6 Questions for a Med Student on International Rotations

Practicing medicine abroad has always been an interest of mine and when I was recently contacted by Work the World, a program which places medical students in rotations in countries across the globe, I was eager to hear more about the kind of work that can be done internationally.

Alison Maclean, a research student at the Liverpool Medical School in the UK whose interest is Women’s Health, took the time to answer some questions I had about her experience doing a 5 week elective in Sri Lanka. I was amazed by the freedom and opportunities she had to really practice medicine and excited to hear about the possibilities for learning and getting truly involved with clinical care.

If Alison’s story appeals to you, taking some time to continue your medical education in a different country might be worth looking into. Work the World is just one of many organizations who offer international rotation opportunities. Additionally, many schools have developed global medical experience programs and may offer financial aid to assist you with travel costs. Consider talking to an advisor or doing some research online to make sure you find the right fit for you!

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Galle Fort, Sri Lanka (all pictures courtesy of Work the World)

1.     What are your interests and passions, what school do you attend, what field are you specializing in, what is your favorite part of medicine, what’s the last book you read/movie you saw?

My main interest in Medicine has always been Obstetrics and Gynecology, and I hope to specialize in the field after my foundation years. I’ve enjoyed the majority of my placements in University so far, both on Medicine and Surgery, which is why O&G really suits me as it allows you to develop skills in both fields. I also really like that in Obstetrics, most of your patients are healthy, but are just going through a time in their life where they need medical assistance, so it’s a very rewarding specialty. Outside of Medicine, I really enjoy cooking and baking, and running to burn off all of those extra calories! I spend a lot of time with friends, either going out, watching films at the cinema or live music, or just relaxing at home. Liverpool is a great city for students as there is a lot of culture and lots of things to do!

2.     Can you talk a little bit about your elective experience abroad? Where did you go, what kind of program was it, why did you choose it?

I spent the 5 weeks of my elective in Kandy, Sri Lanka. I split my time between the General Medicine wards and the Obstetrics and Gynecology department. Originally I was interested in a placement in India, but after deciding I wanted to go with Work the World, I chose Sri Lanka, as it is close to India and I planned to travel there afterwards. I chose to do the General Medicine placement to give me a broader understanding of the types of diseases that are most prevalent in Sri Lanka, and it was interesting to see that a lot of the patients were similar to those you would see in England, for example there was a lot of diabetes and cardiac disease. The main difference was the higher number of patients admitted with infectious diseases such as Dengue fever. The O&G placement for me was so that I could experience the specialty in a different culture, and I was interested to see how childbirth was different in Sri Lanka, as I discovered it has the lowest maternal mortality rate of all of the third world countries.

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Hospital Ward in Kandy

3.     Walk me through a typical day for you on your placement.

A typical day started early in Kandy, in the Work the World house we woke up at 7am, had breakfast prepared by the chef which could be fresh fruit, cereal, toast, pancakes, and sometimes scrambled eggs. I walked to the hospital with the other students, which is about a mile away, along the Kandy lake. The day usually started with a ward round, or a clinic, and I attached myself to the Consultant and followed the team as they worked. The Doctors spoke to the patients and nurses in Sinhalese, but discussed the cases and wrote in the notes in English, so it wasn’t difficult to understand the plan. At lunch I would either meet other students in the canteen, or be invited to have lunch with the team, which was always interesting, as I had no idea what the food being served was! They were always very kind and explained which dish was probably too hot for an English person to try, so I was safe.  In the afternoon I would either go to a clinic, or be free for the afternoon, in which case I would sometimes sit in the library and read up on new diseases I had come across, or head into town to explore the area.

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Group of Medical Students

4.     How do you feel this experience impacted you on a personal and a professional level?

I think it is that traveling and experiencing a different culture to your own is one of the best ways to grow on a personal level. This was the first time I had traveled outside of Europe, and I found it to be an eye opening experience. I learned a lot about the Sinhalese people and the Sri Lankan culture, and was humbled by how welcoming and accommodating the people were.

Through the placement, I gained a lot of clinical experience, and learned some new skills, which will stay with me during my career. It was difficult at first to try to integrate myself in the healthcare team, as I didn’t want to be in the way of the extremely busy Doctors. However, after the first few days I became more confident to ask questions and get more involved. I found that by showing enthusiasm, the Doctors realized I was interested, and would make extra effort to involve me in the ward rounds and clinical decisions. Spending time in an under resourced healthcare system was eye opening for me, I saw how Doctors and other healthcare professionals took care to avoid waste of medical equipment; in surgery every last inch of suturing thread was used, which is very different to what I’ve observed in the UK. However, I saw many situations where patient privacy and safety was compromised as a result of the lack of facilities available, and have a new appreciation for the guidelines we follow to protect our patients in the UK.

5.     What impressions will stay with you from this experience? What won’t you be able to forget about?

During my placement, I was fortunate enough to spend some time with a very keen junior doctor, who found the time to teach me how to repair an episiotomy. This was the highlight of my placement as I felt extremely involved and enjoyed the responsibility, and is something I will not forget in the future.

Outside of the hospital there are lots of unforgettable experiences I had during my stay in Sri Lanka. We traveled every weekend to different parts of the country, from beaches, to safari, to pilgrimages up Adam’s Peak. There was so much to see in such a small country, and I would love to go back one day and explore the places I didn’t get chance to during my placement.

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Pinnewala Elephant Sanctuary

6.     What was the biggest culture shock? What was the best thing that was different?

One of the biggest culture shocks for me was the difference between the Sri Lankan women and men. The women were generally much more shy, and cautious around tourists, whereas the men were more enthusiastic and involved. I noticed this in lots of different situations, for example the female medical students were much less talkative with us and also less confident in answering questions on the ward rounds, but the male medical students were much more inquisitive. The local people seemed surprised when they saw a lone female tourist walking through town, as usually the Sri Lankan women would be in groups. It made me realize that in the UK females have a lot more independence, which is something I hadn’t thought to question before this experience.

Featured image from Flickr | FatMandy

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Chantal Mendes

Chantal Mendes is a writer who loves science. She graduated with a journalism degree from Boston University (go Terriers!) and is currently a third year at the University of Vermont College of Medicine. In addition to her interests in cardiology and pediatrics, Chantal enjoys rock-climbing, anything Lord of the Rings related and looking for the best poutine in Vermont. She shares stories of her journey from journalist to prospective doctor on her blog, journalistdoingscience.blogspot.com and tweets @Chantal_Mendes.