elective

Medical Elective

Staying Safe – Vaccinations & Antimalarials


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Most medical schools or hospitals have clear guidelines on the vaccinations they expect their students or employees to have received. Therefore I would advise you to look at the guidelines of the medical school/hospital/other medical environment you belong to and those of your desired elective location.

I’d advise the following vaccinations: Cholera, Diphtheria, Hepatitis A, Hepatitis B, Meningococcal Meningitis, Poliomyelitis, Rabies, Tetanus, Typhoid, Yellow Fever (Yellow Fever certificate is required at the airport and will need to be shown at passport control)

There are a variety of anti-malarials available, some more specific for Nigeria, its important you receive advice from a doctor or pharmacist before making a purchase. Make sure you are fully aware of the course for the specific antimalarial you have chosen, side effects and drug interactions if you are taking other medication.

Once you know what antimalarial you would like to buy consider buying the generic medication rather than the brand name – this will save you money! You can also calculate the exact number of tablets you need (included before and after travel needs) so you won’t have left over medication.

It may also be helpful for you to purchase some anti-emetics, anti-diarrhoeal, simple analgesia (such as paracetamol) and antihistamines. Getting diarrhoea within the first few days of arriving in Nigeria because your GI system is getting used to the pepper, leaf soups and heat is not the best welcome gift!!

Other resources (mostly relevant to the UK, so please look for the equivalent for your country):

If you have any medical or mental health conditions, seek medical advice from your local doctor before making any definitive plans or payments towards your Nigerian elective.

All medications should be purchased after a medical consultation and with a prescription. All medications should be used as prescribed by your medical practitioner.

Elective Reports

Abiola Adeogun – Medical Elective – Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria


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Name: Abiola Adeogun

Country of study: United Kingdom

Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Elective Period: 28/03/16 – 22/04/16

Duration of Elective4 weeks

Speciality: Cardiology, Diabetes and Endocrine, Neurology and Respiratory Medicine

 

 

  • What was a typical week like?

A typical week included attending ward rounds and clinics attending occasional teaching with the doctors.

 

 

  • What 3 things did you learn?

1) Making a diagnosis without relying on e.g. imaging and test results.

2) Management of tropical diseases.

3) The structure of the healthcare system in Nigeria.

 

  • What were your most enjoyable moments during your elective?

Being able to go to theatre.

 

  • What similarities and differences did you notice whilst on your elective in Nigeria, in comparison to the healthcare service you have witness whilst at medical school?

Differences in doctor patient relationship, communications skills, organisation and resources.

 

  • What were your goals? Where you able to achieve your goals, and how?

To have a better understanding of healthcare system in Nigeria and be able to compare team dynamics. To identify medical ethical challenges in the hospital and their implications. To explore the possibility of working as a Doctor in Nigeria in the future.

 

  • If you had the opportunity to reorganise or redo your elective, what would you change and why?

I’m really glad that I had the opportunity to work in a state hospital and I have no regrets. If I had to redo my electives, I think I would prefer to work in a smaller hospital or private hospital as I feel I would have been more involved and the experience would have been more hands on. I felt the environment in the state hospital that I worked at was sometimes too busy and lacked organisation.

 

 

 

  • Looking forward, how has your experience impacted your career and personal life?

A lot of communication with patents was in Yoruba. As I don’t understand the language I had trouble following some of the consultations. I realise that if I decide to work in Nigeria in the future, I may need to learn the common languages. My cousin was admitted to a private hospital whilst I was in Nigeria. Visiting her at the private hospital enabled me to see what practicing medicine is like in a private hospital, observe doctor-patient interactions and the general work ethos. I think I would prefer to work in a private hospital in Nigeria in the future.

 

Elective Reports

Wumi Oworu – Medical Elective – University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria


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Name: Wumi Oworu

Country of study: United Kingdom

Elective Location: University of Abuja Teaching Hospital, Gwagwalada, Abuja, Nigeria

Elective Period: 04/04/16 to 27/05/16

Duration of Elective8 weeks

Speciality: Obstetrics & Gynaecology

 

My experience in Nigeria was a wonderful experience, although I have visited Nigeria several times before, this elective period was my first experience of living in Nigeria independently and working in a healthcare setting. Starting at the beginning, I arrived in Gwagwalada on Monday and met with my supervisor Professor Ekele, who briefly described what was to come while at AUTH. I was introduced to the head of the O&G department and the senior class representative from the University of Abuja Medical school, a young man called Etuk, who assisted me with settling in. Etuk showed me to my accommodation and was kind enough to take me to a few places to buy some food, utensils, etc. My accommodation, was a 2-bedroom flat in a block of flats containing only medical students, I had my own bathroom and I shared the kitchen and living room with my flatmate. The accommodation was a few minutes from the hospital, but still on the hospital grounds. The flat was clean and well kept, with good space and the basics. Later that day I met my flat mate Tolu, who was a lovely young woman in her penultimate year of medical school.

                                           

During my 8 week placement, I was allocated to one team for 4 weeks, where I joined them on their ward rounds, gynaecology clinics, antenatal and post-natal clinics, theatre sessions and on-call duties. Every week day morning began with a morning meeting, cases that were managed the day before were discussed and assessed. I spent 2 weeks in the labour ward, observing and assisting in the management of labour and Caesarean sections. I spent a total of 2 weeks in the gynaecological emergency unit and special care baby unit. During my elective I was taught how to perform vaginal examinations and perform a pelvic examination using a speculum. During antenatal clinics I had the opportunity to examine numerous women at various gestations. I attended to a few patients independently under the supervision of consultants in the gynaecology clinics. I performed investigations such as pap smears, endocervical swabs and high vaginal swabs. I observed cases that are uncommon in the UK, such as large uterine fibroids, primary presentation of metastatic endometrial cancer and the management of labour in a patient with sickle cell disease. I understand the Nigerian Healthcare system consists of both a private sector and national health service insurance scheme, both with their own advantages and disadvantages. The use of traditional medicine also had an impact on health, I often observed patients with advanced disease because they delayed their presentation to the hospital because they sought cheaper traditional alternatives. I had theopportunity to complete a cross-sectional study titled, ‘The Perception of pregnant women about Caesarean section at the University of Abuja Teaching Hospital, Gwagwalada’. It consisted of 131 pregnant women presenting to ante-natal clinic. I was granted ethics approval for this study. I used interviewer-assisted structured questionnaire to collect data. The acceptance rate was 70%, other literature quoted acceptance rates of 7-30%. The study showed a higher acceptance rate amongst pregnancy women who were older, married, multiparous, educated and have had a previous Caesarean section. This developed my research skills; it also exposed me to the difficulties of international research such as language barrier and limited resourced such as electricity, internet and time constraints.

                    

 

I enjoyed the food to the absolute maximum, I probably ate grilled catfish at least twice a week and utilised the hospital canteen and ate pounded yam with egusi (my favourite) often. I definitely ate well while in Nigeria. The heat Gwagwalada was a different experience entirely, one I have never experienced before, I learnt to avoid being outdoors between 9am-4pm, to be well stocked up on bottled water and bought a mini-fridge as soon as I arrived (to the manifold wisdom of my mother).

 

                                                 

 

When not working at the hospital, I often enjoyed myself in Abuja with my cousin and the new friends I’d made. I appreciated the order and subtleness of Abuja, in comparison to the hustle of Lagos.

I also had the opportunity to visit Kaduna, which was just a 2 hour drive away from Abuja, or an hour flight from Lagos. I also visited an orphanage a couple of times and gave some assistance.

            

I wish I had taken the opportunity to visit Jos, a popular city known for their cool climate, internationally known for their medical education at the University of Jos, as well as other things. Once my elective was complete, I travelled to Lagos to spend some time with friends and family.

                                      

 

My elective has enriched my undergraduate education, I developed basic obstetric and gynaecological skills which will be useful throughout my career. I have improved my knowledge and skills in maternal and foetal medicine. It has also given me an appreciation for the healthcare system available to patients in the UK. I have experienced another element of medicine that I will always be  grateful for.

My experience has made me more passionate about pursing a medical career in Obstetrics and Gynaecology. It has also exposed me to potential opportunities in the Nigeria, especially for someone like myself – young, ambitious and open-minded.

Medical Elective

How to Raise Money For A Medical Placement?


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As a student doctor (and potential student doctor) you have developed skills and acquired knowledge that can benefit many people around you, you do not have to travel to the other side of the globe to have a positive impact! It is amazing the opportunities you have as student doctors to support the health of our local community and other communities around the world. A medical elective placement is part of almost all medical degrees around the world, and once you have found what you would like to spend your time doing, the next step is to source some funding!

How are you going to raise the money for this!?

Here are a few suggestions:

1.       Search for grants, bursaries (and low-interest loans) offered by your medical school, college, university, local authority, charities, businesses, etc.

2.       Go Fund Me – although, to really get people (and strangers) to part with their hard earned money, you really need to:

a.       Clearly layout the purpose of your fundraising and show a breakdown of your costs

b.      Justify why you are deserving of their donation.

c.       Explain how this experience will truly benefit not just yourself but the community you are going to help.

d.      Demonstrate your own personal efforts to raising money i.e. part-time work, etc.

e.      Consider, the evidence will you be able to share with your supporters, i.e. a written report, weekly blog post, pictures and videos, etc. See this as a ‘thank you’ for their support.

3.       Part-time work for several weeks/months.

4.       Create an eBay account an sell unwanted items and new products.

5.       Auction or sell you gifts/talents/skills with in your community (i.e. family, university, church, etc); i.e. put on a small talent show; offer to baby sit, do household chores; cake sales, car boot sales, etc. for an hourly wage.

 

These are just a few of our suggestions; please help others out by commenting in the comment box below if you have any other ideas too! If you have instructions or a secret formula, even better! Lol

Photo Credit: PhotoPin

Medics’ Inn

Blog

Places to Visit in Nigeria – Part 1


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When you are in Abuja Nigeria, consider exploring these places!

Gurara falls

“This impressive waterfall, an hour’s drive from Abuja, is 30 metres tall with a span of up to 200 metres across, dependent on the season. There are two main streams of water crashing over the cliff face, however during the height of rainy season the whole cliff face is engulfed by a formidable curtain of white water.

The Gurara river is a large tributary of the famous River Niger and is most impressive after the rainy season when the water becomes a raging torrent while in January, during the dry season and when water levels are low, there are clear pools at the bottom of the falls in which visitors can swim.

As well as being an area of outstanding natural beauty the area surrounding Gurara Waterfall is also a fantastic place for bird watching.”

Guara falls

Source: My Destination

Photo Credit: Visit Abuja

Millennium Park

“Millennium Park Abuja is the largest of the green areas and parks in Abuja covering a land area of about 32 hectares. It is located in the Maitama district of the federal capital territory. The Millennium park was commissioned in December 2003 by Queen Elizabeth II of the United Kingdom.”

Source: Abuja-ng

Millenium Park Abuja

Photo Credit: Travel Start Blog

Yankari Park and Wikki Warm Springs

“Yankari Park and Wikki Warm Springs are located around the Gagi River, approximately one and a half hours by road, southeast of Bauchi Town. The best time to visit is between November and May, when tourists are likely to see more game since the dense vegetation has dried out and the animals congregate around the rivers. The reserve habours over 50 wide range of prized indigenous wildlife, including Baboons, Monkeys, Warthogs, Hippopotamuses, Lions, Elephants and Leopards.Other animals include Buffalo, Gannet, Roan antelope, Bubal Hartebeest and spotted Hyena in addition to African hunting Dogs, Cheetahs, western Kobs, red-fronted Gazelles, Waterbucks, Grimm’s Dockers, Oribi and red-fl anked Dockers. The reserve also hosted more than 350 species of indigenous birds, 26 species of fish, 7 amphibians and 17 species of reptiles.”

Yankari National ParkYankari National ParkYankari National ParkWikki Warm SpringWikki Warm Spring

About 7-8 hours drive form Abuja, so head out early!

Source & Photo Credit: The Green White Green

Usuma Lake/Usuma Dam

Usuma Lake

Photo Credit: Sky Scraper City

Golf at the IBB Golf Course

“ General Ibrahim Badamasi Babangida, as the then Head of State relocated the Federal Capital from Lagos to Abuja, which could not boast of a golf club. As a result, many key Officers of the government, who were of course avid golfers, desert the City at short notices to Lagos to enjoy their game of golf. In order to solve this problem of unusual trips to Lagos to play golf, the idea of providing a befitting golf course in the City was conceived by then Col. John Nanzip Shagaya with Alhaji Kazaure, Chief C. A. Mbanefo, C. N. Chigbo, B. I. Eze, O. O. Odunuga Nana H. Aliyu and S. O. Jones. The golf course concept was packaged and presented to General Babginda, who as a lover of the game enthusiastically approved it.

The categories of members of the club include ordinary, honorary, overseas, corporate and junior members. It has Ladies and Lawn tennis sections and regular Wednesday and Sunday kitties apart from other small and big tournaments that are organized frequently by the club and outsiders. The club also regularly organizes public lectures on various issues to keep its members abreast of current national and international issues. The club has a well equipped workshop and modern clubhouse with a pro-shop, two standard car parks, six locker rooms for males and females, administrative offices and standard Bar/Restaurant managed by the popular Sheraton Hotel and Towers.”

Ibb Golf ClubIbb Golf Club

Source & Photo Credit: IBB Golf Club

Carnival

“Abuja carnival is a yearly program that hold in Abuja, the capital of Nigeria most in the month of November. It feature road shows, musics, cultural dances, masquerades, durbar and lots more with participants from all the states of Nigeria. It’s a great occasion and has spectators from around the globe.”

Source: Abuja-ng

Abuja CarnivalAbuja CarnivalAbuja Carnival

Photo Credit: African Spotlight

Art Galleries

There are numerous art galleries to be inspired and entertained by!

Look out for part 2 and 3! Please tell us in the comment box below where you would encourage others to visit!

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Equipment For Your Elective


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We have put together a list of items to consider for your elective.

  • White coat
  • Disposable gloves
  • Plastic aprons
  • Face mask (with visors)
  • Antiseptic hand scrubs
  • Liquid plaster
  • Theatre shoes
  • Stethesscope
  • Accommodation essentials: bedding, mosquito net, insect repellent, antibacterial hand wipes

Think carefully about the following questions in respect to your purchases:

  1. Can I guarantee the hospital/clinic/etc will be able to provide me all my protective wear for the duration of my elective?
  2. Does the speciality I am working in require these items? Is it a surgical specialty? Is it community based?
  3. Could I just buy a few items to manage for the first week or 2, then stock up when I get there?
  4. Will I be working outdoors?
Blog

Making Contact With The Nigerian Embassy


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If you are medical student studying at a Medical School outside of Nigeria (and do not possess a Nigerian passport) it is important you contact the Nigerian Embassy to be aware of the cost of a visa application and the documents required. It is important to do this many months in advance of your elective to avoid disappointment.

To help, we have provided a letter you can download and edit to send to the Nigerian Embassy in your residing country. Making Contact With The Nigerian Embassy (download)

We have included some links below.

 

Nigerian Embassy Australia (link)

Nigerian Embassy Brazil (link)

Nigerian Embassy France (link)

Nigerian Embassy India (link)

Nigerian Embassy Ireland (link)

Nigerian Embassy Italy (link)

Nigerian Embassy Malaysia (link)

Nigerian Embassy Singapore (link)

Nigerian Embassy Spain (link)

Nigerian Embassy UK (link)

 

Elective Reports

Adepero Ajayi – Medical Elective – Lagoon Hospital, Apapa, Nigeria


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Name: Adepero Ajayi

Hospital: Lagoon Hospital, Apapa, Nigeria

Elective Period: March 2015

Specialities: General Medicine & Surgery, Emergency Medicine/Paediatrics and Obstetrics & Gynaecology

Duration: 4 weeks

We started our rotation from Medicine > Surgery > Pediatrics/Emergency medicine > Obstetrics & Gynecology.

I would like to share about the hospital environment before I talk about the practice, if I take specific interest in discussing some issues and they seem normal to you, it is because in my school things are not particularly done that way and I appreciated that it was done with such seriousness in another practice.

The hospital environment was welcoming, everyone was practically happy to see you, always greeting regardless of who you are.

For medicine posting, we joined the ward-rounds and attended clinics, took vitals and answered a million and one questions. Many Nigerians are hypertensive and diabetic, we should watch it! I didn’t like the consultant we were assigned, so my first week wasn’t pleasant and I contemplated stopping but thanks to Ba’ami who encouraged me to continue and asked me to stop if my second posting was like that.

I resumed for the second week with fingers crossed, I’m glad I didn’t stop. They carried out at least ten procedures daily and the surgeons were excited to impact knowledge. We observed right hemicolectomy, several colonoscopy, osteotomy, hernioraphy, spinal fixture, gastroscopy, hysterectomy, endoscopy, knee replacement etc.  It was sad we missed the open-heart surgeries done before we started the posting.
Everyone was very cautious of infection control, zero tolerance for any wrong act. Procedures were well explained to patients before it was done; patients were assured if they were anxious in the sweetest way ever. Everything needed for the surgery was inside the theatre, no need to run anywhere in search of what wasn’t lost in case of any emergencies.

The manner in which the patients were addressed was also something that thrilled me, such courtesy and manner of approach. At this point, anyone might want to say, “It’s because it’s a private hospital.” I beg to differ, the federal and state hospitals are meant to be better, if a private owned organization can offer that what is the excuse of the government. It is possible and that I know as two of my colleagues shared their experience in other hospitals in Africa.

The emergency room was well managed and organized, everyone alert for an emergency case. We clerked and managed patients at ER. Something that thrilled me beyond measure was the maintenance system of the hospital, which is the major reason for the dilapidating state in our hospitals. Any complaints were addressed immediately no matter how negligible it was. The cleaners were always cleaning and the toilets were always clean, ensuring toilet rolls were available.

Adepero Ajayi and colleague

The kitchen was another interesting part of our stay, there was no monopoly of food type and I must say kudos to the chef, my heart was at ease knowing whatever I was eating was well prepared and perfectly healthy for me. The quality of food was very good, Sike and Nonso can testify to that. The chef was also friendly; he made us food sometimes on demand.

Here I was commending the staff of Lagoon Hospital Apapa, then I attended the clinical seminar on Ethics and I was blown away with the fact that they were not relenting on the standard already created but striving for more. How beautiful! I’m used to grand rounds were patient cases are discussed but never one in which the vision, principles and values of the hospital are engraved in the heart of the staff. iCARE an acronym for Integrity, Compassionate, Attentiveness, Respect and Excellence represents the values of the organization which every member of staff must uphold at every point.

The use of electronic medical report (EMR) system was fantastic, absurd we still use case-notes, what happens if they got burnt, huh? The EMR has patients record from whenever they registered. Tests are done and results gotten as soon as possible, minimal stress on patients and doctors with the use of intercom. This makes patient care faster and more efficient.

Adepero Ajayi and colleages

The doctors are very friendly and they took us tutorials. Another part of the experience I enjoyed was when they ask Sike and I for our names,
“I am Ajayi.”

“What about you?”

“I am Ajayi.” Epic moment! The drama that follow is usually amusing, they give the look of ‘you guys must be joking’ we give the look of ‘we bad like that’. Lol

I was happy I met Dr Dayo, Oni, Henry, Onabanjo, Anniebuna; and Dr Bukola who saved me the day I had diarrhea, I wish you all the best.

Obstetrics and Gynecology posting was good, here we met another Ajayi. We joined during the consultations at the clinic, examined patients, observed several caesarian sections, hysterectomy etc . There is something about Ajayis and O&G.

Doctor Ajayi was so pleasant; he was my best consultant there. Dr Akinniranye was such a peace loving man, teaching with such gentleness in the intensive care unit and high dependency unit, Dr Onakoya was very interesting too, I wouldn’t forget Blount’s disease for a long time that’s if I’ll ever forget. I haven’t had my neurosurgery posting yet but Dr Ojo was willing to explain the procedure of spinal fixture to us in his usual gentle manner. Dr Jimi Coker is a man of excellence, Sike said she will rather call him Prof, so Prof Jimi Coker, this man touched my being with the way he took his job and addressed everyone under him, surgeon extraordinaire. Although we meet Dr Abudu on the last day of our rotation, explaining how he was going to do the knee replacement to us was enlightening, one of us had the opportunity to watch because of infection control, and he wanted as few people in the theatre as possible.

Two other things I noticed, the bed cover was changed for each patient in the clinic and you sanitize your hand after every contact with patients, even if all you did was give an instrument used for a patient. Hand sanitizers were all over the walkway.

I’m grateful for this opportunity as I have honed my clinical skills and have a broader view of medicine as a profession, special thanks to God for journey mercies this past few week especially when the bus we boarded collided with a trailer on the bridge. For meeting this amazing people, I’m honoured.

Adepero Ajayi

Have a look at Adepero Ajayi’s full post on: https://perryztot.wordpress.com/2015/02/21/my-electives-experience/

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Medical School in Nigeria – A Small Comparison


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The traditional format of medical school in the UK, is quite similar to medical school in Nigeria.

On average, a medical degree requires 6 years of undergraduate study of Medicine. First year is in the Faculty of Science, students study the basic sciences i.e. Biology, Physics and Chemistry. In second and third year, students go on to learn anatomy, physiology and biochemistry. The remaining 3 years are spent in the clinical environment at a Teaching Hospital for students to be taught General Surgery, Pathology, Paediatrics, Obstetrics and Gynaecology, etc…

Most often, there are 4 important written exams, these are commonly referred to as MB exams. One occurs at the end of the second year, one after the fourth year, one after the fifth year and the last exam after the sixth year.
This is a simplified overview of undergraduate medical education in Nigeria, variations are expected between medical schools.

Please comment below with your suggestions and questions, or contact us directly.