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Veni, Vidi, Amavi (We Came, We Saw, We Loved)

Filed under: GEMx Global Network GEMx Student Ambassador Network GEMx Student Reflections

By: Shin Loong Soong,  GEMx Student Ambassador from RCSI-UCD Malaysia Campus who participated in an internal medicine elective at Kasturba Medical College Manipal.

Located in Karnataka, India, Kasturba Medical College (KMC) Manipal is a constituent of Manipal Academy of Higher Education. Since its establishment by TMA Pai in 1953, KMC Manipal has held on to the mission of training competent, compassionate, and caring physicians by providing exceptional clinical teaching. With quality medical graduates practicing worldwide, along with having a college campus and a hospital here, as such Malaysians are no strangers to the name “Manipal”.

 

As part of the RUMC curriculum, an elective component was made mandatory for students prior to graduation, promoting medical knowledge exchange through learning from a system, settings and practices not familiar to the student however, what excited me the most, was the opportunity to travel and experience a cultural exchange. I can still remember attending a sharing session by the RUMC GEMx Ambassador, Dr Low Yik Chin back when I was a fresh third year student in RUMC. Being inspired by her experience, I decided to do my elective at KMC Manipal. As such, I submitted my application in February 2019 and was offered a place in KMC Manipal shortly after the submission of my application.

 

My elective journey in KMC Manipal began in December 2019, where I was attached to the Department of Internal Medicine, under the guidance of Dr Mukhayprana Prabhu, Professor of Medicine and Head of Unit 8 within the department. During the elective placement, I was given the opportunity to join the students in ward rounds and clinical bedside teachings by Dr Prabhu and the resident doctors. This gave me the opportunity to enhance my knowledge on appreciating clinical signs and symptoms as well as opening my eyes to rampant tropical diseases which were not commonly seen in Malaysia. Seeing rare diseases like these was a learning experience of a lifetime. Also beyond my expectations was the opportunity to write a case report on a rare facial fungal infection, working with Dr Prabhu and other authors, which we intend to submit for a journal publication in the future.

 

Physicians used to rely on their senses; seeing, hearing, smelling, and feeling for physical anomalies to guide their diagnosis. Technological advancement has slowly superseded the role of a clinical examination in reaching a diagnosis, and although they are more sensitive and specific, they could also cause harm to patients, e.g. pain during blood taking and radiation exposure while taking an x-ray. However, this doesn’t demean the importance of these investigative tools. As such, the recipe of a good doctor would be having a strong foundation on the wisdom of modern medicine in appreciating clinical signs and symptoms and to apply evidence based practices effectively.

One of the biggest challenges that I have faced during my elective placement is the language barrier. Despite having the teaching and discussions conducted in English, most of the patients admitted were unable to converse in English, and with my inability to converse in Kannada, I was initially fearful that this compromised my learning, as clinical learning relies on communication with patients. However, the challenge was easily overcome with the help from my peers and the resident doctor, Dr Poonam Kamath, who have willingly took some of their valuable time to translate and explain the patients’ conditions to me.

With Malaysia being a big cultural melting pot that consists of three major race groups (Malay, Chinese and Indian), I was exposed to different cultures from a young age, and have always loved Indian cuisine. There are many things that I enjoy and like about India, the colourful sarees, the smell of incense and spices, the scenery comprising animals like cows and dogs roaming freely in the streets, the taste of delicious and authentic Indian cuisine, and the amazing Indian hospitality. As I travelled to India alone, I initially experienced some culture shocks and difficulty in adapting to life in India. But it is due to their amazing hospitality, and the kindness from a stranger who later become a friend, that I never felt lonely and my journey in India turned out to be amazing.

 

More than an opportunity for academic and clinical knowledge development, my elective journey in KMC Manipal, India has allowed me to expand my social networks and form many valuable friendships. Strong bonds were created even though it was just a short 4 week elective. Multiple life lessons have impacted me and lead me to count my blessings. I would like to take this opportunity to thank Dr Prabhu, the resident doctors, and my fellow peers who made this elective journey a fruitful and memorable one. Some feelings are hard to express in words, so to conclude my elective journey in KMC Manipal, I would say “Veni, Vidi, Amavi”.

 

Dermatology in the US

Filed under: GEMx Global Network 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.

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