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Rwanda: A Land of a Thousand Hills and a Thousand Opportunities

Filed under: GEMx Sponsored Events GEMx Student Ambassador Network GEMx Student Reflections

New Blog By: Myles Dworkin medical student at Sidney Medical College at Thomas Jefferson University who has completed his elective at the Central University Teaching Hospital of Kigali (Rwanda) through GEMx 

Rwanda is a small country located in eastern Africa covered by lush green forest and smoldering volcanoes. While the country is known as the land of a thousand hills, its capital, Kigali, might better be characterized as the city of a thousand opportunities. New businesses can be seen popping up on every corner and towering buildings appear as if constructed overnight. It represents one of the few places on earth where one can witness innovation in real-time. I have been lucky enough to work in Rwanda in various capacities for the past 5 years. When I became aware of the opportunity to formally study in Kigali at the Central University Teaching Hospital of Kigali (CHUK) through the GEMx partnership I immediately schedule my next trip.

One of the first things you notice when arriving at CHUK is the beauty of the surrounding areas. Kigali is constructed in the peaks and valleys of a series of large hills and you can see exactly what this means at the hospital. For those interested in studying at CHUK, the hospital is located close to the city center and there are several different housing options. I had a few friends living in Kigali, so I arranged to stay with them, but Airbnb and limited international student housing are also available. My colleagues at the hospital quickly made me feel welcomed and provided all the information I would need regarding where to stay and how to get around. On the first day, several of them accompanied me to the nearest market to ensure that I could get my phone and data plan set up. I cannot speak highly enough of my fellow students. Their hospitality and willingness to support me while dedicated to the rigors of medical school were fundamental to my experience and I look forward to the day when I can repay the favor.

My greatest passion and academic area of interest is surgery, specifically in resource-limited environments. As such, I arranged to spend 6 weeks working with the orthopedic surgery department at CHUK. While the international effects concerning communicable diseases have received attention in the past, the burden of surgical disease has only recently been identified as a growing public health crisis. A 2015 study performed by the Lancet Commission identified many of the areas of greatest need for improved surgical capacity to be located within low- and middle-income countries such as Rwanda. As a student pursuing a career in global surgery, I found CHUK to be the ideal place to study the intersection of surgery and public health. 

Orthopedics is a dedicated specialty is still relatively new in Rwanda as they have only recently graduated their first residency class. This provided me the opportunity to spend time with the residents and medical students in their dedicated orthopedic curriculum. Each day we would meet at 7 am for the morning conference. During this time, we would present new patients from the previous day and review approaches for upcoming cases. This was followed by a lecture by a student or resident on a relevant orthopedic topic. We would round on the orthopedic ward around 8:30 am before heading to the operating theater where we would spend the rest of the day. We would typically perform between 5-10 procedures per day with trips to the emergency room to consult new patients or lectures by attending physicians between cases.

Orthopedic trauma is a significant contributor to the burden of disease in the country, so the primary area of focus was on traumatology. This was ideal for a young student interested in surgery as it allowed for an in-depth review and exposure to anatomic relationships. I was especially interested to learn the similarities and differences in approach to care between CHUK, which is the primary trauma center in the country, and orthopedic trauma care in the US. I was comforted to find many similar protocols and procedures and was fascinated by the ingenuity and problem-solving ability of the Rwandan residents and surgeons I worked with. Despite well-documented resource limitations, they found a way to provide the best possible care to their patients allowing them to return to their friends and family. I was inspired by the compassion and work ethic of these physicians and hope to be able to obtain the education and training need to join them. I was exposed to a wide range of orthopedic trauma and learned an incredible amount in my short time at CHUK.

Despite the busy schedule at the hospital, I was able to take some time to see Kigali and the surrounding countryside. Kigali is a great city with an up and coming arts scene and great restaurants. As I have mentioned, I have been working in Rwanda for the past 5 years, so I have been to many beautiful places. This includes monkey trekking in Nyungwe Forest, safaris in Akagera National Park, and relaxing beach vacations on Lake Kivu. Unfortunately, I have not had a chance to see Rwanda’s world-famous gorilla population in Volcanoes National Park, but I guess I’ll just have to return for another trip and another opportunity.

Journey to the Art of Medicine and Life

Filed under: GEMx Sponsored Events GEMx Student Reflections

By: Kirellos Atef Zaki Abboud from Ain shams University (Egypt) who has completed his elective at The University of Pavia (Italy) through GEMx

It was my first time in Europe. I was a bit afraid and was expecting a lot of troubles. When the plane was landing, I could see how Italy is beautiful and how it’s so green. You could only see green areas, homes, and roads. It was so charming and relieving just to look at it for 15 minutes before landing. I landed safely and started my journey in a foreign country. I searched for a place to stay hoping for an apartment and luckily, I found a suitable one. I traveled on Friday so by the time I arrived it was the weekend. I decided to have a tour on foot to explore the shops and transportation. I found it difficult to communicate at first because not many Italian speak English, but after about ten days I could speak some Italian words that are useful at shops and transportation, and of course google translator was a savior in many situations.

(Left to right) with Prof.Ciro Esposito. Prof.Massimo Toreggiani. & Prof.Marco Colucci.

I called Prof.Ciro Esposito – The Head of Nephrology Department at ICS Maugeri – and informed him that I’d arrived, and he explained to me the way and the transportation I should take to reach the hospital. I met my colleagues, there were three from Poland and one from Cameroon all on an Erasmus elective. I enjoyed their company a lot, they were kind and helpful.

My first 2 weeks at the hospital were in the ward, every morning the professors accompanied us to the inpatients and started explaining their condition, different possibilities for treatment and what we should focus on such cases. Some days our professors had some checkup visits for patients who were discharged from the hospital within the last few months. It was so informative to see such a huge number of patients in such a small time. The average number of patients we see daily was about five patients in the ward and maybe one or two for a checkup. The professors taught us a lot of things concerning Nephrology, how to take a history, how to examine patients, different kidney markers in lab tests and many things that I would list later.

(Left to right) with Professors at the Dialysis unit: Dr.Alice Mariotto, Dr.Giuseppe Sileno, Dr.Ettore Pasquinucci, & Dr.Alessandro Gaballo

My second 2 weeks were in the dialysis ward, every day the professors accompanied me for the round, we checked the patients performing their dialysis session concerning their compliance to medications, their overall health, if there is any pain, the patency of the vessels used in dialysis, their diet, and their last lab values. I noticed that dialysis session became a routine for these patients with little suffering, the hospital supplies them with the drugs and provide good, advanced and comprehensive health care services and ambulance help people with some health problems that where they provide transport for them to the hospital on the sessions days and bring them back home. I was amazed by the continuous assessment and care for the patient.

I attended some surgical procedures including:

  1. An arteriovenous fistula in the arm between the median cubital vein and brachial artery, it was done by Prof.Ciro Esposito and Prof.Massimo Torregiani.
  2. Central jugular catheterization is done by Prof.Massimo.
  3. Femoral venous catheterization is done by Prof.Massimo.
  4. Replacement of an obstructed femoral venous catheter done by Prof.Giuseppe Sileno.

I was honored to work and learn from these great professors, I owe them a lot, I will never forget what they have taught me.

Let’s talk about my daily routine there, I woke up at 5:30 every day, took a shower, brushed my teeth, drink my coffee and go out. After that, I’d spend about an hour commuting. I would arrive at 8 o’clock nearly, then I’d spend about four to five hours with the professors, after that, I’d go home to study or finish some of my work. Some days I would walk to explore the cities or visit historical places.

Visit to Como

On weekends I would travel. The first weekend I went to Como, it’s a small city with a lot of charming places and a wonderful lake. The second weekend I visited Venice, the most beautiful city I’ve ever seen. I wish I could go there every year. The third weekend I visited Milano and the Duomo; Milano is a huge city with many people. I was enriched with a lot of personal benefits and experiences, starting from traveling to a European country by myself, searching for an apartment, washing my clothes, preparing my food and doing everything alone, I had the chance also to visit a lot of beautiful historical places and cities. Italy is a country of art, that’s what I liked the most about it. I managed to deal with a wide variety of different personalities including the pedestrians, colleagues, professors, officers at different means of transportation and the friends I could make in such a short time. It was a wonderful experience that changed me a lot and the way I think and sees the world and I will do my best to repeat it.

Visit to Venice

Visit to Milano: Duomo di Milano.

With my GEMx Award

GEMx and American University in Beirut Making Dreams Come True One Robot at a Time

Filed under: GEMx Sponsored Events GEMx Student Reflections

Blog By: Mostafa Sedky medical student from Ain Shams Univerity who has completed his elective at eye-caching American University in Beirut, Lebanon through GEMx

I went through an elective for one month at the eye-catching American University in Beirut. As it was one of my lifetime dreams to go there, GEMX provided great chance for me to apply for an elective and visit the place. Despite facing some difficulties to arrange for my travel, I used all my efforts and made it there. The amazing historical campus with the unique seafront view was fully equipped with a state-of-the-art entertainment, medical, surgical and educational equipment’s, which all added to the unforgettable learning experience.

One of my dreams that was also fulfilled was to learn more information about robotic surgery with the Da Vinci robot that was at the university and which is now the talk of the town in all the surgical fields. I had an opportunity to meet some kind and famous Lebanese professors and surgeons and learn from them about every single incision and suture while attending in the OR during my elective in the Department of General Surgery. I received a hands-on laparoscopy and suturing workshops on a simulator to add to the excitingly thrilling experience.

 

The administration has provided me with full access to the medical library which had a separate huge building with calm and encouraging weather and the latest medical news and information to indulge your knowledge with as well as a high-speed internet connection with subscriptions to open a lot of scientific databases and journals. I also had access to the student activity center which had a private beach, warm indoor swimming pool with an A/C surrounding as I was there during cold winter as well as an amazing Gym and an indoor basketball court. There were a lot of other courts like a stadium for football and tennis and volley courts but the basketball one was my favorite.

Regarding the exceedingly reputable and scrumptious Lebanese food, it was one of the best things in this country starting from the sizzling cheese of the street mankoosha to the mouth-watering ice cream of el Bachir, it was one of the best things in the country. When I wanted to be more healthy I resorted to the delicious Lebanese fruits especially apples which were unique than any other apples I have ever tried as well as the ambrosial honey from the cedars.

To add to the experience, l spent the weekends exploring this amazing country Lebanon from the far north in Tripoli visiting Faraya, Jetta, Junia, Byblos, Dora to Beirut then reaching to the south visiting EL Shouf, Beit el-Din, Deir El Kamar, Saida, Tyre to Baalbek. It was the first time in my life I built a snowman and went skiing then go to the beach on the same day. I spent some quality time talking to my new Lebanese friends and taking photos that make me perpetually happy whenever I remember them. It’s undeniable that this elective experience has called upon my untapped reservoir of tenacity, perseverance, fortitude, curiosity, and willingness to learn. It has opened the gates for me to believe more in my dreams and turned some of them into precious memories.

 

GEMx-SNO Exchange 2019: Refreshing My Passion for Medicine

Filed under: GEMx Sponsored Events GEMx Student Reflections GEMx-SNO

Blog By: Roxana Ramos, medical student from Faculated de Medicina UNAM who was selected as this year’s GEMx-SNO exchange winner, by GEMx and SNO TUFH and participated in a five week exchange at Flinders University NT in Darwin NT, Australia 

I am a Mexican 5th-year medical student that was selected to participate in the exchange to Flinders University in Darwin NT, Australia. It took me a while to believe the great news, and after I did, my excitement grew every minute until the day of departure.

Flinders University

I spent 4 weeks in the Pediatrics Department of the Royal Darwin Hospital, each week in a different ward: General Pediatrics and Adolescent Medicine, Pediatric Infectious Diseases and Malnutrition, Postnatal and Special Care Nursery, and the Outpatient Clinic. Every day started with the 8 am handover, where each patient was reviewed and after that everyone left with their teams to their ward. I liked this part because it was when I could hang out with the other med students for a little while. Each team was composed by a consultant, a registrar, a resident, an intern (or not), and a student. During the ward rounds it was like what I’m used to: follow the doctors, write some notes, answer questions, examine patients, get papers, and the most important job of a med student: awkwardly be in the way. Since I had already had my Pediatrics placement in Mexico, I felt confident about what I was seeing and listening, but the cool part is I got to experience different epidemiology and learn about diseases like Acute Rheumatic Fever and Rheumatic Heart Disease, that are very rare in Mexico. The two major differences I noticed from my home country to Australia are: – Doctors care for a good work-life balance and the system allows them to do it. The hours are reasonable, the pay is great and in general, the environment in the hospital is so nice and happy. Since the first day I was there I’ve been trying to think how to change the mindset of thousands of years and millions of doctors in Mexico, so that we can have a better quality of life. No clue until now, except lead by example. – Material resources are abundant, so they don’t struggle as much to give the best management and treatment to their patients. This also has to do with the Health System structure, which is very efficient in Australia. Although in Mexico we have a universal Health System, people still must pay (at least a symbolic amount) for consults, hospitalizations, and medicines. Meeting some of the doctors there gave me an idea of the way I want to be when I grow up, not just as a doctor, but as a person too. It refreshed my passion for medicine. We also had occasional teaching sessions, which were outstanding. Some of them included taking history and checking a patient by ourselves, others were to review a specific topic, etc. The Department also had other activities like the Journal Club, X-ray meetings, and Grand Rounds, which were great as well. Apart from the one-month rotation, I got to fly to a Health Clinic in a remote community called Warruwi in the South Goulburn Island. To prepare for this, I had to attend a Cultural Awareness Workshop. I enjoyed learning about the Larrakia people, mainly because I knew little about them before this exchange. I was surprised by some of their traditions, like their kin and family relationships, their traditional medicine history and their actual epidemiology.

Receiving my diploma from Justin Seeling (GEMx Manager) and Vishnupriya Vijayalekshmi (SNO President)

After those wonderful and enriching weeks, I got to assist the TUFH 2019 Conference, which was the cherry on top. I met med students from around the World, I was inspired by the talks and workshops, and pleased to know that there are good people everywhere who are trying to help others. I was excited to learn that next year’s conference will be held in Mexico City, and the best part: I’m the new Local Team Manager. I’m looking forward to the exchange and the whole event.

SNO International Executive Committee 2019-2020

It was a very enriching experience in all aspects of life. I feel blessed for this opportunity, and I think that it impacted me (in a good way) to see how Medicine is practiced in other places.

Reflecting on the 2019 IQMU Competition in Manipal India (Sponsored by GEMx)

Filed under: GEMx Sponsored Events

Post by Harsh Kahlon and Mahisha Virdiana, Medical Students at Kasturba Medical College Manipal

Team of medical students

The International Quiz for Medical Undergraduates, IQMU, is a student-run initiative hosted by Kasturba Medical College, Manipal, a name synonymous with quality medical education, as proven by its consistent ranking amongst the top 10 medical colleges in the country over the years. KMC Manipal is a constituent of Manipal Academy of Higher Education, a world-class institution sprawled over 600 acres in Karnataka, India.

Students working together

IQMU was conceived from the experience and inspiration gathered by a team of students who attended a similar international competition – CICoM, in Mexico, in the year 2016. Upon their return to Manipal, their stories ignited a spark in their fellow peers to create an event which strives to facilitate international academic and cultural exchange, and thus IQMU made its debut in 2017 under the expert stewardship of Ms. Nandini Majumdar and Ms. Anushree Puttur, and the continuous support of its sponsor, GEMx.

IQMU's 3rd edition was hosted in Kasturba Medical College, Manipal from 6th to 9th March 2019, and saw the release of an online portal for international teams to participate from their home countries. IQMU 2019 saw participation from across India and countries such as Mexico, Nigeria and Nepal. The quiz consisted of five rounds, which tested the participants' knowledge and understanding in the fields of basic medical sciences such anatomy, physiology, pathology and pharmacology, and core medical subjects such as medicine, surgery and obstetrics.

 

Students working together to answer questions
The rounds varied far and wide in their formats, ranging from spotters and clinical vignettes, written question papers comprising of multiple-choice questions, matrices and comprehensive passages, to IQMU’s acclaimed Mental Relay, which provides participants with a clinical case scenario that must be solved by ordering from a set panel of investigations that would lead to diagnosis, in a relay fashion, as would be in a hospital setting. This year’s edition saw the addition of a crowd-favourite – an escape room-based wild card round that challenged the participants’ clinical and diagnostic skills in the presence of a ticking clock.

Participants were also engaged in enlightening, fun workshops conducted by the college’s academic clubs and mesmerized by cultural events which served to both provide a reprieve from the fierce, competitive quizzing and to also enrich their experiences.

IQMU is thus an amazing opportunity for medical students worldwide to experience the best possible 3-day quest comprising of an extensive, nail-biting quiz, informative workshops, programs showcasing the rich culture of India, clinical and medical learning and most importantly, interaction and exchange with other medical students of different backgrounds from around the world!

lighting a ceremonial lamp

The next edition of IQMU will take place at KMC, Manipal on 6th to 8th March, 2020. Email iqmu.manipal@gmail.com to get started on signing up for the adventure and learning of a lifetime at Kasturba Medical College, set against the scenic backdrop of the coastal university town of Manipal.

Follow IQMU!
Facebook:
https://www.facebook.com/IQMU2019/
Instagram: @iqmu2019

Medicine is a Lifestyle

Filed under: GEMx Sponsored Events GEMx-SNO

Photo of Yassein Elhussein

Post by Yassein Elhussein, a medical student who shares his experience on the GEMx-SNO exchange program and completed an elective at the University Hospital Limerick, Ireland. 

I was lucky to have two weeks of clinical elective at University Hospital Limerick in Ireland as one of the 3 winners of the SNO-GEMx international exchange program 2018. This experience not only added to my clinical knowledge and skills, but it also changed the way of my thinking, my future plans, and career. It helped me to deal with different health systems, policies, and health issues.

It was the first time for me to travel alone abroad out of the African region. 4 weeks of being far away from my family and friends seemed to be difficult at first but as soon as I reached there all the fear and challenge changed to a sense of very exciting adventure. The journey started when I met my colleagues Prudence and Esther. Together we joined Mr. Gerard Byrnes’ surgical team at the hospital with Dr. Hellen, Dr. Awis and Dr. Shoib.

Yassein enjoying a nice meal with his colleagues.

During this period, I learned a lot from the team. I was impressed with the hospital departments, the new medicine, advanced tools and types of equipment as well as surgical techniques such as Robotic Surgery.  I got the chance to be an assistant in one of the laparoscopic surgical operations. ( lap. Cholecystectomy )

The hospital was amazing and the most thing I liked there, was the diversity of the working hospital staff and the team, which was a chance for multi-cultural exchange and building international bonds and connections across the globe. This experience helped me to see the beauty of Ireland and visit a lot of historical places and beautiful natural scenery in Dublin, Limerick, Tralee, and Killarney.

I also participated at the TUFH 2018 conference at Graduate Entry Medical School (presented 3 posters). It was my pleasure to meet GEMx Manager (Mr. Justin Seeling) at the conference and thank them for this great opportunity and support.

Yassein and GEMx Manager, Justin Seeling

Throughout most of my academic career, I have always sought out and taken positions in leadership roles in different students associations and communities. This stands true for my academic endeavor into medicine as well.  This experience motivated me to join the international SNO executive committee and serve as the Vice President with a very committed, motivated and amazing team.

Medicine has always been my childhood dream, a chance to satisfy knowledge curiosities, and, above all, an opportunity to make peoples’ lives better. It is unique, among all other professions, in that it deals with the most precious asset each person owns, his/her health, with all that this means in terms of delicacy, responsibility, and accountability. Thus, medicine offers an opportunity for personal and professional growth and a sense of accomplishment that no other profession offers.

I am looking forward to attaining more elective experiences. I would love to work at hospitals in the US, Australia, as well as in developing countries. That way I will be able to compare and contrast the differences in health care systems. Furthermore, I’m keen to meet health care professionals from all over the world to exchange ideas and experiences and to build long-lasting connections. I’m also ready and very eager to share details about my country and university with the rest of medical students out there.

Yassein working at the hospital

Last but not least, I want to thank SNO and GEMx for such great challenge and exciting opportunity and amazing experience.

This exchange program is one of my biggest achievements till now. Reached one of the target goals, hope to go far soon😊

Medicine is a lifestyle,🌸

Traveling is a lifestyle ❤

Join SNO, join GEMx, join the family ❤

 

Kind Regards,
Yassein Elhussein

GEMx-SNO Experience at the TUFH conference

Filed under: GEMx Sponsored Events GEMx-SNO

Esther Hallal

Post by Esther Hallal, a 3rd-year Medical Student at the Carol Davila University of Bucharest Romania. 

This August I had the privilege to be one of the winners of the SNO- GEMx elective student exchange program, and honestly, this experience has propelled me both professionally and personally in various ways.

I had the opportunity to interact with a different medical system and while working within the surgical unit I was able to develop my surgical practical skills and further my theoretical knowledge through real-life problem-based learning. During the internship, I had the chance to communicate with patients and colleagues alike; strong bonds were forged, so much so, that I wish to visit the hospital once again in the future.

After the hospital internship experience, the bar was set quite high, which is why I underestimated the impact the TUFH conference would have on me. Nevertheless, the conference did not fall short from revolutionary because I was inspired by the student projects and the passion with which they presented. The overall atmosphere of the conference persuaded me to become part of the Student Network Organization movement; whose goal is to help students rise together. This is how I became the European Regional Representative of the Student Network Organization and now it is also my mission to empower students alike around the world.

 

Prudence Baliach, Yassein Kamaland, and Esther Hallal at the TUFH conference

Group Photo at the Conference

Esther Hallal and two colleagues in their scrubs!

 

A Journey from Medicine to Health

Filed under: GEMx Sponsored Events GEMx Student Reflections

Photo of the blog author, Dr. Myron Godinho

Dr. Myron Godinho

Post by Dr. Myron A. Godinho

myrongodinho@gmail.com

Research Associate,
Public Health Evidence South Asia (PHESA),
(South Asian satellite of the Cochrane Public Health Group)
Manipal University,
India

Public policy has always been an issue of great interest to me. The task of decision- making for societal development and progress is exciting and terrifying, when one considers the immense responsibility that such a role carries. Such decisions ought to be transparent, and should be justifiable to all the stakeholders involved, especially taxpayers and end-users. This conviction led to my involvement in Model United Nations (MUN) conferences in high school, where I participated as a delegate in various councils, and chaired the General Assembly at the national Bahrain MUN. At medical school, it baffled me that the most phenomenal discoveries in health science were unable to produce the paradigm shifts in human progress that their pioneers had initially envisioned. If health was such an egalitarian topic, why do some societies experience exponentially better health than others? As I engaged with patients throughout my clinical postings, the social determinants of health pointed towards converging disease pathways: it became apparent that the foundational systems of modern societies were not designed with health in mind.

Myron with Justin and Dr. Ciraj

Justin, Dr. Ciraj and I

With this understanding and my high school background in policy, I collaborated with college faculty and the student council at Melaka Manipal Medical College (MMMC), in Malaysia, to offer students a platform to foster debate and discussion on pertinent global health issues. Having harnessed their support, I conceptualized/developed MedMUN (Medical Model United Nations) by contextualizing the Model United Nations policy debate platform for deployment among health professions students of various disciplines. With the help of the student body, we recruited a mixed group of medical, dental and pre-medical (foundation year) students to participate in the initiative. After participating in four, weekly training sessions (involving presentations, groups sessions and peer learning), the students then participated in the 1st MedMUN debate where they discussed international maternal surrogacy legislation.

After I completed my MBBS studies, I was keenly looking for opportunities to deploy MedMUN in larger, more diverse settings, with an interprofessional focus. It was during this networking, that my teacher at MMMC in Manipal campus strongly encouraged me to submit my research entry for the Student Projects for Health competition by GEMx for the World Summit for Social Accountability 2017.  It was a proud moment to know that my project was selected and funded to be presented at this esteemed Summit at Tunisia. It was extremely special and exciting as this was my first international conference experience (please modify this statement). Through the Facebook group and mails from the other winners during our pre-conference preparation, I began to see the strong links that previous student winners had developed with each other, facilitated by the hard work of the GEMx and FAIMER teams. I was also fortunate enough to meet Justin Seeling during his trip to Manipal for the IQMU, and see the face behind the patient and helpful e-mails that would regularly keep me posted on developments in the run-up to the conference. A few months later, armed with my poster and travel bag, I boarded the plane to Tunisia with Dr. Ciraj and much excitement.

Disembarking at the airport, I met with a number of people, who, like me, were protectively clutching large cardboard tubes. Introducing myself, I found myself surrounded by other medical students, each with their own stories and experiences. Together, in a place we’d never before been to, we finally found our way to the waiting buses and were off to Hammamet. The bus ride took us out of the city and into the lush Mediterranean countryside. Acres of olive gardens and farms flanked the winding highway that carried us, set to the backdrop of a mountain range in a national park. The warm sun and the rhythmic sway of the bus lulled me to sleep, and I woke just as we arrived at the conference venue. It looked more like a little walled village than it did a hotel; and I learned that that was exactly what a medina was. After hovering in the lobby to finalise registration formalities, we were off, led by a sprightly young concierge to our respective rooms to freshen up. Once I was done, I headed out to explore the medina. The ‘souk’ was lined with shops, replete with salesmen peddling their wares: food, clothes, souvenirs, incense, olive wood carvings. A metalworker tapped away with his hammer, engraving a metal plate as I watched intently. Sitting at an outdoor restaurant, I learnt about harissa chilli and ‘brik’, a traditional Tunisian pastry. Soon after, a snake charmer sent a live snake down my shirt while three cobras swayed lazily on a stage. I decided that that was quite enough excitement for one evening and instead went in search of the nearby Mediterranean shoreline and a quiet dinner of mixed mezzeh and a delicious steak.

Myron presenting at TUFH

Presenting during the conference

The next morning I met most of the other SPFH winners; each of us sharing our travel experiences and our mutual excitement at having made it to the conference successfully despite various obstacles. The conference began in full swing, and we were introduced to the Student Network Organisation (SNO) – an excited bunch of well- intentioned, enthusiastic medical students from all corners of the globe who networked and collaborated with other organisations (e.g. IFMSA) to promote a proactive approach to medical education. We all introduced ourselves and were immediately involved in a group activity that highlighted the main conference themes. There were large cohorts of students from some countries in particular, but language and culture was no barrier whatsoever. A powerful sense of community and inclusion prevailed, and it wasn’t long before we, the new additions, were making impromptu presentations and securing new friends through it all. We were encouraged to maintain our involvement and affiliation with the organisation by assuming positions of responsibility in the secretariat, as regional representatives, or in the many other professional bodies affiliated with the THE Network:TUFH.  I myself signed up to be a journalist for the quarterly newsletter and recently published in the June 2017 issue.

A blue door in Tunisia
Over the next two days we were given the opportunity to present our posters, receive feedback and questions, and learn from the experiences of our peers. It opened my eyes to the different ways design and implementation challenges could be overcome to achieve better community health outcomes. I was particularly enamoured by other projects which, like mine, had focused on capacity building in health policy and systems to foster systemic change in the way that health systems ensured the basic health status of their populace. This conference offered me the opportunity to network with people working towards similar goals as myself, and learn from their experiences while sharing mine too. It truly was a mutually beneficial experience for us all. Through further seminars organised by the SNO, we discussed with, and received valuable advice from, potential mentors; drafted a policy statement representing the views of the international medical student community; and thought deeply about our roles and responsibilities in society at large. It was a wakeup call, and a most welcome one too.

The summit was not without ample opportunities to socialise and mingle with our peers in a ‘less structured’ setting. Each evening provided another exciting opportunity to meet up with our newfound friends and discuss work, play, and everything in between. We were also able to take a tour of the historic city of Carthage, and visit Sidi Bou Said to capture some iconic photos of the region and make some great memories. Overall, the amalgamation of intellectually stimulating conversations, silly shenanigans, and barefoot midnight strolls through the freezing surf of the Mediterranean made for a heady, addictive concoction of experiences.

Tunisian metal engraving

Metal engraving

Because of the opportunity offered to me through the generosity of GEMx and FAIMER, I am encouraged to continue pursuing a career in public health, with a focus on evidence to inform health policy; and have a renewed passion to continue building capacity to improve health policy and system restructuring in India. My immediate aims are to publish my work in a peer-reviewed journal, and I look forward to collaborating with my new network of colleagues on future projects. Encouraged by the success of the project I presented, I’ve submitted more of my work for conference presentation opportunities, and will be presenting another recent project at the International Congress on Peer Review and Scientific Publication in Chicago, September 2017. This experience has undoubtedly helped to shape my career; I will soon be pursuing postgraduate studies in health technology assessment (HTA), to use medical research together with health economics to inform resource-allocation decision in public healthcare systems for Universal Health Coverage (UHC). While much work remains to be done, the knowledge that I am just one of many who share this vision is a great source of encouragement and motivation for me.

I might be tempted to say that the World Summit for Social Accountability 2017 was a truly ‘once in a lifetime experience’, but that would be to understate my desire to participate in such a conference again. No, it was a truly momentous experience; one that I hope to, once again, be a part of in the near future.

GEMx Elective Reflections – Exchange from Fundación Universitaria Juan N. Corpas (Colombia) to University of Tunis El Manar (Tunisia)

Filed under: GEMx Sponsored Events GEMx Student Reflections

GEMx has had the pleasure of not only extending travel grants to students going on GEMx system elective exchanges but has been an active supporter of  student developed and led competitions and exchanges. We have aided CiCoM and IQMU, and more recently supported the Student Network Organization of The Network –TUFH to implement the 2017 pilot, GEMx-SNO-International Exchange Internship, which occurred in conjunction with the World Summit on Social Accountability Conference in Tunisia   

GEMx provided funds for Alejandro Avelino Bonilla of Juan N. Corpas University (Colombia)  and Vishnupriya Vijayalekshmi  of Kerala University of Health Sciences (India), two SNO member students, to cover their roundtrip airfare to Tunisia, accommodation fees and daily budgeted meal allowances while they undertook their internship experience at University of Tunis al Manar Faculty of Medicine. ECFMG and its GEMx program appreciated the opportunity to partner with SNO in this pilot and is honored  to share their experience with all of you here!

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)

Exchange experience

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.

Alejandro and Vishnu sitting in a room
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 and Faculty Discussing Medicine Around a Table
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.

Skull X-Rays
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.

 

Lessons learned

Photo of Students at University of Tunis
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.

Selfie of Alejandro and Vishnu with Tunisian Students
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.

Alejandro and Vishnu on University of Tunis Campus
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.

Thank you.

Alejandro with a Hawk on His Shoulder

GEMx Elective Reflections – Student Network Organization (SNO) Exchange at University of Tunis El Manar (Tunisia)

Filed under: GEMx Sponsored Events GEMx Student Reflections

GEMx has had the pleasure of not only extending travel grants to students going on GEMx system elective exchanges but has been an active supporter of  student developed and led competitions and exchanges. We have aided CiCoM and IQMU, and more recently supported the Student Network Organization of The Network –TUFH to implement the 2017 pilot, GEMx-SNO-International Exchange Internship, which occurred in conjunction with the World Summit on Social Accountability Conference in Tunisia   

GEMx provided funds for Alejandro Avelino Bonilla of Juan N. Corpas University (Colombia)  and Vishnupriya Vijayalekshmi  of Kerala University of Health Sciences (India), two SNO member students, to cover their roundtrip airfare to Tunisia, accommodation fees and daily budgeted meal allowances while they undertook their internship experience at University of Tunis al Manar Faculty of Medicine. ECFMG and its GEMx program appreciated the opportunity to partner with SNO in this pilot and is honored  to share their experience with all of you here!

Post by Vishnupriya Vijayalekshmi, Medical Student at Kerala University of Health Sciences (India) who completed a GEMx Elective at University of Tunis El Manar (Tunisia)

EXCHANGE EXPERIENCE:

Vishnu in front of Social Accountability Sign

Pre-departure:

As a medical student,it was my dream to go for an exchange program and to experience  the  culture and to learn about the health care system in a different country.From my high school days,Tunisia has always fascinated me with its diversified culture and tradition.I was really excited when I received the mail,mentioning  that I have been selected for the exchange,that too in the University of Tunis El Manar.But the initial excitement later became confusion and sadness when I had some unexpected trouble with the visa.Till the last moment.l  was not sure if I will be able make to it.But finally,everything ended up well and I could attend the World Summit on Social Accountability and fulfill my long cherished dream of an exchange program.

Accomodation and briefing about internship:

The essence of an internship program is team work.I was quite sad when I came to know that the other 2 selected winners couldn’t make it to the exchange.But  finally,it was my pleasure to have Alejandro from Juan.N. Corpas University,Colombia as my companion .Though we have known each other for the past one year,the internship was the beginning of a friendship for a life time and a couple of beautiful memories.

In front of Service Des Malades Infectieuses
The day we reached Tunis,the acivity co-ordinator,Chiheb gave us a warm welcome and took us to the apartment arranged for us at Manza Zanc.Though  it was distant from the university,the apartment was really nice and we were comfortable.The  only little problem,was the communication  with the owner,who speaks only French and Arabic.

The next day,we were taken to the Hospital La rabta,department of Infectious and Communicable diseases.As I hail from Kerala,a state in the southern part of lndia,where infectious and communicable diseases are quite prevalent,I was really curious to learn about the cases here , make out the similarities and differences and learn the treatment modalities.

After a quick and brief introductory session,we joined the case presentation session in the morning.Though  it was in French,the interns (Aziz and Ousama) did a great job translating it to English and making us feel comfortable.After  the session,we were given briefing about the internship timing and the activities we were supposed to do in the department.

Clinics:

Clinics started with the case presentations  in the morning which were very informative.lnfact,the difference in the spectrum of infectious disease as compared   the Indian scenario made it really interesting.After  the session,we joined for rounds,where the faculty ,residents ,interns and externs discussed about the cases ,in between questions were asked and the professors clarified our doubts.There  were 2 floors -one for the male and the other for the female patients.In  spite of the busy work,they managed to teach us about the different treatment regimens and we did clinical examination as well.The students(externs)were also really helpful.We also had the opportunity to join the consultant in the out patient department .We also made a point to read about the cases we saw at the hospital,once we were back in the apartment.A fact which deserves special mention is that,even though language was a barrier, the hospital staff and the patients were very friendly and we felt like being in our home country,in our own hospital and that made us really comfortable.

X ray image

An interesting case of ‘cannon ball metastases’, in a 54 year old gentleman

Afternoon session :

In the afternoon session,there were seminars and case discussions.But  since everything was in French,we attend a few sessions and then decided to utilize the time to explore the beauty of Tunis and savour the diversified Tunisian cuisines.In spite of the busy schedule,our Tunisian friends spared their time  and made sure that we visited the historical places in Tunis ,and enjoyed the traditional Tunisian dishes.As someone who is allergic to egg,I was worried regarding the food,but I was really happy that my friends  were all very understanding  and took care of it very well and never made me feel that I am all alone in a foreign country.

Altogether,the exchange program has been the best thing ever happened in my life.  lt  was a great opportunity to learn,to observe and explore,but above all it was a wonderful chance to make friendship which would last for a lifetime and take back a bunch of indelible memories.Not  even a single moment,we felt that we were far way from India and Colombia and were in a different country in a different continent./ had to leave early,and I was literally in tears when I said bye to Alejandro and left him alone ,as in those 2 weeks,we had really become best friends.

Its hard to bid adieu to people and places which gave us so much to remember.The  country,the people,the food ,had already taken away a piece of my heart and saying bye to my friends who gifted me the best few days of my life was so hard and I tried my best to hold back the emotion and promise them that I will come back to Tunis ... ...….......

LESSONS LEARNED:

As someone who is really interested in medicine,the  first hand experience  in the department of infectious and communicable diseases,strengthened my passion for the subject and has inspired me to be a good clinician and dedicate myself for the service of the community.  Even  though,there is no similarity at all between the community in Tunis and lndia, l could find similarities in the patient care and the treatment practices  and the differences which I could make out in the treatment regimens and the diagnostic approach of the cases can be disseminated among my community and shared with the medical professionals and it can open up the door for future advancement  in the arena of patient care.  
Above all, l learned that in spite of the dissimilarities,the essence of medical profession,is team work,sharing of knowledge and having an attitude of empathy and concern for the patients and as a future health care provider, I have to develop all these qualities and be the flag bearer for the betterment of the society.

POTENTIAL RESEARCH PROJECT IDEAS:

Antibiotic resistance is an emerging problem in the global scenario.Different studies have been conducted on this at  regional and international levels,but SNO has the planned to conduct a study on this ,with student community as active participants.  The spectrum of antibiotic resistance in different countries will be assessed and a meta analysis will be made at globallevei.  As the first step,it has been discussed in an interactive session with the students at the faculty of medicine,of the University of Tunis El Manar and the study will be the prime initiative of the SNO team 2017.

FUTURE PROSPECTS:

Getting inspiration from this,I thought about the possibility of creating a platform for an exchange program and received the support from the Emergency Medicine department of Malankara Orthodox Syrian

Church Medical College,Kerala,lndia which is in partnership  with the Indo-US Health & Medicine Collaborative.The department is really interested to receive students from around the world and give them first hand experience  in trauma care.The outline for a 3 week training programme,dividing trauma care into 3 phases: pre -hospital,in-hospital and post-hospital  care is in process and will be sent soon for approval from the Kerala University of Health Sciences. The SNO Team 2017 is looking forward to work on this,with the continued support and encouragement from GEMx  and believe that just like the amazing experience we had in Tunis, this would widen the horizon the students and will be an asset in their career as the future health professionals.

” From the deeper recess of my heart,I express my sincere gratitude to GEMx and SNO for giving me this wonderful opportunity”

 

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