Skip to Content
GEMx

GEMx Blog

A Firsthand Account of the Devastating Earthquake That Hit Central Mexico on September 19, 2017

Filed under: GEMx Student Reflections

We here at GEMx have valued the development of reciprocal, supportive and enduring relationships with the students we serve well after their exchanges are behind them. We also understand that expanded perspectives and growth opportunities occur in individual daily lives as much as through international travel and exchanges, which is why we are especially honored to share an introspective account by one such student. – Carol Noel Russo, GEMx Senior Coordinator

Photo of post author, Mercedes

Mercedes Aguilar Soto

Post by Mercedes Aguilar Soto, Medical Student at Universidad Nacional Autónoma de México Facultad de Medicina (Mexico) who recently completed a GEMx Elective at PAGNY (New York)

The Earthquake

I have lived my whole life in Mexico City, I was born here, I studied here and I will probably continue living here. I always tell people I have a love-hate relationship with this city because it has a lot of problems but at the same time it has a lot to offer to its citizens and visitors.

As I said before I studied here and I have done my medical training in hospitals in this city. Right now I am doing my intern year in a very big hospital that was founded around the 1900’s and has been working since. I am currently finishing my rotation in Emergency Medicine, which is one of the busiest areas of the hospital and I stay there for 24-hour shifts every three days.

This last September, Mexico City and other cities in Mexico experienced two devastating earthquakes, and I was in the hospital on call during both of them. The first one, on September 7th happened around midnight. Since Mexico is considered a seismic zone, alarms have been installed around the city and they are supposed to get activated as soon as there is an earthquake detected in the coast of Mexico, which gives us around 30-60 seconds to evacuate buildings.

This first earthquake was scary, but we all had enough time to leave the building and to make sure everything and everyone was OK. I called my family immediately since we live in one of the high-risk zones and was happy to hear that everybody was doing all right. Other zones of Mexico, especially Oaxaca were really affected, but Mexico City seemed to be doing fine.

I must say that earthquakes in my hospital are scary, not only for its location in a high risk zone, but because in 1985, on September 19th a huge earthquake hit Mexico City and damaged a lot of buildings including several towers in this hospital including the OB/Gyn tower, the residency and several others. I still have professors who remember friends who died during that horrible earthquake, which is why we always get an uneasy feeling whenever there is an earthquake.

The next morning, on September 8th, engineers and safety staff checked the whole hospital and told us it was suitable for working, so everything went on like nothing had happened. When I came home my mother hugged me really hard and I realized she had been very worried since she remembered the hardships the hospital went through in 1985. But luckily we were all fine. However, we did not expect another earthquake to happen so soon.

Every year on September 19th, as a way to remember the 1985 earthquake and to remind us all of the protocol to follow in case of this kind of disaster, in all schools, hospitals and offices; an evacuation drill is performed so that we are all informed on what we are supposed to do in case there is a real earthquake.

This last September around eleven in the morning, we were all requested to evacuate the building and count the number of people to see if we were all complete. After the drill everybody went back to work like nothing had happened. As usual, the ER was full of people and we were all doing our jobs as we normally do. Later on, I was running some tests on a patient when one of my colleagues told me that an earthquake was beginning. I turned around to ask her about it because I didn’t hear the alarm and I didn’t feel anything, but as soon as I turned my head I felt the floor pulling me to one side and realized it was a strong earthquake, but luckily I was close to the door so I was out of the building in ten seconds. Later on we discovered the alarm wasn’t activated before the earthquake because the epicenter was not in the coast but close to land so the usual alarms were not able to detect it.

While we waited for the earthquake to stop I saw nurses praying and a friend of mine crying because she was really scared. I grabbed her hand and told her everything would be OK, only to find myself wanting to cry too and with my hands sweating. The earthquake probably lasted a minute or so, but it felt like forever. When it was finally over, the chief of service and the safety staff started counting everybody and told us to walk calmly to another safety zone.

While all this was happening I was receiving texts from my family who were all in different places around the city. My father was walking back home from his office, when he realized there was an earthquake happening and he started running towards my house. On his way he found one of the many buildings that fell down and with his hands still shaking he took a picture of it. He continued running to my house, to find that luckily it was still in place.  After telling us he was doing fine and that our house was OK he sent us the picture of the building, and then news started running in the hospital: there were a lot of buildings that had fallen down and rescuers were on their way.  My boyfriend called me, almost crying, and told me that buildings had been falling down around the city. I realized that this had been a terrible earthquake.

A photo of some of the devastation caused by the Mexico City earthquake

For several minutes we didn’t know what to do, we were waiting for instructions from the engineers when we started smelling gas, which is one of the many dangers of an earthquake: the leakage of gas from cylinders and tanks that get broken during the movement. Since the source of the leakage was unknown we received orders to evacuate the building until further notice, but we needed to take the patients out. I was worried that there could be an explosion any minute, especially since all hospitals have oxygen pipes than run under the hospital, but I stayed and tried to help getting out the patients.

After an hour or so we were told that the leakage was outside the hospital and that it had been taken care of, so we were safe to go back to the building. The rest of the hospital tried to discharge all of their patients, since we didn’t know how many injured people we would get. The attending in charge came to all of the interns and told us that those of us who wanted could leave if we needed to, and if we had a night shift that day only half of us were expected to stay. I talked to my friends and we all decided to stay, even a friend whose father was in the ICU in another hospital that was rumored to be damaged and another friend who hadn’t heard from her family.

Since the number of injured people was unknown we received orders to discharge all patients that could be discharged so there could be enough space available for rescued people that might come from all over the city. However, the hospital in which I work is not specialized in trauma so all the patients were first sent to trauma hospitals.

(more…)

A Regional Exchange at the University of Malawi College of Medicine

Filed under: GEMx Regional Exchanges GEMx Student Reflections

a smiling student

Post by John Baptist Ssenyondwa
GEMx exchange student from Makerere University School of Medicine 

John standing outside of the Queen Elizabeth Hostipal

My first day at Queen Elizabeth
Hospital

Medical school without a clinical rotation outside the teaching hospital environment of one’s training is not comprehensive enough. Through elective rotations, medics are exposed to the different experiences that come with working in a different setting from one’s training facility. I was one of the students that got the opportunity to take part in the GEMx Electives program this year. It was last semester for me and not only was I looking forward to completing medical school but also engaging in a clinical rotation for the weary holiday prior to internship. I had tried to apply for several programs that I could enroll in before I started internship but in all in vain.

As I walked through the busy schedules of school, the call for applications by GEMx Electives came to my notice and so came the interest to apply to take part. I had always wanted to travel as a student to a different medical school for an exchange program that would contribute to building my future career as a doctor. I immediately logged into my new GEMx account to find out the available universities for elective applications. I also found out that I was under the GEMx- South to South program which included University of Witwatersrand in South Africa;  College Medicine in Malawi, Makerere University and University of Rwanda. The days passed by and three weeks later on, I received the good news that my application had been accepted for the elective rotation at Malawi University College of Medicine. Filled with joy, I shared my good news with friends who were happy for me.

Malawi is divided into the central, northern and southern regions with 28 districts. The college of medicine is located in Blantyre, which is found in the southern region of Malawi. Having been established in 1992, it is the only medical school in the country with four undergraduate courses offered which include the five-year-long Bachelor of Medicine and Surgery (MBBS), and the four-year-long programs of Bachelor of Medical Laboratory Sciences (BMLS), Bachelor of Physiotherapy (Hon) and Bachelor of Pharmacy (Hon). For a greater portion most of my rotation, the College was on holiday and therefore I had appropriate contact time with the senior lecturers however limited interaction with the other students.

surgery being performed

Assisting surgical theater at Mercy James Centre for Paediatric Surgery and Intensive Care

The first official day of my elective found me at Queen Elizabeth Central Hospital in the Surgical Annex for the handover meeting held daily. Queen Elizabeth Central Hospital is the largest government tertiary unit and main teaching hospital for the College of Medicine. The hospital handles the referrals from the districts surrounding Blantyre. I was oriented through the facility ends and corners so that I could get my bearings well thereafter. I was introduced to the head of department, Surgery and each individual on the team I was joining in paediatric surgery. I rotated through paediatric surgery for first three weeks and one week at Beit Cure International Hospital.

Cure Malawi is a 58 bed teaching specialized in treating orthopedic needs of children and adults opened in 2002. The hospital also has special expertise in total hip and knee replacement surgery, making it one of the few places where this surgery is available in Sub-Saharan Africa. The hospital treats a wide range of orthopedic conditions including clubfoot, burn contractures, osteomyelitis, and other acquired or congenital conditions. In addition, CURE Malawi also provides physiotherapy and chiropractic services.

Table of Metrics

Table I. The cases observed and assisted in Paediatric Surgery rotation at the MJC theatre

 

Table of Metrics

Table II. The different surgeries participated in at Beit Cure International Hospital

While at Queen Elizabeth Central Hospital, I attended the handover meeting first before heading out for the day’s work each day. At these sessions, a 24 hour recap of the cases handled by the department was held and these cases discussed by the resident doctors together with the respective surgical teams of General Surgery, paediatric and orthopedic surgery.

Ward rounds were conducted daily by a senior consultant and residents on the different wards. The wards included: Paediatric Surgical Ward at the Mercy James Center; Chatinkha Neonatal Unit; Paediatric Nursery Ward; Paediatric Oncology Ward.  At the ward rounds, I was able to see several of the common conditions in paediatric surgery most of which I hadn’t seen during my school rotation. Additionally, we were able to discuss the conditions with the consultants and learn the approach to managing the ailments.

While in paediatric surgery, I was able to attend 3 ward rounds in a week. At the ward rounds, I was able to see several of the common conditions in paediatric surgery most of which I hadn’t seen during my school rotation. Additionally, we were able to discuss the conditions with the consultants and learn the approach to managing the ailments.

The OPD [Out Patient Department] ran every Monday afternoon after the rounds. While at the clinic I participated in eliciting history from the patients, examining and discussing with the consultants the different cases. This was a special learning experience as we saw several patients with a variety of conditions and therefore I always had various conditions to study. I had assignments to do every clinic and this facilitated my learning throughout the rotation. It was exciting to be in theatre and take part in the management of patients. I worked in theatre on Tuesday till Thursday for about seven hours each day.

surgery being performed

Assisting through the operations at Beit Cure Hospital

The rotation at Cure hospital was one week during which I rotated through the OPD clinic, theater and the wards. The OPD clinic also ran on Monday the entire day. I attended one clinic day of which we saw 30 patients with various orthopedic conditions. I was well facilitated by Dr. Lubega Nicholas, an orthopedic surgeon at cure who always discussed and ensured I followed through the activities at the facility.

I also attended teaching seminars at Cure hospital with the resident orthopedic students. Much as the cases discussed at these seminars were beyond my scope, I was able to learn the basic concepts on how to diagnose and know who to refer to. I learned the basic surgical skills employed generally in the field of surgery. I also took part in the general surgical management of the patients admitted at Cure, assisting in the various operations at the facility.

natural waterfall and pools

At Dziwe Lankhalamba Waterfall

While in Blantyre, I toured several beautiful places around the town during the weekends which also rejuvenated me throughout the rotation. I hiked Mulanje Mountain the highest peak in Malawi and visited several other sites like Mandala historical site among others. I met so many people and made quite a number of friends both within the medical field and other fields.

During my stay in Blantyre, I was able to work in a different environment with warm people eager and committed to improving the health of their patients. Despite the fact that the setting was much similar to my training hospital, I was able to achieve the objectives of my rotation.

I was able to develop and build my confidence in proper approach to pediatric surgical cases. My diagnostic acumen depending on history taking from the patients without need to depend on newer imaging diagnostic modalities was greatly improved. I was trained by highly qualified surgeons in the basic surgical skills and technique employed in the operation theatre which is a lifelong skill obtained.

group of young people

With new friends

The rotation greatly supplemented my prior curricular clinical rotation in which some concepts and topics had been unsatisfactorily taught. I was able to deeply appreciate and understand some of the topics clearly through the ward round discussions with my supervisors and mentors. Throughout the rotation, I had ample time to read up the cases I saw on the ward and in theater. I was also able to identify the deficiencies associated with our African health systems and how these impact on the health of our patients. I met different individuals practicing in the medical field and made friends throughout my rotation and stay in Blantyre. It was great interacting and socializing with people from all over the world but with similar goals and interests. I was able to share several ideas and experiences with my new friends and establish career building relationships.

 

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 Makerere University College Of Health Sciences To Kenyatta University School Of Health Sciences

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Post by Wasukira Bugosera Sulaiman, Bachelor of Medicine and Bachelor of Surgery student at Makerere University CHS (Uganda), who went on a GEMx regional exchange to Kenyatta University School Of Health Sciences (Kenya)

GEMx student at medical camp

Medical camp at Huruma Children’s home

The first clinical year at Makerere University College of Health Sciences is always climaxed by doing a clinical placement in a field that a student is interested in and done from places of their own choice. Well, this was my opportune moment to hunt and grab a site and an opportunity to do my placement in a very resourceful fun and skill- impacting environment for one month (4th July – 4th August).

In just the same time, a rare and perhaps a first time opportunity presented itself in which a call for students interested in undertaking exchange electives through the GEMx exchange system was put up.

Application and Vetting

Another selfie of exchange students
Having been an ambitious highly motivated and open-minded medical student ever looking around for opportunities and trying out on each of them, I went ahead to initiate the application for the GEMx elective exchanges through the GEMx web based system. Application was through the international office and was consequently followed by an interview, which I presume to have just excelled in and followed by being successfully nominated to undertake an exchange elective at Kenyatta University School of Health Sciences, through the GEMx- MEPI partnership. This was with two other classmates: Namingira Simon Peter and Barigye Aston.

The rest of the process involved obtaining a couple of documents as required by the host University. I was amazed by the way the GEMx web system eased the whole process of document submission and with the fact that I could actually store these documents for another application in the future. At the end of the whole process, all documents were submitted through the web system! By this moment, I just had to hold on for the host institution to review and accept my application which came in through on the 9th June 2017.

Preparations before travel

GEMx exchange students in front of a monument
Just as the Luganda saying goes “Okutambula kulaba, Okudda kunyumya” literally meaning that “to travel is to experience and returning home is to tell stories”, the preparations were quite filled with a lot of expectations and excitement; new experience, a lot to learn, first time in Nairobi and so much more. As all preparations were under way, I am sincerely grateful the support given to us (me and the other two colleagues) both from the home institution (Ms. Phiona Ashaba and Dr. Isaac Ssinabulya) and Host institution (Dr. Kahiga Titus and Mr. Vincent) plus the GEMx staff (Ms. Faith Nawagi). As a team, they ensured that the funds to facilitate our electives were processed in time, bookings for accommodation made, bus station pickups arranged, plus guiding on what we need to carry for daily living in Nairobi. At this moment, the GEMx checklist was important since it acted as a measure of the progress in the preparation process. The GEMx web system also played a big role in the preparation process as it provided the emergency contacts from both the host and home institution. This greatly eased communication towards and during our travel.

Travel to Nairobi

Selfie of exchange students
Right after securing our fund facilitation for electives, we booked the bus to Nairobi on the eve of our travel with travel date of 3rd  July 2017, and opting for the 7am bus because we wanted to experience the epic scenery as we go sight-seeing the way to Nairobi as long as no one interrupted my peace in my window seat.

Our journey was a fine one with a lot scenery along the way and with most of the attention after crossing the border. The stops in Kisumu and Nakuru, made the journey was less tiresome and awesome.

I should say my eyes are wiseacres as they immediately identify and report to me the good and unique things they see. The same thing happened upon entry in Nairobi, it was the beaming street lights and the skyscrapers that welcomed me then I knew this is the capital of the famous Kenyatta land!!!  The great hospitality we received made me feel like actually we sometimes have 2 hearts- one that pumps blood and the other one for caring. Our arrival time in Nairobi was 9:30 pm and we were picked up by Mr. Vincent, one of the administrative staff members at Kenyatta University. Off we went to Kahawa-Wendani, where our accommodation had been booked in a Destiny Park Hostel, a student hostel approximately 500metres from Kenyatta University.

Stay in Nairobi, Kenyatta University and the elective site

Student with faculty supervisor

With our supervisor Dr. David Galgallo

HABARI!!!! Our Kenyan life begun with a visit to Kenyatta University where we were given a tour around the university by a medical Student (Kiema Lucky) and later on met the GEMx coordinator, Dr. Kahiga, Mr. Vincent and Dr. Francesca Ogencha. The three were to be in charge of our stay in Kenyatta University.

The lecturers strike and Nurses strike.

I thought we had left the habit of lecturers’, non-teaching staffs’ and other government workers’ strikes in Uganda. But little did we know that this would be our big welcome in Kenya. By the time period we arrived at Kenyatta University for our electives, the lecturers in all public universities had gone on strike and so was the case with the nurses in Kiambu hospital, which is the teaching hospital for Kenyatta university school of Health Sciences.

These happenings put our rotation on the clinics and wards on a halt for a full week as the staff at Kenyatta University tirelessly worked around to get us a nearby hospital to undertake our elective at. By the second week, Dr. Francesca had managed to secure us a place at the Mater Misericordiae Hospital, where I and Barigye Aston were to do Pediatrics and Child Health and our colleague Namingira Simon Peter was to do Obstetrics and gynecology. The group in pediatrics and child health were to be supervised by Dr. David Duro Galgallo and the colleague in Obstetrics and gynecology was to be supervised by Dr. Irungo.

The Mater Hospital: The clinical experience

Mater Misericordiae hospital is a catholic founded missionary hospital, a multispecialty hospital with many branches worldwide, and the Nairobi branch being one of them. Located in Nairobi South B, having our clinical rotations in Mater Hospital meant that we had to travel an approximate distance of 20km to reach hospital from our residence in Kahawa, which is north of Nairobi city. A tiring but rather good opportunity for me and my colleagues to learn how to go around Nairobi by ourselves.

At the Mater Hospital, we were given a great hospitality with all the staff mindful to teach us whatever they could.

Outpatient clinics

Exchange student with hospital staff

At the OPD clinic

The outpatient clinics in The Mater hospital are conducted by consultant pediatricians and during the clinics, I was involved in clerking the patients to take history and also do clinical examination under the guidance of the attending consultant for the clinic. This was followed by forming a diagnosis and a management plan. Subsequently, we discussed the patient’s condition with the consultant and participated in patient education about their conditions including informing them about what the diagnosis is, helping them form decisions about treatment course of action and preventive measures for recurrence of certain conditions.

The outpatient clinics are mainly for follow up and review of review of patients who were discharged from the inpatient care.

At the outpatient clinic, patients who had symptoms that pointed to a diagnosis for which a patient needed inpatient care were admitted on the pediatric ward.

At the outpatient clinic, I also participated in the immunization of children and the consultant taught me about the recommended immunization schedule as per the ministry of health in Kenya.

Pediatric ward (Lourdel Ward) and Special Care Unit

Student poses with the admin staff at Kenyatta University

At the OPD clinic With administrative staff at Kenyatta University

On the pediatric ward and the special care unit, I was involved in clerking the patients to obtain history and also did clinical examination then later presented the patients to the consultants. After the patient presentations, we were engaged in the patient condition discussion and later patient education. I also participated in the request for the required patient investigations and follow up on the patients’ progress on the wards. The whole process was incorporated with bedside teachings about the common conditions experienced on the ward.

Obstetrics theatre

During the caesarean section theatre sessions, I would occasionally attend with the pediatrician and participated in receiving the babies.

Postnatal ward

In the postnatal ward, we participated in review of the wellbeing of the newborn babies who were always kept at the hospital for up to a maximum of 4 days. During this period, all those who developed any complications like hemolytic disease of the newborn and neonatal sepsis, were isolated and taken to general nursery or special care unit for the necessary care to be given.

Continuing Medical Education (CME) Sessions

The Mater hospital holds continuous medical education sessions for its clinical staff, aimed at updating the clinical staff members about the latest advances in management and care of patients with certain disease conditions.

During my electives period at Mater hospital, I attended CMEs about management of Asthma, Ateriovenous malformations and Cholera. During these sessions I learnt in detail about the etiology, epidemiology, pathophysiology and management options of the above conditions

Nairobi city and Culture

GEMx Student in traditional African attire

Trying out the Masai attire

Learning on job has never been among my hobbies but as it’s said “a drowning man even holds on a straw to survive”, I was made to reproduce the spoonful Kiswahili that I had learnt ages ago as I needed to get along with some “rafiki” and also navigate my way through the city. However, this in most times never worked and my thick accented English made in Uganda had to come and bail me out. But save for the fact that I did not know a lot of Kiswahili which is the national language in Kenya, the rest of the cultural experiences were just amazing and since most of the ward round and clinic activities ended by lunch time, we used to utilize most of our afternoons to explore the beauty of the city of Nairobi and trying out the local delicacies.  Tours to the Uhuru Park, Central park, Kenyatta International Convention Centre and many more other places enabled us view Nairobi from a variety of angles.

Most notable are the Matatus and the matatu culture. Matatus is the commonest public means of transport within Nairobi and the design plus the music in the matatus made using them to move around Nairobi a thrilling experience.

Kenyatta University: Involvement in student activities and Interaction with student community

While at Kenyatta University, even when we did not get chance to rotate on the wards with other clinical students due to the ongoing strikes, we were able to get time to meet with them in other activities. Important to mention is the Medical camp at Huruma Children’s home, which was organized by Kenyatta University Pharmacy Students Association (KUPhSA), where I was able to meet with many Kenyatta University medical students plus students from University of Science Philadelphia who were also visiting students to the Kenyatta University School of Health Sciences. During the camp, I was paired with a pharmacy student at the consulting desk, an experience which gave me a new touch of the importance of involving pharmacists in the day to day patient care. 

Group of students together after dinner

At Dr. Kahiga’s home with students from Kenyatta University and University of Science Philadelphia

As we were coming to the end of our electives, we were privileged to be hosted by Dr. Kahiga Titus for a luncheon at his home in Kitengela-Kajiado. Here I was able to meet a lot more students from Kenyatta University, meet the Students from Philadelphia again and still meet many officials from the Kenya Pharmacy and Poisons Board. This was a moment to grow social and professional circles.

Lessons learnt

As the medical discipline is known to be a monkey see monkey do business, for the knowledge we can read and acquire but skills have to be passed on through apprenticeship. With a very good mentor assigned to me as my supervisor, my rotation in Pediatrics and Child health at The Mater Hospital made the love for the discipline glow more and more. Being in Mater Hospital, a state of art hospital, I learnt a lot about comprehensive patient care and the practice of medicine in the concept of family care. I also got a deeper understanding of the importance of team practice in patient care. These two aspects of which I believe will enable me grow into a better healthcare provider. With the disease patterns slightly differing in Nairobi as compared to Kampala, I was able to experience child health in a new environment and learn of management of common childhood diseases in Kenya as compared to Uganda. This enabled widen my scope of thinking as a clinical student which is an important aspect in patient care. This coupled with the many differences in health policies made me better appreciate some of the concepts of global health.

Future commitments

The name may be called GEMx exchanges but personally I customized it as GAME CHANGER for the experience, knowledge and skills acquired. I can undoubtedly say it has been a cornerstone in my medical education and I believe it has already shaped my path as a future health worker. Talent may be everywhere but opportunity isn’t, thus I am committed to pass on information about GEMx exchanges to other students within and outside my university so as they may be able to gain the same experience or even better.

 

 

GEMx Elective Reflections – GEMx African Regional Exchange Experience

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Post by Kennedy Omondi Ogutu, BScN Student at Jomo Kenyatta University of Agriculture and Technology (KENYA) in 2nd week of GEMx elective at University of Zimbabwe (ZIMBABWE)

PRE-DEPARTURE

GEMx student steps off plan for exchange

Indeed, I lack words to express my sincere gratitudes to the GEMx committee represented by Carol Noel Russo, the host coordinator at the University of Zimbabwe, Mrs. Hope Chuma Vunganayi and my school GEMx coordinator at Jomo Kenyatta University of Agriculture and Technology, Dr.Monicah Karara.

It is my pleasure to thank you all for your commitment and determination made to ensure my elective at University of Zimbabwe attached at Parirenyatwa Group of Hospitals become a success.

As a medical student, it was always my dream to participate in an exchange program outside my country in order for me to learn and gain skills on how healthcare systems workout in other countries.It was with much joy and happiness when I received an email congratulating me for being elected to participate in GEMx elective at the University of Zimbabwe (MEPI), to me the medical elective was a golden opportunity which only comes once in a lifetime. I was prepared both psychologically and physically to participate in the elective and make it a success.

ACCOMODATION AND ORIENTATION ACCOMODATION.

GEMx Student in housing accomodations

The day I arrived at Harare International Airport, I was received warmly, I felt at home. Later on, I was taken to the place of residence within the University. Indeed it is a well-furnished guest house meant for visitors who come for elective at the University of Zimbabwe. The house is conducive for learning activities and well secured. Indeed it is nice and comfortable.

CULTURE

The main languages spoken in Zimbabwe is Shona and English. I found it quite a challenge adapting the language because most of the places, the commonly used language is Shona. This led to some communication barriers at times but I was able to cope through the interpreters.

ORIENTATION TO PARIRENYATWA HOSPITAL.

My 2nd day in Zimbabwe, I was taken to Parirenyatwa Hospital located near University of Zimbabwe, College of Health Sciences.  It is the largest referral hospital in Zimbabwe, with well-equipped facilities and personnel. I was privileged to be oriented by one of the students at Parirenyatwa School of Nursing. It was a very nice learning exposure while at the hospital. I got the opportunity of visiting almost all the departments in Parirenyatwa Hospital despite the largeness of the hospital. Among the departments I visited were the paediatrics ward, surgical ward, medical ward, the oncology ward, the Intensive Care Unit, the labour and delivery ward, the accident and emergency department among the very many departments in it.

CLINICAL ROTATION AT THE LABOUR AND DELIVERY WARD.

Based on the elective that I chose, majorly dealing with obstetrics and gynaecology, I was attached to the labour and delivery ward for a two week experience

I report to the labour and delivery ward at 7am, where reports from the nightshift duty staff is given to the staff starting of the duty. The reports on the patient was given inform of case presentation.It was a very nice learning session to me during the ward rounds and giving off the patients report. Ward rounds were conducted with the presence of the Obstetrics consultants, the midwives, interns and the students. Different aspects on different patients were discussed based on their condition. The staff were able to teach us the very many obstetrics emergencies and complications and their management. Being a referral hospital, I was able to witness most of the complications related to labour and delivery and their management. Among the complications I came across was post-partum haemorrhage, breech presentation, retained placenta among many others emergencies and complications.

View of Parirenyatwa Hospital

View of Parirenyatwa Hospital

KNOWLEDGE AND SKILLS OBTAINED

For the duration less than 2 weeks that I was attached to the department, I have been able to meet my objectives in the labour and delivery ward.  Among the very many objectives set and which have been achieved include; the assessment of a pregnant woman, prevention of mother to child transmission of HIV/AIDS, management of women with post-partum haemorrhage, eclampsia etc, management of babies with special needs, performing and suturing of an episiotomy, administration of medication used during labour and delivery. Finally, was conducting labour and delivery.

IT IS AN AMAZING EXPERIENCE.

LESSONS LEARNT

GEMx exchange student in hospital
GEMx Exchange Student in front of university sign
I believe in improving and prolonging the lives of human beings through a holistic approach of healthcare services to humanity. It feels good when a patient who was critically ill, bed-ridden and was not be able to do activities of daily living, gets well as a result of good health care service offered to them. I learnt that medical practice is similar globally, and it needs teamwork, sharing of knowledge and empathy to patients in order to ensure holistic approach of care to patients.

From the deeper recess of my heart,/ express my sincere gratitude to GEMx for giving me this wonderful “golden opportunity”

 

GOD BLESS

 

 

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.

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”

 

Student Exchange From MOSC Medical College (India) to Penang Medical College (Malaysia) by Prannoy Paul

Filed under: GEMx Student Reflections

Post by Prannoy Paul, Medical Student at Malankara Orthodox Syrian Church Medical College (India) who completed a GEMx Elective at Penang Medical College (Malaysia)

Our institution, Malankara Orthodox Syrian Church Medical College, Kolenchery, Kerala, India, has always encouraged students to get more exposure in medicine by attending various medical competitions and medical student conferences happening around the world. It was in December 2016, that the GEMx coordinator of our institution, Dr. Anna Mathew informed me that I and my friend Kiron are selected for the GEMx student elective for the year of 2017 from our institution. I was really excited hearing the news, but I was also uncertain about how it is going to be or where should I be going.

Photo of MOSC Students at Airport

At the airport

While we were discussing about which institution to apply for the elective, it so happened that the GEMx representative from USA, Mr. Justin Seeling visited our institution for the promotion of GEMx. We had an opportunity to talk with him and he recommended that Penang medical College, Malaysia would be a good choice for us. So we contacted Penang Medical college, sent all the documents required and we got approved for the elective in the department of Surgery for the month of May, 2017.

Photo of Penang Medical College Taken by MOSC Students

Penang Medical College (PMC) is a private, Malaysian campus owned by two world-renowned medical universities in Ireland, the Royal College of Surgeons in Ireland (RCSI) and the University
College Dublin (UCD). PMC is affiliated to the Penang General Hospital, also known as Hospital Pulau Pinang, which is very near the medical college campus. Being the largest public hospital in Penang with 1090 beds, Penang general hospital is always busy with patients.

Photo of MOSC Students with Professors of Surgery and Medicine

With Professors of Surgery and Medicine

On our first day at PMC, we were introduced to Penang Medical College and Penang General Hospital by the administrative officer at PMC, Ms. Masitah Sihabudeen and we got an orientation session about the college. Our supervisor for the elective was Dr. Premnath, the head of Department for Surgery at PMC. We were grouped along with the final year students there at PMC.

Photo of MOSC Students with With Surgery Unit C2 at Penang Medical College

With Surgery Unit C2

In the mornings, we had to go to the wards to clerk the patients and take cases. Patients spoke mainly Malay, Chinese and English. For the patients who spoke Malay and Chinese, we were provided with translators to help with our communication. The students there were also very helpful in our communication with the patients. I was able to see and understand many diseases that are not very common here. We discussed often about the variety of diseases and surgical conditions that present to the hospital, and how it was different in India.

In the afternoons, we had various sessions like seminars, tutorials, case presentations etc. Professors and students ensured that I actively participate in those sessions and asked me to explain how various procedures were done in my country and how it was different from that being done in Malaysia. Those sessions were filled with lots of fun along with gaining new knowledge .Our classes in the mornings would begin as early as 7 am on some days and the afternoon classes typically lasts till 5pm. Saturdays and Sundays were holidays. Apart from that, there are also many local holidays every month in Penang due to the rich cultural heritage of the city. Throughout the elective, our supervisors and student representatives were always in touch with us to know if they can help us with anything.

Photo of MOSC Students with the GEMx Student Ambassadors at Penang Medical College

With GEMx Student Ambassadors of PMC

The GEMx student ambassadors at PMC were Syafaf Humaira Aman and Yik Chin Low. They were very helpful to us throughout our stay in Penang. They helped us with our academic doubts, took us to the major tourist destinations and also helped us try out some local cuisine in Malaysia.

Malaysia is a favorite tourist destination for tourists all over the world. On holidays, we were able to visit some of the major tourist destinations in Penang. Our friends at PMC and even the professors suggested good places to visit for the holidays. Penang is also very famous for the food. It is called the food heaven of Malaysia. The varieties of foods include Malay, Chinese and Indian cuisine. Penang is also very famous for its very delicious but cheap street food which is a very important attraction for the tourists visiting Penang.

Photo of Transportation in Malaysia

The population in Malaysia is mainly Malay, with others being Malaysian Chinese, Malaysian Indians, and other indigenous people. Islam is the state religion while many other religions like Buddhism, Hinduism and Christianity are also common. Languages spoken include Malay, which is the official language, English, and Tamil.

As most people, especially the younger generation spoke English very well, communication was not a problem for us while in Malaysia. People were very friendly and helpful. If we asked someone for the way to a place, they would eagerly tell us in detail. The hospitality of the Malaysian people made our stay, a very comfortable and enjoyable experience.

Photo of Malaysian Cuisine

Char Keoy Teow

The elective to Penang Medical College in Malaysia was a wonderful experience for me. It helped me understand how the health systems and medical education work in Malaysia and  how to interact with patients, medical students, and professors from another country. I also learned and understood the differences in medical conditions and health care in another country and achieved a broader, a global perspective in medicine. I recommend more students make use of the fantastic student exchange program provided by GEMx, it is very easy to apply to, and we are supervised in each step of the elective. The elective improves our academic knowledge, our communication skills, confidence, and our very perspective about medicine and about the world.

GEMx Elective Reflections – Student Exchange from Penang Medical College, Malaysia to University of Gadjah Mada, Indonesia

Filed under: GEMx Student Reflections

Post by Thaneswaran Jeyakrishnan, Medical Student at Penang Medical College (Malaysia) who completed a GEMx Elective at Gadjah Mada University (Indonesia)

Student Exchange from Penang Medical College, Malaysia to University of Gadjah Mada, Indonesia
I have now completed an elective course of 4 weeks in a tertiary hospital named RS Dr. Sardijito in Yogyakarta, Indonesia. The course comprises of 2 weeks of being in surgical rotation and 2 weeks in Orthopedics. I have chosen this place via the GEMx School Partnership program that was offered in my home institution (Penang Medical College, Georgetown, Malaysia). After being selected by my institution I was offered a range of options to carry out electives, all of which were listed in the website in terms of the GEMx Partner Schools and the courses they offered. I chose Indonesia mainly because of its expanding expertise in medicine and surgery in the expense of a low-resource setting especially with the burden from the rural areas and the ever growing population. RS Sardijito is a university hospital, attached to a reputable Indonesian public university called University of Gajah Mada. My time was entirely spent in the hospital and I was able to use the university facilities such as the library which was situated in close proximity to the hospital.

Thaneswaran Jeyakrishnan
Initially before embarking the elective, I was brought on an orientation to visit the facilities in Sardijito Hospital. The students from the university there was very welcoming regarding my visit. On the first day of my rotation, I introduced myself to the supervisor whom was the person-in-charge for me and he gave me a brief outline of the possible activities that I could benefit during the rotation. I was then placed in a group of residents who are doing their postgraduate course and for most of the times I was in this team of doctors whom I have been tagging along. The beautiful aspect of work in this hospital is that everything that is done here was more of team-work whereby the residents would help each other out and together they divide their tasks besides updating each other about their patients’ condition. I find this method very efficacious not only theoretically in preventing overworked atmosphere but it is healthy in many ways in maintaining the best patient care. Moreover, the residents working as a team teach and guide each other at all times. My routine usually starts as early as 6 am when the residents would do their patient-visiting and review their cases. At around 7.30 am in the morning report presentation would take place where the residents would present their cases in PowerPoint slides to the panel of specialists and consultants. There would be exchange of questions and queries which were all beneficial in the point of view of learning. I learned about the importance of a good presentation skill which comes with practice. I understand that only through discussion and reflection that one would be a better doctor. After this, I would usually go to either the operating theater or the outpatient clinic.

Thaneswaran Jeyakrishnan photo 2
The residents here in Indonesia have all been so welcoming, friendly and helpful. Something to be highlighted here is the way they handle patients- besides being friendly and caring, they show enormous amount of empathy towards their patients via body language, verbal and actions all of which are explicitly patient-centered. Perhaps it is the culture of politeness here that has shaped these doctors to be very empathic but I can assure that these values came-forward so often here not only in just the patient-doctor setting but even in my everyday lives in Indonesia. Since my stay here I realize that the locals are very helpful and friendly in which there were many situations when the locals tend to offer helping hands even though if you don’t ask for one. There are lots of ‘sorry’ and ‘thank yous’ going around in their own way of language expressions and sign. I believe that these are something that should be modelled everywhere else too. In terms of the patient care, the social aspects are always taken into serious consideration especially in terms of patient’s access and transport to hospital, finance and support from the family. Whilst this is how it should be anywhere globally, nevertheless there are many circumstances when doctors somehow omit these aspects of care when there is overcrowding and overwhelming stress especially in developing countries with low-resource settings. This is one of my salient learning point during my elective course in Indonesia which is to pay attention on how patient is going to recover in a long-term. During the course here, the senior residents here were very encouraging and they have provided adequate guidance for me.

 

 

GEMx Elective Reflections – Student Exchange from Universitas Gadjah Mada, Indonesia to University of Sharjah, United Arab Emirates

Filed under: GEMx Student Reflections

Post by Navilah Hidayati, Medical Student at Universitas Gadjah Mada (Indonesia) who completed a GEMx Elective in Elective in General Surgery at the University of Sharjah (United Arab Emirates)

Navilah Hidayati, Medical Student at Universitas Gadjah Mada
What have you gained from this exchange experience offered through GEMx?  What were the benefits?

I gained many unforgettable experiences, global connections, and lovely friends from this exchange experience. I met a lot of people in the hospital and learn about the international hospital dynamic there. I observed the medical students activity in the University and learn some good habits they have. I visited the beautiful tourism in Dubai and Sharjah. I tasted the traditional food, which has a very unique and strong flavor. I also had the chance to learn some Arabic language and enjoy their culture.

How did you prepare for your elective exchange? Were you prepared?

To be honest, I was not sure that I will be able to go for this exchange. I had some trouble with my post-acceptance documents. The problem became more complicated because I couldn’t contact the representative in the host university.

Fortunately, GEMx staffs also helped me to get in touch with her. About 2 weeks before my departure I received my acceptance letter. Ten days later, they sent me my visa. My parent bought my airplane ticket two days before the elective started and I was able to go to Sharjah to do my elective training. Only when I sat in the airplane that I thought,

“Ah, so I am going to do this..”

What did you learn from this experience both personally and professionally?  (consider your clinical experience, community experience, cultural experience, communications and interactions with faculty, staff, peers, and patient population)

Truthfully, I didn’t get many chances to improve my clinical skills in my host university. I had some trouble with the placement in the university hospital. I was glad that my supervisor, Ms. Eman and Prof. Nabil, take care of the problems quickly and I can start my elective training on the second week. I had one week in Pediatric, one week in Internal Medicine, and one week in Surgery. This actually different from what was written in my acceptance letter. I supposed to go to the General Surgery department for four weeks. I need to adapt every week in the different department. I also went to two different hospitals that have different regulations. Because of it, I barely had the chance to perform clinical skills on patients. But thankfully, the doctors were so active and always told me about the patient conditions. They also like to discussed some cases, which enhanced my clinical reasoning skills. The patients in the hospital was mostly Arabic, so sometimes I had trouble communication because I didn’t understand their language. When I faced this problem, my friends and the doctors helped me out. The staff in the hospital also very kind to me. Most of the nurses came from outside the UAE so they understand English. We sometimes had a chat on break time.

Apart from that, I had a beautiful experience with the University of Sharjah, the people living in the UAE, and their genuine Arabic culture.

How did you feel when you returned to your home school?

The first thing that came to my mind was I cannot believe it is already over. Everything ends so quickly. On my last day in Sharjah I had a very busy schedule. I need to take care of documents before leaving for my home town. Time flew so fast I didn’t realize it was already evening and I had to say good bye quickly to my dorm-mate.

The next day, I arrived in Indonesia. I had a short five days break before come back to my home school and do my clinical rotation. It felt so weird that time. It  seemed like my heart is left in my host school.

Can you share your story on this experience and how it has impacted you?  Were there any unexpected outcomes that you would like to share?

This experience is one of the most unexpected experiences I have ever had. I didn’t have the chance to see a lot of procedure that I think I will, but to tell the truth I gained so much more than that. I learn to deal with people (the patient, the hospital and university staff, my colleague). I learn to adapt with any given situation. I learn to understand every perspective. I learn to solve my problem independently. I learn to be brave, honest, patient, and wise. When I came back to Indonesia a lot of people said that it such a pity that the elective didn’t go as I expected it to be, but I don’t think so.

I am happy with my experience and it teaches me beyond the procedural thing. (more…)