Post by Alejandro Avelino Bonilla, Medical Student at Universidad Juan N. Corpas (Colombia) who completed a GEMx Elective at University of Tunis El Manar (Tunisia)
I had the incredible opportunity to do the international exchange internship in the department of infectious and communicable diseases in La Rabta Hospital. From the beginning, due to the last minute changes, it was difficult to know the details of the internship, the communication with the local organizer was almost null (which is understandable because he found himself busy working on the event). Despite these drawbacks, I couldn’t wait for it to begging, I was very excited because it was my first international internship. I felt somewhat anxious because I didn’t prepare properly about of the pathologies because the epidemiology is really different in Tunisia compared with Colombia. I knew that I would have to study a lot but I was born for challenges.
For this experience I had the pleasure of being accompanied by Vishnu, a medical student from India whom I already knew but we forged a very strong friendship. The first day the head of the service welcomed us, greeted and congratulated us, then explained our duties and the day to day activities and what was expected of us. In the morning we would attend the service meeting where the new patients are presented and people from other departments ask for advice on the management of complicated patients. Then we took a brief rest and then we review the patients assigned. Vital signs, general physical examination, physical examination focused on the disease and review of paraclinics, just like any other intern. On Tuesday a general round was being held in the men’s hall, and on Thursdays through the women’s hall with the head of the service, together with all the residents and interns. The cases and its particular management were discussed and the necessary studies were requested.
Every day we had lunch with someone different, we made friends quickly and they took us to different places,mainly traditional food restaurants, it was quite a culinary experience. Later in the afternoons there were classes or discussions of cases but they were done in French which was a great difficulty for us and eventually we stopped attending. We used the afternoons to study the pathologies and to know little by little the city. The cases in the department were extremely interesting and medium-high complexity, so that each day was more interesting than the previous one, I highlight the case of an older adult patient who suffered left temporal lobe necrosis secondary to a herpes type 2 infection And HIV.
Students were key to us, many times interns and residents had too much work, so they took care of us especially to translate and help us to examine patients and understand cases. On a couple of occasions in the afternoons we accompanied the residents and students in external consultation, it was interesting to see how the people who attended the consultation were also very open to foreigners. Finally in the last days of the rotation the intensity of the questions increased to evaluate our academic performance, in some points it became difficult to answer questions in English (while speaking French or Arabic among them) having to think some things in Spanish and answer. In English, was a very beneficial experience for my mental and learning process. Vishnu left first that I, as an inmate in her hospital were expected many responsibilities and commitments and it was hard to see her leave.
Being alone, my new friends took care of me and every day I stayed in the house of one of them, during these days I had the opportunity to live the day to day life of a native, clear medical student, and this forged an even stronger bond with my friends and with the country. All the time they were waiting for me, if I wanted something, if I had already gone to all the places, etc … I felt like in my country, surrounded by my best friends. The last day was difficult to say goodbye to the members of the service, in fact it was easier for me to leave a letter, than to tell them what I felt because I can be too emotional. After saying goodbye to each of my friends and acquaintances, I went home to prepare the suitcase and left Tunisia but I carry in my heart a part of this country, its people and its food.
It was one of the most wonderful experiences I have had and I have to thank GEMx infinitely for this opportunity.
From all this experience, I can say with conviction that the most important thing I learned in Tunisia was that no matter the country, medical education and clinical practice have great similarities, they face similar difficulties and the medical team must come up with plans so they can provide the best service with the means available. I remember that in my motivational letter to apply mentioned the fact of knowing the health system of other countries to complement my training and my projection to one day be health minister, and now after this internship I must say that this goal is stronger than ever. My passion and my future is public health and this experience has strengthened me and motivated me to continue working hard and so, someday, to be able to generate a big impact on the health of communities.
Finally I learned that the love for medicine, the devotion to patients is the same in Colombia, India or Tunisia. Physicians and other members of the health team are willing to make large sacrifices for the benefit of patients and communities. It is the beauty of this art.
Potential research project ideas
The idea of carrying out a study on antimicrobial resistance arose, in which the characteristics of each country are profiled and evidenced and then a global comparison is made. This project will be developed from SNO and I will supervise this personally as President of this organization.
I want to thank GEMx infinitely for this opportunity, it has strengthened and motivated me psychologically and academically. My motivation to look for my future could not be clearer and stronger.