Belgrade, Serbia
Name: Nina Ramic
Location of elective: Belgrade, Serbia
Health care setting: Hospital
Organization/affiliation: IFMSA
Supervisor: Dr. Milena Micic (a physical medicine doctor)
Nature of elective (highlight all that apply): Clinical / Research / Public Health /
Other: Exchange program
Length of elective: 4 weeks
Number of students on trip: Just me from Queen's, 20ish total from all over the
world
Please describe the nature of your activities during this elective:
A month long observership with various physical medicine physicians in the
large clinical center in Belgrade
What were some of the strengths of this elective in terms of your clinical or
research experience?
- Learning about how the medical system works in Serbia, learning about Serbian
culture (medical and otherwise)
- Meeting medical students from all over the world
- Comparing and contrasting medical programs with students from around the
world
- Improving my Serbian language skills
What were some challenges you experienced in meeting your clinical or
research objectives?
- Due to the nature of the service, I had very little chance to practice my own history
and physical skills
- Preceptors were not aware of how much knowledge I had about medicine, often
grossly underestimated (they have a 6 year medical program, don't understand how
the north american system works)
Would you recommend that future participants should expect a lot of
structure and supervision or that they should be prepared to work
independently?
- If you want to "work" or create a project, you'll have to work independently
- Some preceptors were excellent teachers, others required you to take more
initiative if you wanted to learn something
Please describe how you felt about working in this culture or setting.
- I was very accepted and felt comfortable with the physicians
- Out of the many people I worked with only one didn't seem to enjoy having a
student (so I left and found a preceptor that was more receptive)
- The culture was very different from Canadian medicine - much more paternalistic
and lacking confidentiality and privacy - it was difficult to keep quiet about the way
things were run in the entire hospital
- Staying in a student dorm with medical students from around the world was a very
interesting experience, and I loved meeting all the new people - we had so many
surprising similarities and differences!
Any other comments on your experience:
- Knowing the language was a huge advantage, it allowed me to understand the
history taking and talking between physicians While most people knew how to
speak English, Serbs preferred to speak in Serbian and many of the people in the
program felt that this was a huge challenge - not all of the conversations were
translated for them (due to lack of time or awareness by the supervisors).
- Know the dress code before you pack - I ended up with a lot more business/formal
clothing than necessary!
Kuching, Malaysia
Name: Daniel Ting
Location of Elective: Kuching, Malaysia
Health Care Setting: Urban Hospital
Organization/affiliation: Sarawak General Hospital
Nature of elective: Clinical
Number of students on trip: I was the only Queen's student, though
there were a number of senior medical students from the UK who were
also there
More information about my experience:
My goal for my GH elective was to experience the culture of healthcare
in the developing world, and to use that experience to compare and
contrast Canadian medicare. To these ends, my elective gave me insight
into the differences in medical culture in Malaysia compared to
Canada. The elective itself is pretty unstructured, and much of the
clinical learning gained is up to the student and his initiative to
get involved. A couple of barriers to learning include the language
(most locals/patients speak Malay, though the teaching is done in
English) and a lack of clinical exposure/knowledge if you go after
your first year of medical school (as I did).
The elective involved weekly rotations in different specialties. Most
of the experiences happened during ward rounds, with physicians
teaching students using a pimping teaching style. There were also some
clinics, but most of these were difficult to gain knowledge just based
on language barriers. Another learning format were mortality and
morbidity conferences, and other pharmaceutical company-sponsored
talks. There were also opportunities to volunteer in community
outreach clinics on the weekend, which involved setting up medical
clinics and helping with development work in a rural
community/longhouse. Despite not being able to learn or do as much in
the hospital as I had hoped, overall I had a great, unforgettable
experience that made me more inclined to participate in future global
health projects.
To optimize the experience, I would recommend going after second year
medical school so that one would have a greater medical knowledge base
to follow along in hospital. There are also good opportunities to meet
UK medical students, and there are phenomenal travel possibilities
around your elective dates. Feel free to contact me if you have any
questions (dting@qmed.ca).
Moshi, Tanzania (3 perspectives)
Name: Emily Stern
Location of elective: Moshi, Tanzania
Health care setting: Clinic
Organization/affiliation: Pamoja Tunaweza
Nature of elective (highlight all that apply): Clinical / Research / Public Health /
Other:
Length of elective: 4 weeks
Number of students on trip: 3
Please describe the nature of your activities during this elective:
Worked in a small clinic that saw about 25 patients per day - mostly women and
children but also some men. Helped with the research projects being conducted by
other Queen's students at the clinic - this included helping with surveys and health
education for a Maasai community. Also, helped collect blood, urine and ECGs for an
international epidemiological survey.
What were some of the strengths of this elective in terms of your clinical or
research experience?
My favourite part about this elective was the variety of activities available to
students. The team really made an effort to ensure that you got to experience
different things. There was also an opportunity for additional learning if you sought
it out - for example going to a local hospital with one of the doctors to watch a
surgery or birth.
What were some challenges you experienced in meeting your clinical or
research objectives?
This was an extremely well organized elective. I felt that I was able to meet my
objectives.
Would you recommend that future participants should expect a lot of
structure and supervision or that they should be prepared to work
independently?
Because there are a few students working at the clinic at once, it is quite structured
and organized to ensure that everyone has a fair opportunity at each activity. THere
are times where you will be working independently , but for the majority of the time
you will be supervised.
Please describe how you felt about working in this culture or setting.
I felt comfortable in the culture and setting. There is a language barrier, but the
people at the clinic translate and help ensure that you understand what as going on.
I always felt safe in Moshi and found everyone to be very welcoming to foreigners.
Any other comments on your experience:
This was an AMAZING experience and I definitely recommend it to anyone
considering a GH elective!
Name: Ryan Fitzpatrick
Location of elective: Moshi, Tanzania
Health care setting: Rural and Urban Moshi - Surveying and Clinical Work
Organization/affiliation: Pamoja Tunaweza
Nature of elective: Clinical / Research / Public Health / Other: All
Length of elective: 2 months
Number of students on trip: 4
Please describe the nature of your activities during this elective: Researching
cervical cancer in rural and urban moshi with a cross-sectional survey.
What were some of the strengths of this elective in terms of your clinical or
research experience? The ability to go out to the women's homes in remote areas
of the country and see how they lived and interact with them on a 1-1 level.
What were some challenges you experienced in meeting your clinical or
research objectives? The politics of Africa and the issues co-ordinating a large
team of students and translators.
Would you recommend that future participants should expect a lot of
structure and supervision or that they should be prepared to work
independently? Completely independently.
Please describe how you felt about working in this culture or setting. Very eye
opening but very enjoyable. The locals are some of the friendliest people I have ever
met.
Name: Amy Chen
Location of elective: Moshi, Tanzania
Health care setting: Women's Centre (family medicine)
Organization/affiliation: Pamoja Tunaweza
Nature of elective (highlight all that apply): Clinical / Research / Public Health
/ Other: cultural
Length of elective: 1 month
Number of students on trip: 3 clinical medical students at one time
Please describe the nature of your activities during this elective:
- observership with clinical officer in family medicine setting
- opportunity to observe a surgery with a doctor in a private hospital
- helping with a cohort study in rural Tanzania (running ECGs, organizing the
collection of urine and blood)
- public health education in Masaii village
What were some of the strengths of this elective in terms of your clinical or
research experience?
- the variety of opportunities that were available
- the flexibility in terms of scheduling and activities
- the people involved at the clinic were wonderful, welcoming and fluent in English
- the organization was very easy because of help from Dr. Carpenter and Dr. Yeates
What were some challenges you experienced in meeting your clinical or
research objectives?
- the clinic was less busy than we thought it would be
- the equipment available often limited what could be done for the patient
- the language barrier made it hard to interact with the patient without a translator
Would you recommend that future participants should expect a lot of
structure and supervision or that they should be prepared to work
independently?
- there is a lot of room for planning activities independently, however a lot of the
planning is done for you and there is structure available if you want it
- I would say that the clinic portion of the placement was very structured, but
finding other activities independently was what made the experience amazing.
Please describe how you felt about working in this culture or setting.
- Moshi was wonderful, the people there were amazing, we always felt very safe, the
guesthouse was very nice and there were a lot of people who looked after us.
- I was very attached to Moshi and was very sad to leave.
- Tanzania was beautiful and I got to travel a bit, to a rural village of a friend that we
made, to Zanizibar and nearby waterfalls. It was easy to travel and the country was
very accessible.
Any other comments on your experience:
Rebecca and I kept a blog of our experience that have pictures and better
descriptions of some of the activities that we participated in:
http://amyandrebeccaintanzania.blogspot.ca/
There are pictures too! I'd also be happy to talk to anyone who has any questions!
Little Current, Ontario
Name: Andrea Robinson
Location of elective: Little Current, Ontario
Health care setting: Family clinic and ER
Organization: NOSM aboriginal family medicine placement
Nature of elective (highlight all that apply): Clinical / Research / Public Health
/ Other: cultural
What is unique about doing a global health placement in Canada?
Manitoulin Island doesn’t seem like your typical global health placement. It only
took a few hours to get there, I certainly didn’t need a passport and I could still call
home for free on my phone plan. However, this placement gave me insights into two
different healthcare challenges in our own country. The first relates to practicing
medicine in a rural area. Little Current is a town of 1500 people. It has a family
health team which runs a clinic and a small hospital. Doctors there must
occasionally adjust their practice to match the resources available to them. The
pharmacy can occasionally run out of common drugs (meaning that we have to use
second or sometimes third line therapy to treat URIs) and women giving birth must
either get themselves and their loved ones to the nearest tertiary care centre in
Sudbury or deliver with very little in the way of pain control options.
What kinds of patients did you work with?
The second aspect of this placement related to health care among Aboriginal
populations. The family health team also provides clinics and physician support to 3
or 4 of the nearby First Nations reserves, including Wikwemikong, home to around
3000 from the Odawa, Objibway and Pottawatomi nations.
What clinical skills and other learning experiences did you have?
This placement was a great opportunity to learn about the modifications that are
made when providing health care for a different culture, such as allowing smudging
ceremonies in the hospital and attempting to collaborate with local medicine men. I
learned a lot about dealing with chronic problems such as diabetes management,
prescription drug abuse, problems associated with a lack of access to health care
resources like methadone clinics, and even had the opportunity to go on home visits
with the long term care nurses.
Please describe how you felt about working in this setting and community.
Overall, this placement was a great way to practice my clinical skills (in the ER and
in the family clinic) as well as to learn more about Aboriginal culture and Aboriginal
health. Little Current is small and without much in the way of attractions, but
Manitoulin Island is beautiful and there’s a lot to see, especially if you have a car (we
did not). The family health team was very welcoming, loaning us bikes and on
occasion their cars so we could see the island, making sure we had a well-rounded
experience and got to see every aspect of practicing medicine there, both the pros
and cons.