The museum that followed provided insight into how aqueducts use gravity to deliver water to an entire city, enabling even indoor plumbing. I would love to come back in future years in July or August, since the river flowing below it becomes warm enough to swim and relax in.

 After this excursion, we made our way to the actual city of Avignon, where we were immediately impressed by the high city walls and the palace that succeeded them. As we initially explored the city, a few of us found a small Japanese restaurant where we got delicious bento boxes. We didn’t stay too long, though, because we were excited to explore the lookouts located at the top of the city. This was hands down the best scenic outlook of the day!

Finally, our tour of the Palace of the Popes began, which I had never heard of until this week. The tour explained that, for a brief period, the papacy’s headquarters were moved from Vatican City to Avignon in the 1300’s. Much of the architecture reflected this time period with gargoyles and sweeping rooms filled with frescoes. Along with the elaborate interior, the gardens and courtyards also provided calm places to sit and chat with friends. Overall, this has been an excellent week filled with new friends, great food, and interesting history!

by Avery Fleming

Bonjour!

This first amazing week in Aix-en-Provence has been jam packed with friends, food, and learning.

Our first few days were spent working off jet lag while taking in our new town. My first thoughts were that Aix looked as though it was a storybook town straight out of Beauty and the Beast. Saturday and Sunday were a lot cooler than I was expecting, but it was nice for our walking tours of both the International American University and town as a whole. We also visited and learned about many of the beautiful and historical fountains that make Aix known as “The fountain town.” Over the first weekend, our group honestly clicked fast as we walked everywhere together and bonded over health care.

Throughout the week, we began classes and were joined by three guest speakers. We started by learning about the United States health care system and reinforced general concepts that most of us had learned in various other classes. In comparison, we then learned about the French health care system. I was surprised to learn that some of the concepts were very similar to the United States. However, there were some large differences as well, such as their increased taxes and paid time off, but most notably, the universal health care structure. Our first speaker, Emmanuelle Hartmann, spoke to our female-dominated group about women’s health in France and the overall focus of the French health care system. After this, Nitin Beeharry and Benjamin Gerard, spoke with us about the ins and outs of the French health care system and how this system came to be. In addition to our lecture portion, we spent two days touring parts of Camp de Mille, Pont du Gard, and Avignon. These immersive experiences allowed us to take in more of this beautiful and historic country.

France so far has been nothing short of a dream. Although my French is terrible and I still really have to think if I say “Bonjour” or “Merci,” I have truly loved the culture and life here. The walkable city allows for a different way of life where the streets are not overrun with cars, but instead have people walking, selling flowers, or offering candy samples. Three days a week, there is a large market where locals have stands for textiles, foods, and other goods. I was able to spend time with my friends walking around and discovering many things that are not often available in the United States. We found that our new favorite meal is a focaccia sandwich with truffle spread and prosciutto. I have also had the opportunity to try so many different sweets and fun snacks, but my favorites are definitely the fresh fruit, Nutella crêpe, and a classic chocolate croissant.

Overall, studying abroad and signing up without knowing anyone has paid off already in more ways than I could have imagined. First, with my end goal of being a physician in the United States, I believe that learning about our health care system in comparison to other health systems and societal infrastructure allows for a deeper perspective of medicine globally. Next, this experience has already opened my eyes to places I likely would have never had the opportunity to immerse myself in otherwise. Last, I have met absolutely amazing people that I couldn’t imagine this trip without! I can’t wait for all that is to come in the next three weeks and even though this trip will be over before I know it, these memories will be with me forever!

by Abby Flynn

Bonjour!

This past week in Aix-en-Provence has been nothing short of amazing.

One of my favorite days has been visiting the Toulouse- Lautrec exhibit. We followed along with
his work through individual players, which allowed us to play an audio recording of the piece
after we reached a certain number. It was really nice for everyone to go at their own pace and
appreciate the art. His work was so lovely to see; one of my favorite pieces was of Jane Avril.
She was a French dancer at the Moulin Rouge in Paris. She was known for her jerky
movements and was nicknamed “La Melinite” (meaning “explosive”). In this photo, specifically,
she was sitting in an audience of a theater. Toulouse- Lautrec used abstract elements but
noticeable symbols, like black gloves, to help others recognize what he was painting.

The first two days of classes were focused on the United States healthcare system. Although I
had a bit of prior knowledge, I was really interested in learning why and how this system came
to be, as well as the current problems our country faces. The United States truly is so different
from the rest of the world, and I enjoyed learning more!

Today, we started by learning more about the French healthcare system. It was interesting to
learn how every system prioritizes different areas of improvement and that there’s no correct
way to make a perfect system. We split into groups of three and separately rated 5 categories
(cost, access, outcome, innovation & research, and opinions). After sharing our rankings, there
were no rankings alike. This really highlighted how different countries prioritize different needs
and how there’s no “correct answer”. We also had the privilege of hearing from Professor
Beehary from the IAU this past week about the Healthcare system in France. This has been one
of my favorite speakers, and he made his lecture interactive as well. He shared about the three
key principles of healthcare in France- Equity, Accessibility, and Quality and transitioned into the
history of how the system came to be. One of the most shocking things I learned was how high
taxes are in France. Some of the higher brackets pay 45% of their pay and are okay with it,
mostly because of the care they receive. Another cool thing I learned was that France has a
“Mutuelle,” which is complementary health insurance on top of universal care. Since 2016,
employers have been required to pay at least 50% of this additional healthcare, but most pay
60-70%. It is divided into two sectors. The first sector is the set-fee sector, reimbursed by the
Sécurité Sociale; it is known as the “public” sector. This sector typically has better equipment
and services. The second sector is free to set fees and can charge extra. All workers in this
sector typically start in Sector 1 and move to the “private sector”.

I am so excited to see what the rest of this trip has in store for us! Au revoir!

by Kelsey Glessner

The past few days in Aix-en-Provence have been wonderful! On Tuesday (5/19), we started the academic portion of our trip with a morning lecture on the United States Healthcare System, where we learned about its strengths and weaknesses and its general structure. The United States has an ever-growing technology base and a strong drive to learn and discover more about potential cures and improved healthcare. However, our health outcomes are not necessarily better than those of other countries. Although our tax costs are low, we struggle to provide equal access to healthcare for everyone and continue to spend unnecessary money repeating tests to prevent patients from suing providers or healthcare companies for negligence and malpractice. The picture below shows our classroom where we spent the morning learning!

After our class, some of us went to explore the local market. Aix-en-Provence has three different local markets filled with food, jewelry, bags, and clothes. We spent our entire break wandering through all of the unique stores. Before we returned to our classroom, we grabbed a quick lunch and ate on the way to class. The sandwiches in France are truly so delicious. Below is a picture of some beautiful jewelry we saw at the market!

During our second class session, we heard from two guest speakers. The first was a French woman, Emmanuelle Hartmann, who discussed what women’s health looked
like in France. I really enjoyed hearing from her and learned many interesting truths about France’s healthcare system regarding women, including: abortion is legalized, women get a four-month maternity leave, many tests and screenings for diseases are mandated, and IVF is covered for the first three treatments by the French healthcare system.

The second speech came from a CNRA (the French term for CRNA) and another man who spoke on the French Healthcare system, how it operates, and how the French system and medical schooling differ from ours. We learned that the French Healthcare system focuses on equity, access, and quality. France operates under a risk-averse system, meaning stability is very important in its healthcare system. Something that shocked me was the amount of paid time off the French receive, which can total around 5 to 8 weeks of vacation time. Secondly, I was shocked to hear that medical school is free in France, though it becomes highly competitive by the second year, reducing many people’s chances of becoming physicians.

After an amazing first day of classes, I went to hang out with some of my new friends and had a wonderful dinner at a local restaurant called Chez Lion. We shared some hummus and bread, and truffle pasta, which was inDuring our second class session, we heard from two guest speakers. The first was a French woman, Emmanuelle Hartmann, who discussed what women’s health looked
like in France. I really enjoyed hearing from her and learned many interesting truths about France’s healthcare system regarding women, including: abortion is legalized, women get a four-month maternity leave, many tests and screenings for diseases are mandated, and IVF is covered for the first three treatments by the French healthcare system.

The second speech came from a CNRA (the French term for CRNA) and another man who spoke on the French Healthcare system, how it operates, and how the French system and medical schooling differ from ours. We learned that the French Healthcare system focuses on equity, access, and quality. France operates under a risk-averse system, meaning stability is very important in its healthcare system. Something that shocked me was the amount of paid time off the French receive, which can total around 5 to 8 weeks of vacation time. Secondly, I was shocked to hear that medical school is free in France, though it becomes highly competitive by the second year, reducing many people’s chances of becoming physicians.

After an amazing first day of classes, I went to hang out with some of my new friends and had a wonderful dinner at a local restaurant called Chez Lion. We shared some hummus and bread, and truffle pasta, which was incredible. After dinner, we stopped for some gelato.

The next day, on Wednesday, May 20th, we woke up and headed back to our classroom to finish up learning more about the United States Healthcare System and a recap of the French Healthcare System. After class, I went with some of the group to get a quick lunch. We got poke bowls (the best I have EVER had), sat by the beautiful Rotonde fountain, and ate together, enjoying the warm weather. We spent the afternoon touring Camp des Milles, an internment camp where Jews were locked away before being sent to Auschwitz. The tour was very eye-opening to the unimaginable conditions that these people had to endure.

by Abby Tyndall

Even though we have only been in Aix-en-Provence for three days, I feel like we have already had so many great experiences in this beautiful city. Yesterday was our first official day of class, and we spent our day getting acquainted with the IAU-ACM campus and Aix as a whole. After our orientation with the IAU staff, we took a lunch break at Cafe Med, a cafe specifically reserved for students. After lunch, we set out to explore the city, and stopped inside this stunning cathedral near campus.

Next, we were given a guided tour of the city, in which we learned about some of its history and landmarks. This glimpse into Aix helped us to better understand the environment we will be studying in during the next two weeks, and it only made me more excited! One particularly interesting stop was the Palais de Justice, where there is currently a high-profile trial taking place. Other than that, we were educated about Aix’s notable locations, as well as many beautiful fountains, which the city is known for (given its nickname, the “city of a thousand fountains.”)

That night, a large group of us had dinner at Casa Capri, an Italian restaurant in the city center, and I will definitely have to visit it again before we depart for Madrid!

On Tuesday, we began delving into the subject of health systems, which we will be studying throughout this trip. Our morning consisted of an introduction to the healthcare system as it exists across the world, including an overview of America’s approach to healthcare, which we will utilize as a point of comparison to that of the countries we plan to visit.

After our morning class, me and three other members of our group ventured out to the food, flower, and clothing markets on Cours Mirabeau and Place Richelme, where we spent the afternoon sipping our coffee and shopping in the numerous stalls. My favorite stall was a vendor selling what must have been a million different types of soap, and I could not resist buying a few for myself!

Our class session on Tuesday afternoon contained two wonderful guest speakers who provided us with greater insight into the French healthcare system. I was most captivated by the first speaker, who discussed women’s health in France, as well as Aix-en-Provence in particular. Women’s health was one of the topics I was most excited to learn about during this experience, so I am grateful that we got such an informed perspective on it from our speaker

by London Hoxworth

It has been such a fun and exciting time in France so far, packed with such good food and getting to know my peers! I have especially loved working on my French and trying to speak to the locals.

We started classes yesterday and had our first orientation at the Institute for American Universities (IAU) where the Dean of Students shared university policies and current students shared bits of advice and recommendations on places to visit while in Aix. We then went for a tour of the campus and got to see all the buildings. One of my favorite spots was the garden behind the Villa Celony building! It was very calm and peaceful out there. For lunch, a group of us grabbed a croissant at La Maison de La Viennoiserie. I had a chicken sandwich on a croissant and it was amazing! Some of my friends got the raspberry (framboise) filled croissant, which looked incredible!

We ate lunch at the Med Cafe, the student-only cafe on campus, where we met some students from the University of Michigan that were also in Aix studying abroad. After lunch, we went back to the classroom and had a quick debrief of upcoming assignments and we were able to meet with our groups to talk about what we wanted to do for our group project. We had a city tour of Aix, where we learned about some of the history of the city! Then, some of my new friends and I went shopping and had dinner at a sushi restaurant! It was such a fun day but I was exhausted after it all.

Today was a lecture-heavy day. We started out the morning with learning about the U.S. healthcare system, going over its complexity and uniqueness. Afterwards, we had a long lunch break, where a group of us spent exploring the market, but we needed to stop at our favorite coffee shop first!

For lunch, we had bagels from a place called Bagelstein, which I would highly recommend. It’s a great spot for a grab-and-go lunch and you could also eat in if you want. After that, we went back to campus, where we had two lectures about the French healthcare system. The first lecture was focused on women’s health and was given by a former leader of the Saint Marc Jaumegaude village.

This lecture was amazing and taught me much about French policy as it relates to women’s health. For example, French women have a federally mandated maternity leave of 16 weeks, while in the U.S., that gets decided on by employers. The second lecture provided an overview of the French healthcare system. I was fascinated by how different and more straightforward many of its policies seemed compared to the U.S. healthcare system. I also really appreciated the opportunity to hear firsthand about the experiences of a French healthcare worker. I know that these lectures are helping me to expand my cultural knowledge which will help me in the future in my role as a healthcare administrator!

All in all, France so far has been such a fun experience! I am looking forward to learning more about the international health perspectives that are to come! Au revoir!

by Kaitlyn McKay

Bonjour de France! We are currently in Aix-en-Provence, where we will be spending the next two weeks.
We started our week on Monday by touring the IAU campus, which is so beautiful and located right in the
center of the city. We had an orientation where we discussed wellness and safety, which helped me
become more familiar with how their school operates and what is expected of international students. They also gave recommendations for stores, coffee shops, restaurants, and other places around Aix that will help us feel more comfortable during our stay. We learned more about the local Markets as well, including Place Richelme, which is the daily market, and Place des Precheurs, which occurs Tuesdays, Thursdays, and Saturdays. We also discussed transportation, cultural awareness, and social customs to help us better understand the city of Aix.

After orientation, we toured the city with one of the student guides named Eleonore. She was very
interested in the art and the history of France, and she showed us awesome things such as where the old
city ended, some of her favorite study spots like the Pavillon De Vendome, and many buildings where we
may have classes. It was very exciting to gain a different feel for the city and see where students spend
their time. After the tour, we had a lunch break where a few classmates and I stopped at Cafe Med, where
I had a chicken Caesar salad made by the amazing Chef Jean.

Later that day, we had another walking tour, this time around all of Aix-en-Provence to learn more about
the city’s history and important landmarks. One thing that stood out to me was the Palais de Justice, a
large courthouse that represents the French legal system.

That evening, a group of 17 of us walked to get dinner at Casa Capri, an Italian restaurant. We ended the
night walking around the city together and enjoying our first days in Provence.

Tuesday was a little busier, as we officially began class at 9:30 am. Our class focused on an overview of the United States healthcare system and its delivery. We discussed how the United States is the only wealthy country without universal healthcare. We also looked at different healthcare models, insurance structures, government health programs like Medicare and Medicaid, and contributors to healthcare costs in the U.S.
We then had lunch!

During our lunch break, Morgan, Abbi, London, and I all explored the Place de Precheurs market since it was open that day and grabbed lunch at Bagelstein before heading back to class for our guest speakers. Emmanuelle Hartmann spoke to us about women’s health in France, while Nitin Beeharry and Benjamin Gerard discussed the French healthcare system as a whole. We learned about France’s universal healthcare system and its emphasis on accessibility, equity, and preventative care. The speakers also discussed women’s healthcare rights in France, which included reproductive healthcare and maternity benefits. One of the most interesting parts of the discussion was seeing how the French and the United States healthcare systems compare to one another.

It has only been the first couple days of class, and I can’t wait to see what the rest of this program has in store. Au revoir!It has only been the first couple days of class, and I can’t wait to see what the rest of this program has in store. Au revoir!

by Ava McNeice & Caroline Garufi

Caroline and I, along with 10 of our classmates, traveled to Paris this past weekend! Some of the many benefits of studying abroad include exploring other cultures, cities, and lifestyles. Paris is very different from our “homebase”, Aix-en-Provence, because of its international culture and large metropolitan area. We furthered our cultural education by visiting the Eiffel Tower, Arc de Triomphe, the Louvre, and other historical sights. One of the main lifestyle differences we noticed between France and the United States is the ease of public transportation. Getting from Aix-en-Provence to Paris was easy and fast by train. The drive from Aix to Paris would have been 7 and a half hours, so it is crazy that we were able to get there in only three! We did some research and found that we were going as fast as 200 miles per hour. We also took the metro, taxis, and Ubers to get around the city. Public transportation lowers the emissions put out by cars, decreases traffic, and increases walking. Below are some pictures of us exploring Paris!

In our lecture on Monday about the US healthcare system, we explored the complexities of our healthcare system and the differences between the US and France that our textbook and previous speakers pointed out. Some of these differences include insurance, lifestyle, and continuity of care. One fact that stood out to us was that the US spends the most on healthcare, but has the 59th highest life expectancy.

Today, Emilie Kassentini spoke to our program about French food culture. Caroline and I have a cooking class tonight, so this was a beneficial precursor. Emilie spoke about how the history of food leads to cultural values, beliefs, and ways of life in each part of a country. While different cities in France have different foods and ways of life, they share the history of the “Mediterranean triangle”. The Mediterranean triangle includes wheat, olives, and grapes. These foods led to common French foods, such as pasta, bread, pizza, wine, and more! The birth of agriculture and settlement led to trading, the creation of roads, and communication between societies. Emilie asked us to consider the heritage of the Mediterranean diet and its heritage worldwide.

The cooking class was a wonderful experience and I am so glad we got to do it. We made onion pies and stuffed peppers for dinner, based on French food culture of eating food in season and local. Our instructor Perrine was so insightful and she shared that cooking is her passion, so much so that she hopes to open her own restaurant in Aix. She plans to make American food at her restaurant and was asking us for all the recommendations. Ava, myself, and the rest of our group were listing places she had to try in the U.S. next to get some more inspiration. At the top of the list was fried okra, chicken minis, and the Texas Roadhouse butter. Perrine even shared some photos of the barbeque, brisket, and pulled pork she has made and it looked amazing. Looks like we will all have to come back and try it out when she opens it!