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My GEMx Elective Placement At Kiambu Leavel 5 Hospital Under Kenyatta University

Filed under: Uncategorized

Post by WAMUBIRIGWE EMMANUEL MAKERERE, a medical student at Makerere University College of Health Sciences (Uganda) who completed a elective exchange at Kenyatta University School of Health Sciences (Kenya)

Acknowledgement

Meeting the GEMx students of Kenyatta University

Meeting with GEMx students of Kenyatta University

I am grateful to the Global Educational Exchange in Medicine and Health Professions (GEMx) for this opportunity to participate in the exchange program at Kenyatta University and facilitating my electives period and stay in Kenya.

I would also like to appreciate Ms. Faith Nawagi the African GEMx representative, Dr.Ssinabulya Isaac GEMx coordinator at Makerere University and Ms. Phiona the assistant coordinator for international programs at MakCHS. Dr.Kahiga Titus, GEMx coordinator at Kenyatta University and Madam Dorothy for the good reception at Kenyatta University.

Dr.Ngatia Justus the chairman obstetrics and gynecology department Kenyatta University. Dr. Were Francis, my supervisor at Kenyatta University and the fourth year students I was rotating with, thank you for making my rotation wonderful.

Travels

At KICC, Nairobi town view.

At KICC, Nairobi town view.

It was on 25th May when we boarded the modern coast bus heading to Nairobi. We set off at around 10:45pm. All my colleagues Muhumuza Mark, Agaba Kenneth,Turyamureba William and Isingoma Simon were all on board on the same bus.

However, it being night, we all slept off and woke up at the Busia boarder for the check up and we cleared everything. Our first stop over was in Nakuru town where I bought some breakfast. The price of the coffee was 100ksh and I felt it was so cheap but when I tried converting to Uganda shillings, it’s when I felt it was quite expensive.

We arrived in Nairobi safe and luckily enough, Madam Dorothy didn’t take long to come pick us up and she took us to Destiny park hostel in Kahawa Wendani, which would become our new home for the next four weeks.

First day

I did my clinical rotation at Kiambu level 5 Hospital

I did my clinical rotation at Kiambu level 5 Hospital

At the hostel we found some people there and these would be our first friends in Kenya, the likes of Derrick. Madam Dorothy got us lunch served in the dining room; we had rice and meat on our first day in Kenya. Later on, Derrick showed us around that day, there was a pool table and we started by spending part of the evening playing pool.

We moved around the place Kahawa while we were going for our supper with Derrick.

Food

Food seemed to be a shock at first because what seemed to be snacks back in Uganda was main food in Kenya. There was a variety of food in Kenya, chapatti, beans, meat, dengu, matumbo, ugali etc.

Their matooke wasn’t made like in Uganda. It was a little different and people eat one type of food at ago, they don’t mix all varieties at ago. Most people were eating chapo(chapatti) with beans which looked weird because back home, such food was eaten when someone ran out of options that day and was completely broke.

They have very good fish; my best meal I ate was ugali with fish plus some greens. I ate that meal every Sunday supper. It was my best. However normal days at hospital I used to eat rice, beans, dengu, ugali, matumbo, chapo depending what I wanted that particular day.

I also had a chance to eat the local food ‘mukimo’ it’s a mixture of smashed irish potatoes, maize, pumpkin leaves. It appeared greenish and it had a very good taste. I liked it most with meat. Also had a chance to eat githeri, amixture of beans and maize fried together. I didn’t enjoy it that much though.

People and the language

One particular thing I liked was the fact that these people have one common language they all speak, Swahili. It makes communication so easy. Of course I found it a challenge because I didn’t know the language. However, by the end of my stay, I had learnt some few words and phrases. How to greet, asking for price of something, asking for food. I had friends who always told me which word to use.

The people are so friendly and welcoming and always willing to help in case your lost or don’t know where to go. They were always willing to teach me a few Swahili words for survival around.

I made some good friends in Kenya, Ivy Reni, Onsare, Gibs, Felix, Bonniface and we have always kept in touch with them. They all promise to come to Uganda very soon.

In terms of transport, I was used to boda boda in Kampala but in Nairobi they are very rare. However the matatu are similar to ours in Uganda. But the matatus are not allowed within the city center so I used the bus mostly when going to the city center then matatu when going to campus, going to other places outside the city center.

There were the taku taku, I got a chance to board one while going from the by-pass to go and have chama choma. I had never sat in any of them, they are comfortable but so scaring, I always had a feeling they were going to knock it because it’s very small and sharing the road with big vehicles. But it was very safe.

Weather and climate

We were in Nairobi around the rainy season, it was really cold both day and night. I wasn’t used to wearing sweater whole day but Nairobi made me get used.

Hospital work

Fellow students rotating in obstetrics and Gynecology at Kiambu Hospital

Fellow students rotating in
obstetrics and Gynecology at
Kiambu Hospital

I was doing my rotation from Kiambu hospital level 5. It’s a county referral hospital of Kiambu county. I used to go to hospital in the University bus together with other medical students in the morning. We had different buses going at different times so you had a chance to board a bus that is convenient for the timing.

I was rotating in the obstetrics and gynecology department. I was oriented by the class representative, Onsare together with Ivy Reni. There were different wards, the gynecology ward, antenatal ward, postnatal ward, outpatient clinics and the theatre.

I decided to rotate in all these departments at least to have a feel of everything. I used to clerk patients with the help of my friends from Kenyatta University because of the language barrier. Presented to the doctors and discussed different conditions and their management. I had a chance to attend all the lectures organized in that period.

I also attended the labor suite where I mainly assisted the nurses in delivering mothers, went to theatre during obstetrics days and gynecological days. I had a chance to witness procedures that I had not seen in Mulago hospital especially the gynecological procedures. I also witnessed ward procedures like the manual vacuum aspiration.

The doctors were willing to teach and they demonstrated to us different skills we needed to learn. They were good and explained every question you asked during the teaching. I enjoyed mostly the bed side teachings where we had to clerk the patient, present to the doctor then we discuss the patient and management with the doctor. I had a very good experience with my rotation.

Social life

At the Biennial Infectious Disease Conference Nairobi Hospital

At the Biennial Infectious Disease Conference Nairobi Hospital

Socially Kenyans were nice people. The people we were staying with were very good, we became friends and used to watch television together, we used to play pool together especially in the evenings back from hospital. We used to prepare our own food on some days but we mostly used to buy from the nearby restaurants.

On weekends, we used to go out to some good places around. We got one of our friends from Kenyatta university and we used to tour with him around Nairobi town. We went to the parliament, the railway station, KICC, Uhuru Park, where we had some ice cream, horse riding.

One of the things valued a lot in Kenya is nyama choma. So we had a chance to go and have a taste of this nyama choma, we boarded and went in the evening with our friends and it was really nice. We also had a chance to visit Thika and Ruiru towns. We went to Thika road mall and had some good time there.

All in all, my experience in Kenya was a wonderful one. Had never thought I would get a chance to experience a life outside my home country, but Kenya gave me that experience. Will live to remember my days I spent in Kenya.

Internal Medicine Elective at Queen Elizabeth Central Hospital (Malawi)

Filed under: GEMx Regional Exchanges

Post by Tebogo Bolani, a medical student at University of Witswatersrand (South Africa), who recently completed a GEMx elective at the University Of Malawi College Of Medicine (Malawi).

Umuntu ngumuntu ngabantu. This a Zulu proverb that I have never fully appreciated until I arrived in Malawi. My first experience of Malawi was the airport – it was certainly not what I expected. We were welcomed by a small group of local children standing behind a fence waving at us stepping off the plane. It was humbling and exciting at the same time. I completed my elective at the Queen Elizabeth Central Hospital (QECH) in Malawi. We arrived on the 26 of November and stayed until 23 December 2017.

When we arrived at our temporary home at Kabula lodge, we were greeted with no electricity and no food and no means to get food. The food situation certainly improved throughout our stay, the electricity not so much. Power outages and load shedding occur regularly in Malawi. The country is reliant on hydro energy, but there has been a drought of late resulting in electricity shortages. All in all, the next month looked like it was going to be a challenge. We made it work though, we started cooking outside on a coal stove, locally called a Mbalula. Funnily enough the president came to town and for the entire duration of his stay we had continuous power.

villagers sitting around a tent
Monday morning, we woke up bright and early to go to the hospital. What struck me first was the bright colours from the chitenje that the locals wear. Malawians take pride in their culture. The chitenjes are used as clothing, bedding, to carry babies and many other uses that I have never encountered. I spent a significant amount of my time collecting different patterns and colours as gifts and to wear myself.

We were allocated to the internal medicine department, at our request. When I first walked into the ward I was shocked. It was nothing like I imagined. I expected a similar setting to South Africa, instead I found poverty and overcrowding but also the spirit of Ubuntu – which translates as “a person is a person through other people”. Malawians have a true sense of community. We joined the ward round and soon found out that resources are severely limited and that receiving something as basic as an ECG can be near impossible for the low-income patient. They do not have a Blood Gas machine or CT scanner. An MRI machine is available, provided the proper procedures are followed.

There are no barriers between patients resulting in no privacy, there are inadequate beds resulting in patients sleeping on mattresses on the floor and some even in the corridors.
One of the things that impressed me most about QECH is their ability to improvise. No chest drain is available, so they use a catheter, no hand sanitizer is available so they poke a hole in a bottle of spirit and use it as disinfectant. Also, they have what they call guardians. I am used to a system whereby nurses bear the brunt of the responsibility. In Malawi patients are always accompanied by their guardians. Guardians are family members that stay with the patient at all times, they do a lot of work that would ordinarily be considered the nurses’ job. Guardians empty catheters, give patients bed pans, feed patients and provide some of the medical history. They have no medical training and sometimes, they are a hazard (force feeding a patient with a reduced GCS), but I still consider them invaluable. Guardians sleep on the floor next to their relative without a blanket or pillow or mattress. I honestly believe they keep the hospital running. They exemplify the spirit of Ubuntu.

selfie of four african medical students
I have this memory in my head. It is the image of an elderly gentleman who was very ill. He was visibly wasted, weak and confused. His son was his guardian. Every day I would watch his son position himself behind his father on the bed and allow the father’s upper body to rest on his chest as he fed him. It was heart-breaking to watch. Partly because the father was very sick and had a poor prognosis, but also because his last moments where spent in a hot hospital, with flies everywhere that he did not even have the energy to swat off himself. It just seemed like a very unpleasant way to die, my only consolation is knowing that he was never alone, and his son was by his side.

Patients in Malawi seem to have a very high tolerance for pain. I was shocked when I assisted in performing a lumber puncture and no local anaesthetic was given. This is the norm here. Of all the patients that received a lumber puncture, not one screamed in pain. At home in South Africa local anaesthetic is used, and the majority of patients scream at the top of their lungs, so much so that the nurses come and check what is wrong. One of the senior doctors was asked why patients here never complain. He claimed that in the patient’s eyes, doctors can do no wrong and they are too polite to complain. The only response patients seem to have is to reach towards the hand causing the pain. But they never make a sound.

On a more positive note, the academic teaching in the internal medicine department is excellent. They have daily case presentations prepared by the students and everything from history, management and microbiology is thoroughly discussed. I learnt most during these early morning sessions. My Chest X-ray interpretation skills have improved. I loved that it is a platform for active learning. The consultants would sit in a line in the front row and the students and registrars behind them. After the presentation the consultants would ask questions about the case. It did not come across as an interrogation at all. It was academic discussion amongst academics.

The ward rounds where similar. Students are part of the work force. They clerk all the patients with the assistance of the intern and registrar and on Mondays and Thursdays present their patients on the consultant ward round. They ordered their own investigations and drugs as well. They are very independent when managing patients. Sometimes they would even come in on Sunday to prepare for Monday’s consultant ward round.

Four African Medical Students
The ward round was another platform for teaching. I am accustomed to passive ward rounds where students do not really participate. But QECH certainly does not conform. The ward round is run by the students with help from the junior doctor. The students, which soon included us, would present most patients and then have a discussion with the consultant. It is probably what I enjoyed doing most. It was the perfect combination of theory, clinical skills and fun. Granted it was exceedingly stressful, because of the pressure and fear of doing something wrong, but it always worked out in the end.Once we got the hang of how things worked we started seeing our own patients. I found it very satisfying to be managing my own patients from admission to discharge. I was certainly grateful for the help that the students and registrar provided. It was probably the first time I have ever felt like I am really becoming a doctor. It was stressful at the best of times and writing a discharge summary in the health passport is time consuming, but the joy of doing something right outweighs it all.

Looking back now, my experience at the hospital is not what I expected at all. We were necessary labour and I appreciated that. We became part of the team. We made friends with the students so much so that even though they have left, we still chat with them on WhatsApp group. My independence has definitely been put to the test. Being away from the comforts of home was difficult but bearable. I got used to the new normal. I think I gained more completing my elective internationally than I could have at home. I developed my ability to communicate with people that don’t speak the same language and my ability to adapt to a new community and culture. I also succeeded at performing procedures that I have repeatedly failed at, at home (lumber punctures). Additionally, I have proved to myself that I can live in another country and still be happy.

Daily Reflections from a Nursing Student’s Community Health Elective Exchange in Uganda

Filed under: GEMx Regional Exchanges

Post by Akingbohungbe Oluwatosin Sonia, a nursing student at University Of Ibadan. Department Of Nursing, College Of Medicine, in Nigeria, who completed a elective exchange in Community Health through Makerere University, College Of Health Sciences, Department Of Nursing, in Kampala, Uganda.

 July 2019

All thanks to God for this opportunity, I was privileged to be one of the students selected to participate in the exchange program in Makerere University, Kampala Uganda by the Global Education in Medicine Exchange (GEMx). The exchange school was the Department of Nursing, College of Health Sciences, Makerere University, Uganda.  The program started on the 17th of June 2019 and I joined them on the 22nd of June 2019 due to logistics. We took off from Lagos Murtala Muhammed International airport on the 21st of June 2019 by 12:40 P.M, We had a stopover in Nairobijomo Kenyatta International Airport By 11P.M and board another airplane to ENTEBBE by 12:55 A.M on the 22nd of June 2019. The plane landed in ENTEBBE by 02:10 A.M and we were picked up by Mr. Martin the driver to the department from where we were taking to the prepared accommodation where we slept over for the night. The following day we were taking to Ms. Lydia Kabiri at the department of nursing around 11a.m for proper welcoming, recognition and further directives on how the program will run. Afterward we left for Mpigi to join the rest of the students in the Mpigi Health Center IV where we were also welcomed warmly by Katumba Lawrence and kwikiriza Grace followed by the rest of the students Gerald, Olivier, Innocent, Sonita, Janet, Francine, Shilla and Clement the leader of the group. The students were on a recess posting which includes Domiciliary midwifery and community health as subset of Public health nursing. The Health Centre had different units, the General ward, Out-Patient Department (OPD), Antiretroviral Therapy Department, Maternal child health Department and the Labour ward. Alongside the posting into the ward, we also took part in Continuous Medical Education (C.M.E) undertaken by health practitioners in the Mpigi Health Center IV, the forum is a productive and an interactive one which affords everyone both students and the health workers to brainstorm and learn new things through researches and new discovery for rendering health services to the people.

Day 1

24/06/2019

The day started with meeting with the senior nursing officer, in charge of the health centre and she welcomed us and then there was a brief orientation to the setting of the health facility, visiting the various units of the health centre. The various units include the Out-patient Deapartment, the General ward, the Maternal and child health unit, the Maternity unit and the Anti-retroviral (ART) clinic. Day 1 started with posting to the General ward of the health facility. The ward included the male, female and paediatric wards and conditions found there includes malaria, pneumonia, injuries and other minor health conditions. On the ward, orientation was given and the nursing duties peculiar to the ward was explained to us. Observation of the assessment of patients, administration of medications and admission was carried out.

Also, one of the students from the university, Akwanya Innocent, gave a health talk to nursing mothers and we were all in attendance. The topic was on Danger signs during postpartum and it was delivered to the nursing mothers and women who came for antenatal clinic at the maternity unit of the health facility. The student nurse spoke in English language while another student helped to translate in the local language Buganda. The education was for about 20 minutes. Mothers asked questions about the topic discussed and they were duly answered.

In the evening, it was a period for discussion among the students and the topic on Community and Prevention-oriented population-focused practice: the foundation of specialization in Public health nursing. Discussion was on what public health nursing is, the core functions of public health which includes assessment, policy development and assurance. Categories of public health workforce competencies was discussed and also health services pyramid with the largest base being population-based health care services, Clinical preventive services, primary health care, secondary health care, tertiary health care and finally the benefits of public health nursing was discussed.

Day 2

25/06/2019

Work continued at the General ward today. Admission and discharge of patients was carried out. Administration of medications was also carried out and patients were given adequate care.
Health talk on Family planning by Egwela Clement was given to mothers and women who came for antenatal and postnatal clinic respectively, they were shown pictorial guides and models were also used to explain further the various method of family planning.
Due to the unavailability of adequate data on the population and logistics of the different settlement of the community we were yet to visit the community.
In the evening, there was group discussion and it was a continuation of the topic discussed yesterday on changes and continuation that has occurred in public health nursing and also Perspectives in Global healthcare. We discussed the topic with sub-topics on primary health care, nursing and global health, major global health organizations. We all discussed the topic, questions were asked and they were duly responded to.

(more…)

Faith Nawagi – GEMx Global Partnership Development Representative, Africa – wins Nursing Now Scholarship, May 2019

Filed under: From GEMx Staff, GEMx News


We are pleased to inform you that Faith Nawagi was 1 of 30 nurses who received a scholarship award from Nursing Now; out of 800 applications. Faith attended the WHO 2019 World Health Assembly in Geneva, Switzerland, and received training in global health policymaking and advocacy.  This award was in recognition of the work Faith performs for GEMx; developing inter-continental, institutional partnerships to facilitate student exchanges across Africa.

Faith met with leadership of Nursing Now, Sigma Nursing, and the International Council of Nurses.  Leaders of these organizations expressed a strong interest to form a global nursing exchange network using the GEMx web-based platform.  GEMx plans to meet with leadership in November of 2019.

Faith also met with Dr. Jim Campbell, Executive Director of Global Health Workforce Alliance and Director of the Health Workforce Department at the WHO.  Dr. Campbell acknowledged the good work of ECFMG FAIMER, and is pleased that GEMx is a service of such a wonderful organization.

ECFMG FAIMER continues to receive recognition for the good work we do around the world.  ECFMG FAIMER continues to strengthen opportunities for our services and programs like GEMx, and garner opportunities to collaborate with WHO, Nursing Now and other highly-reputable organizations that are committed to global health, education and quality health care.

Faith standing by WHO sign

We congratulate Faith Nawagi on her good work, contributions and commitment to GEMx, and to ECFMG FAIMER.

About Nursing Now

Nursing Now is a “three-year global campaign (2018-2020), aims to improve health by raising the profile and status of nursing worldwide.”  Nursing Now works in collaboration with International Council of Nurses and WHO.  Barbara Stilwell is the Executive Director of Nursing Now Global Campaign; a former FAIMER Board member.

That was epic: my one month rotation at Universidad Iberoamericana!

Filed under: GEMx Student Reflections

Basel Magdy Abdelmohsen Abdelazeem, Ain Shams University student in front of UNIBE

Basel Magdy Abdelmohsen Abdelazeem

For those who dare to dream, the world spreads out its arms, and for those who aspire to realize their dreams, they conquer the world. This belief has made my family and I walk diverse paths to learn, compete and shine. Due to the continuous strive to chase our passions, we became a family of dreamers.

My name is Basel, Student at Ain Shams University – Faculty of Medicine, Cairo, Egypt. My nickname is Dr. Nobel because My dream is to get the Nobel Award in Medicine in the future Insha’Allah.

Abdel in front of Hospital General de la Plaza de la Salud emergency center

I’ve gone on a lot of electives worldwide, but this was a totally new different experience in the Dominican Republic. My rotation was divided in two hospitals. The first one in Hospital General de la Plaza de la Salud (HGPS) which is a teaching hospital facility and has helped more than 140,000 low-income patients with discounts and waivers of its health treatment plans. I did one week at internal medicine Department both inpatient and outpatient in addition to one week in ICU and Emergency Department.

At the second hospital,Hospital Escuela Dr. Jorge Abraham Hazoury Bahles (INDEN), one of the greatest hospitals in diabetes’ management in Latin America, I went through every aspect in diabetes management starting from the outpatient clinic by ordering basic lab & imaging and adjusting the doses of medication and Insulin up to management of diabetic retinopathy and surgical aspect of the Diabetic foot. It was really an amazing experience.

Abdel with several colleagues in a classroom

Can you imagine that you go through all medical specialties in a month while getting the opportunity to improve your Spanish at the same time?! We had morning case report, grand round, interacted with physicians and residents and finally the awesome UNIBE students  who are all so nice, humble and willing to help you as much as they can. And fortunately, they speak both English and Spanish so you Ain Sham Universcan overcome the language barrier while interacting with the patient.

 

There are seven broad benefits of my rotation there and you should consider them in your next medical rotation.

  • First, I expanded my clinical knowledge and skill set as the style of medicine you’re studying is not universal, nor are the cases you’re familiar with.
  • Second,  I must admit, I was nervous on my first day on the wards. I had no idea what to expect but the doctors made me feel like a part of the team. I found out what I’m made of and strengthened it.
  • Third I made myself more employable as an elective abroad stands out as a badge of durability, resourcefulness, and aptitude.

  • Fourth, traveling is an opportunity to see a part of the world you’ve never seen and might never otherwise consider.
  • Fifth, an elective helped me in building my personal and professional network and if you’re clever about it, you can also build an international network of professional contacts
  • Sixth, I sharpened my language and communication skills, right now I’m confident enough to take history and doing the complete physical examination in Spanish.
  • And finally, it renew my perspective on the worldwide health and I mentioned before my life goal is Nobel award and you should know a little bit about everything in each field in this world and you must know everything about your specialty.

 

Away of medicine, let’s talk about the country and culture.  The Dominican Republic is the most popular tourist destination in the Caribbean region. I traveled a lot, so I learned how to enjoy each country to the most.

Abdel with friends from UNIBE having fun at a bar
This country is awesome if you have the correct company, I mean that you should interact with the real Dominican people and hang out with them. There is an amazing beach here, the old city, jungles– I mean literally– great nature. If you like dancing and drinking we’d definitely have a lot of fun as everyone literally is dancing to Latino music everywhere.,  Don’t forget to visit the Colonial Zone and Punta Cana. And make sure that you eat Dominican food made by locals and ask them to teach you how to dance to Latino music. You will have a lot of fun if you have good communication skills and know a little bit of Spanish.

Abdel with a professor and a colleague

My last word is thank you for everyone who helped me to get this rotation, for every doctor who taught me during the last month, for every student I met there and helped me.

Thank you, Dr. Mejia, Program Manager of HGPS

Thank you, Dr. Ammar Ibrahim, Director General of INDEN

Thank you, Danny, UNIBE Coordinator

Thank you, Eunice Kamami, GEMx Student Engagement Assistant

And Big Thank you to GEMx to giving us these opportunities.

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

Dermatology in the US

Filed under: GEMx Student Ambassador Network, GEMx Student Reflections

Post by Divya Gautam, Student Ambassador at Royal College of Surgeons in Ireland (RCSI) and University College Dublin (UCD) Malaysia Campus has completed an elective exchange at PAGNY in New York City.

Divya Gautam

The aims of this elective were to gain a better understanding of some of the rotations that I am interested in and to narrow down the field in which I hope to specialize as well as to learn how the American healthcare system functions. In medical school, we were unable to achieve a specialized exposure to Dermatology and therefore, this elective was very attractive to me as it offered the opportunity to shadow one of the most established dermatologists in the United States. As an international student in Malaysia, I have gone through most of my clinical years barely scraping the minimum requirement for patient interaction. It is an entirely different experience to be able to converse with a patient about their problems in your first language and be able to counsel a patient directly, instead of through a translator. Another major objective was to be able to work on research with PAGNY, an established organization that is responsible for publishing hundreds of quality papers. Forming contacts within the United States system is extremely vital for me to give myself a chance for furthering my career.

Divya with Dr. Bijan Safai, Dermatologist

Throughout this elective, there were some ups and downs due to the mere timing of the placement as it was around the winter holiday period. There were fluctuations in the number of patients being seen; however, I was, without a doubt able to identify some key differences in the practice of medicine in Malaysia and the USA. I was very happy with the way I was treated as a medical student. When I was rotating from clinic to clinic, I was always introduced as part of the consulting team and was asked for my medical opinion when it came to clinical decision making. Working with the physicians at PAGNY, encouraged me to continue my journey in medicine. I was on the elective with three other students, and during the research segment, we were given the option of being put on existing research or creating our own topic and literature review. We, of course, being extremely ambitious, as medical students are, chose the latter. Our research paper is a cross-cultural literature review on the substance use patterns in the countries that we are from. In my opinion, given the massive burden of substance abuse and dependence on the healthcare systems, globally, this paper can be an asset to warrant further research on intervention and public policy.

Now for some fun stuff—since I grew up in the States and a lot of my friends from boarding school ended up there, I spent a lot of time catching up with old friends and just drinking A LOT of apple cider and eating A LOT of Christmas market food. I could list about a hundred things I fell in love with while I was in Manhattan. The dollar pizzas, the museums, the brunch spots, the convenience of the subway, the musicians and street artists, the hustle and bustle of Wall Street, the fantasy lifestyle on the Upper East Side, the strolls through central park, hearing over 20 different languages on your way home from the clinic, the list goes on and on and on and on!

Divya with Anna, Justin, Maureen, (PAGNY exchange facilitator), and other students at PAGNY

I want to thank GEMx for providing me with this fantastic opportunity. It is rare to carry out an elective in the United States without having given the USMLE, and together with PAGNY, this was made possible. All of the physicians that I worked with were extremely kind and did not hold back on teaching us and guiding us through the rotation. Our research coordinator was always available in case we were having difficulties and provided us with ample resources to aide our monumental task of doing a literature review over a span of 6 weeks.

Overall, it was also a great experience, being able to live in Manhattan and experience the diverse culture of the state of New York—that too during the most wonderful time of the year!. I’m more confident in my decision to practice in the United States as I feel that I understand the structure and inner workings of their healthcare system. I’ve been able to successfully establish a good relationship with practicing physicians that have been kind enough to offer recommendations and continued contact for mentorship.

Take Hold of the Learning Opportunity

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Onthatile Thusi

 

Post by Onthatile Thusi, a medical student from University of the Witwatersrand Faculty of Health Sciences [South-South] who recently completed an elective exchange at the University of Malawi.

The plane cut through the clouds to reveal the first views of Malawi from the sky. The land was patterned with areas of green and brown and scattered housing. The scene was a great contrast to the landscape of Johannesburg which is populated with housing. As the plane began to fall towards the earth the exhilaration rose in my body while the thought of stepping my feet onto to a foreign land soon became a reality.

Queen Elizabeth Central Academic Hospital found in the city of Blantyre, Malawi is the largest referral health facility in the country of Malawi and was the setting of my 4-week elective along with 4 other students from South Africa. I was in the Department of Medicine under the supervision of Dr. Mallewa.  I was placed in the male medical Ward 3b and was welcomed by the team responsible for Bay 2 which consisted of Dr. Lester, an experienced consultant, Dr. Basami a proficient intern, Dr. Pink an enthusiast registrar, and Allan Masapi a friendly and helpful final year medical student. The only directive we were given for the elective was to follow the final year students timetable and we were given the freedom to attend any of the lectures or teachings carried out by the Department of Medicine.

Onthatile Thusi with her colleagues

“You are responsible for your own learning”.

This was a statement repeated to us throughout our second year of study and it is now in this elective experience, that I have come to grasp the significance of this statement. There are numerous opportunities to learn from patients whilst in the wards. The team working in Ward-3b, Bay 2, and the members of the Department of Medicine was willing to impart their knowledge onto the students. However, it was my responsibility to take hold of the learning opportunity and initiate engagement and discussion with every source of knowledge at my disposal. Other than the scheduled final year student lectures, and the bedside teachings carried out during the ward rounds twice a week, learning was often self-directed.

My day at Queens began with student case presentations which I found very valuable. In these case presentations, I saw the theoretical knowledge acquired in medical school come to life through practice.  It is in the discussions of these cases where I learned the value of the art of medicine in a resource-limited setting. Each investigation was challenged for its relevance and utility. The principles imparted in these discussions are some that I hope to apply in my personal practice of medicine in my home country of South Africa that face a number of resource limitations with a similar HIV burden. Following case presentations, were morning ward rounds often done with the intern and joined by the student and consultant twice a week. It is in these ward rounds that I was inspired by the extremely knowledgeable intern Dr. Basami and had the privilege of seeing the art of medicine practiced with efficiency and great proficiency despite the many limitations.  Under the patient guidance of interns and final year students, I was able to carry out a number of my clinical skills and acquire new skills with the encouraging consent of the patient.  It was often that the ward round and ward work was completed before 13:00, and I would find myself with nothing to do the rest of the day. I attempted to shadow an intern in the medical admissions in the Emergency Department or searched the wards for a doctor to have discussions surrounding patient’s cases.

One of the very exciting experiences was at the Grand Ward round which took place once a week. It is in this ward round where ongoing studies at the hospital were presented. Exhilarating discussions were had on the clinical relevance of the study and conclusions were made from the study. Active conversations between departments would take place on how the challenges and recommendations brought forward by the study could be mitigated and implemented. It was exciting to hear the dynamic interactions between professionals that bring tangible change in public health and ultimately improve patient care.

Malawi home

Malawi the warm heart of Africa. The pulse of this heart is felt through the people of Malawi.  The patients I encountered were willing to engage with me and consented to my intention to learn new skills with welcoming eyes. The language was a great obstacle, as most of the patients speak Chichewa, there were very few patients that spoke English. I felt that my opportunity to gain crucial experience in clerking and presenting patients was hindered. This language barrier limited my ability to perform procedures and examinations using a patient-centered approach, as all communication was done through a third party.

The pulse of this warm heart of Africa extended outside the hospital confines. The owners and staff at Home Up guesthouses, our accommodation for the duration of the elective, welcomed our arrival with expectant and cheerful spirits. Throughout our stay, they created a friendly and cozy environment. The staff was eager to help in any regard and provided valuable information to make the most of our experience in Malawi.

The vibrant and energetic spirit of Malawi is reflected in its landscape. We had the privilege of exploring some of the great sites in Malawi. We trekked through the majestic Mount Mulanje, trudged the lush green forestry of Zomba plateau and strolled through the tranquil fields at Satemwa tea plantations.

Views from Zomba Plateau

The friendly people, the warm culture and the exposure to a number of new medical experiences made these 4 weeks greatly fruitful. Despite the delays during the application process and the challenges in securing the funding before my departure, thanks to the diligent work of Mr. Motlhabani and all involved this elective experience was made possible. Each moment has been a true privilege. I have obtained valuable exposure to a wide range of medical conditions, although ideally, I would have enjoyed the chance to rotate through the different medical wards and engage with different doctors. Similarly to South Africa, Malawi has a large HIV burden and through this elective, I learned crucial principles concerning the monitoring of HIV in a resource-limited setting. The greatest personal revelation that I have taken from my 4 weeks in the Department of Medicine, is that true learning comes with an eager and earnest attempt to acquire it. I have retained a great amount of information due to a personal growth desire to gain a greater understanding of the patients I encounter and I hope to continue to grow into an experienced and proficient doctor.

 

My GEMx Elective Added Value to My Medical Career

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Stephen Odiwuor

Post by Stephen Odiwuor, a medical student at Jomo Kenyatta University of Agriculture and Technology, Kenya [MEPI]

I was born around the mid-90s as a son to John Ochieng and Janet Ochieng at home in the middle of the night, with the assistance of a traditional midwife as the only complementary and alternative medicine provider on standby at that critical hour of my birth. My name, Odiwuor, means born at midnight.  I thank God that neither my mother nor I developed perinatal and post-natal complications because had my mother experienced any obstetrics complications, there would be either no ambulance or vehicle to rush us to the nearest health facility except for an old, poorly maintained wheelbarrow that could be easily accessed from the nearest neighbor.

This meant that I had to catch up with the immunizations the vaccines that I should have received at birth, at 6 weeks, at 10 weeks and at 14 weeks later on in the course of my infancy period. In the course of my neonatal period, my mother reports that she developed breast disease, which, after literature review and medical knowledge, I concluded could be either mastitis or breast abscess. I then had to be shifted from exclusive breastfeeding to completely cow milk and that was the end of me with breastfeeding at that tender age before the recommended six months period had elapsed. My parents could not afford the infant formula milk because we were wallowing in the mud and mire of poverty.

At the Zimbabwe Medical Students’ Association annual general meeting (AGM)

In our village, I had to put up with a life that meant learning how to live with malnutrition and, occasionally acute malnutrition and severe malaria due to lack of untreated mosquito nets. My passion to pursue a bachelors in medicine and  a bachelors in surgery course is being driven by these health concerns that I had to survive right from my perinatal period, the immunizations I did not receive according to schedule, the exclusive breastfeeding that I did not get a chance to enjoy, the malnutrition I suffered among other health risks that I faced.  I, therefore, acknowledge the Education Commission for Foreign Medical Graduates (ECFMG) for their Global Educational Exchange in Medicine and the health professions (GEMx) that sponsored my electives at the University of Zimbabwe College of Health Sciences, Parirenyatwa Hospital, that would help me realize my dream of giving back to the community as a doctor by addressing the health challenges that I faced.

It was in early 2017 as I was going about my normal academic obligations at the Jomo Kenyatta University of Agriculture and Technology (JKUAT) school of medicine as a fourth-year bachelor of medicine and bachelor of surgery (MBChB) student when, a bachelor of pharmacy student, whose lecturer is Dr. Karara, the JKUAT GEMx Coordinator, sent me a link about GEMx electives. It was my first time to hear about GEMx so I did not take it with a lot of seriousness that it deserved. After a period of contemplation, I decided to give it a trial. I opened a student account on the website and requested Dr. Karara to confirm my details and accept me in the system since she is the JKUAT GEMx Coordinator which, she did. I then proceeded to start my applications for elective. I applied to Kwame Nkrumah University of Ghana, the University of KwaZulu Natal and the University of Zimbabwe. My electives would be in August and September 2018. University of Zimbabwe College of health sciences accepted my applications after uploading all the requirements for the elective on the system and submitting my applications.

At the Medical and Dental Practitioners’ Council of Zimbabwe (MDPCZ)

I arrived in Zimbabwe on 20th of August 2018 at around midday and went straight to the University of Zimbabwe College of health sciences. To my amazement, the elective department had been waiting for me. After a few minutes of engagement and introduction, I was taken to the building at which I would be hosted for the 42-day period that I would be at Parirenyatwa Hospital for my elective. The awesome reception, the transport around the city and the orientation that I received from the elective department on the first day are among the many things I cannot fail to highlight in bold when talking about my elective experience. I did my clinical elective rotation in internal medicine. Among the things I learned were: The good attitude of the consultants towards both students and patients, the awesome reception by the nursing staff, the interactive sessions we had with the junior registered medical officers, the healthy discussions we had with the final year MBChB students, the vast medical knowledge that I gained during ward rounds and enjoyed the beautiful culture of the Shona community. Generally, it was such a life-changing experience for me. Moreover, I was also able to attend the Zimbabwe Medical Students’ Association (ZiMSA) annual general meeting and Dinner and the Family medicine conference at the University of Zimbabwe College of Health Sciences, Gellfand hall.

GEMx sponsored everything during my elective period. GEMx sponsored my accommodation, my upkeep, my flights to and from Zimbabwe and all other expenses. Special thanks to Mrs. Faith Nawagi, the GEMx Africa Coordinator for the constant counsel and help that she provided for me at every stage of my application, Mrs. Chuma Vunganayi, the elective coordinator at University of Zimbabwe College of Health Sciences and Dr. Monica Karara, the GEMx JKUAT coordinator. I also want to acknowledge and appreciate Dr. Reuben W. Thuo, the Dean school of medicine (SoMED) JKUAT, for the recommendation letters and the support he accorded me towards the application for my elective attachment.

Thank you GEMx, you have added a lot of value to my medical career.

 

 

 

 

Increasing Quality and Accessibility to reach everyone, everywhere

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Nyasha Dzinotyiwei

Post by Nyasha Ronald Herbert Dzinotyiwei, a student from University of Zimbabwe College of Health Sciences [MEPI] who recently completed an elective exchange at Kwame Nkrumah University of Science & Technology

Acknowledgments

I would like to thank the Global Educational Exchange in Medicine (GEMx) for providing opportunities for medical students all over the world to go on exchange programmes. I would also like to thank my school, University of Zimbabwe College of Health Sciences, for selecting me to take part in the programme. I would also like to thank the Kwame Nkrumah University of Science & Technology (KNUST) for accepting my application, as well as Ms. Charlotte Osei Boateng, Bismark Addu-Appiah (the Exchange Officer) for assisting me in settling in. I would also like to thank the medical students at KNUST for welcoming me and making me feel at home. Medase pa!

Experience in Ghana

My experience in Ghana has been awesome. For sure I had never imagined that I was going to experience what I had experienced. I love so many things about Ghana – the rich heritage, the different languages, the traditional dress (called Kente), the food, and the people. More importantly, I also noted the many similarities between Ghana and Zimbabwe.  Moving forward, I can use the different things I learned to make suggestions and improvements in my home country.

Nyasha and his friends

Elective Placement

I took up an elective placement in internal medicine that lasted 4 weeks. I was based at Komfo Anokye Teaching Hospital (KATH), which is the hospital affiliated with the KNUST (Kwame Nkrumah University of Science and Technology). I was placed in 4 different departments: Cardiology, Respiratory Medicine, Nephrology, and Neurology. Each placement in the respective subspecialties lasted 1 week. I had difficulties communicating with patients, as some of them were not comfortable speaking in English.

Nonetheless, I managed to communicate with them, and I managed to examine patients as well.

Adjusting to the hospital set up was not very difficult for me because the teaching styles employed at the hospital were identical to those I was accustomed to back home. One of the major things I learned from my stay in Ghana was the provision of the National Health Insurance Scheme (NHIS), and how it aimed at providing equity in healthcare across economic divides in Ghana. I learned about the strengths & weaknesses of the system and how best the system could be tailored to meet the needs of the population.

Nyasha standing outside of the Emergency Department

The teams I was attached to were the teams that had been on duty at the Accidents & Emergencies section. The system in Ghana differs from that in Zimbabwe. While in Zimbabwe we have firms that have admitting days, in Ghana they have duties in which firms take care of patients in the Accidents & Emergencies Department (Our equivalent of Casualty). Back home, there are about

5 firms which, despite being specialized, admit all patients sent to Internal Medicine. In Ghana, the medicine subspecialties operate independently and therefore cardiology patients only attend to Cardiology patients & consults. It reduces the workload tremendously and I believe it also improves outcomes. I also learned about a triaging system for patients who present to casualty, which divides patients into green, yellow, and red depending on the triaging score, which also estimates the severity of disease/injury.

 

Food

The most intriguing part of my stay in Ghana was the new food. I had never seen such variety in dishes! Ranging from Jollof rice, fried rice, and Waache to Fufu, Omo Tuo, red red, Banku and Kenkey, I had the opportunity to experience a different array of dishes. The food was awesome, and I loved it.

Jollof Rice

Other Experiences

I also had the opportunity to meet many other exchange students who were affiliated with KATH as well: many of whom were from Germany, Finland, Austria, and Nigeria. The experience was very nice and I got to make new friends and learn about their health systems. I also got to know how their medical experiences have been and how they differ from ours. I made friends that I hope to keep for the rest of my life.

I also had the opportunity to travel whilst in Ghana. I went to Cape Coast & Elmina, and while there I visited Cape Coast and St. Georges’ Castles. I learned more about the slave trade, and how the castles were used to detain slaves while waiting for slave merchants to arrive and collect them as they began their journey across the Atlantic Ocean. I also visited Kakum forest while there. I also went to Mole National Park, which is northern Ghana. The environment was different from the one I had already adjusted to in Kumasi. I had a nice time with the elephants J and I also visited the Ancient Mosque in Larabanga, which happens to be the oldest mosque in West Africa

Elephants in the background

Last but not least, I had the opportunity to attend the opening ceremony of the 14th International Federation of Medical Students Associations’ (IFMSA) African Regional Meeting (ARM), which was held for the first time in Ghana and in Kumasi. The 13th edition was held in Zimbabwe, so for me, it was a déjà vu experience. I had the opportunity to meet people from many countries, including my own. The theme for the 14th edition was “Rural and remote healthcare – Increasing quality and accessibility to reach everyone, everywhere”. I was inspired by the address given by the Dean of Public Health, Professor Ellis Owusu-Dabo, whose message was in accordance with WHO recommendations. He highlighted 5 main aspects: providing proper healthcare financing (for which he commended the launching of the national healthcare financing scheme in Ghana); deployment of health personnel to remote hard-to-reach places in countries; availability of essential medicines; compiling health statistics and data (incorporating health informatics), and ensuring quality service delivery

Opening ceremony of the 14th International Federation of Medical Students Associations’ (IFMSA) African Regional Meeting (ARM)

 

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