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.
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 Elective: 4 weeks
Speciality: Cardiology, Diabetes and Endocrine, Neurology and Respiratory Medicine
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.
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 Elective: 8 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.
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
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What is Depression?
Depression is a mental illness that is predominantly associated with the following symptoms: low mood, lack of energy and loss of enjoyment in our usual activities. Student doctors and practicing doctors can say these core symptoms of low mood, anergy and anhedonia quicker than saying pseudopseduohypoparathyroidism. But identifying these symptoms within oneself is a much slower process.
Depression during medical school is not a new phenomenon, and despite our understanding of mental health is improving, many student doctors are struggling daily with depression. There are various factors during medical school that can contribute to ill mental health:
- Lack of sleep due to a busy schedule.
- High expectations – from your yourself, medical school, parents, family friends, etc.
- Financial strain – the accumulation of student loans, balancing paid work and studies, etc.
- Emotional strain – wanting to provide the best care you can to patients.
- Personal responsibilities and commitments – being a parent, friendship commitments, relationship commitments, carer duties, etc.
- The intensity of constant assessments, persistent appraisals, exam after exam, etc.
- Unfortunately some environments have a stench of over-competitiveness, over-compensation, intimidation, etc.
- A new environment, new city, new country, new friends, etc. – medical school may be the first big change you have experienced in life so far.
So how can we lighten the load?
Discussing mental health is often thought of as taboo, both in the medical profession and public; therefore to speak of it, requires courage and encouragement (having both simultaneously is not easy).
So how can we lighten the load? How can we start healthy habits that lead to a healthy lifestyle?
At Medics’ Inn we do not claim to be psychiatrists, but we are experts in seeking help! That is what we urge you all to do.
If you are struggling with your work load…seek help.
If you are experiencing financial strain…seek help.
If you are second guessing a career in medicine…seek help.
If you are having difficulty balancing your responsibilities…seek help.
If you feel sad and lonely…seek help.
Seek help from those around you, your supervisor, your tutor, your personal GP/doctor, etc.
Sometimes, because we do not want to ‘bother’ anyone with our issues, we dig ourselves into a hole. But the earlier you seek help, the easier it will be to come out of that hole.
Photo Credit: PhotoPin
At the forefront
They say that whatever doesn’t kill you makes you stronger
Say that to the oncology patients, the pain in their eyes, wishing not to remain any longer
My heart tremors as I walk down the corridor
The palpitations of my index fingers are too persistent to ignore
My trachea collapses every time my beeper goes off
I sweat and sweat, I try to replenish it with water, but it’s not enough
Hours on the ward seem to be long days that make me weary
I think I’ve caught what the patient was diagnosed with in bed three
Although I’m told not to, I self-diagnose
Lists of symptoms and signs I compose:
- Fears of not being able to supply their demand
- Suffocating my thoughts with predictions and plans
- My imagination runs wild as I begin to contemplate
- Mistakes and devastating actions I could make
- That leaves someone who trusted me in pain
- Scribbling my signature at the bottom of their records – shame
- Blood stained resume no longer fit for practise
(A disgrace to the Medical Council, incompetent and useless)
- These notions come to greet me every moment of the day
- They’re absent at breakfast, present at lunch, occasionally there at dinner, they never go away
- Making me question my ability and sanity in this field
- I’m no longer in control of how I feel
But since I’ve started sharing the content of my mind
Something has been fertilised inside
Teamwork introduced me to ‘Mechanism to cope’
These thoughts of the day seem to be replaced with hope
Lately I’ve befriended a new angle of view
It is a subtle friendship because those that know about it are few
The budding beginnings bring about brand new brainwaves
Constantly contemplating and constructing confident considerations which are crucial
I think I’ve come to understand that I’m not the superhero the world has been waiting for
This fight isn’t over; battles are being won every day but we all remain in war
Nevertheless it is the daily combat that keeps things ticking
The persistent resistance against invasion
The inconsistent resilience that makes us human
And the hope of tomorrow that keeps us going
This poem is titled ‘At the forefront’ because it expresses the thoughts of a doctor who is struggling with the harsh uncontrolled reality of death and disease. They are constantly faced with patients who look to them for help to overcome their terrible disease they battle. At first it is all too much for Doctor A, the mental and emotional problems are presenting themselves physically, or so he believes. This portrays the first big idea in Whole Person Care, ‘Illness and its remedies lie at many levels within a system’; although the pathology can be explained through the activity of adrenaline in the body there is an emotional level that suggests a the trigger for the release of adrenaline, it is more likely that clinical signs have emotional factors are their trigger. This also addresses idea seven, “We can learn from different philosophies of health.”; the psychobiological relationship presented by Doctor Amid shows that his mental health affected his physical health, hence the physical manifestations of his worries. Integrative Medicine is employed by many practitioners to focus on the patient as a whole and to make use of all appropriate therapeutic approaches; if Dr Amid presented his physical symptoms to a fellow doctor it would be easy for his colleague to be absent-minded towards Dr Amid’s emotional symptoms and only treat the physical issue.
He comes to a point where he is emotional attached to the patients he cares for. In order for a practitioner to relate to their patient they must be able to empathise, it should be something that is constantly applied throughout a consultation. Although, being human means a doctor is often subject to emotion, empathy can consume a doctor, leaving them in a dysfunctional state. “…I think I’ve caught what the patient was diagnosed with in bed three. Although I’m told not to, I self-diagnose. Lists of symptoms and signs I compose…”. But this is something that we can all identify with, when we’re too attached to a vulnerable person we become we bear their burdens as if we were them. Empathy should be a costume doctors wear when needed, but in order to make rational decisions this costume must be taken off, it is then put on again when appropriate.
‘…Effective relationships are central to effective care…’ is the fourth Big idea, kit wasn’t until Dr Amid shared his fears and used the support system around him that he was able be released from his prison of negative thoughts. It was through teamwork that he was able to know about these mechanisms.“…But since I’ve started sharing the content of my mind. Something has been fertilised inside. Teamwork introduced me to MOC ‘Mechanism to cope’. These thoughts of the day seems to be replaced with hope. Lately I’ve befriended a new angle of view…”. The effective relationship between Dr Amid and his colleagues lead him to effective care.
The poem ends with Dr Amids new thinking; it is evident that the new technique adopted by him has created resilience. This ending does not paint a safe, comfortable and nice image of life as a doctor but accepts the reality that death is painful and despite human intervention, is inevitable. “…The inconsistent resilience that makes us human…” this shows that Dr Amid is still on a journey, like many us this journey may last for a lifetime. In practise resilience can be hard to define because people are different therefore their resilience will manifest differently; there can be no time allocation, characteristics criteria, physical duties or a check list to be ticked off. Resilience in intrinsic, it is a characteristic that can only be activated by yourself, which confirms the sixth Big Idea ‘…Self-care helps create resilient practitioners..’.
Dr Amid is a fictional character that represents the thoughts and worries of medical students and doctors.
Photo Credit: PhotoPin
Medicine is similar to other professions is many ways, but it is also different from other professions in many more ways. The hustle of medical school is like no other undergraduate course. As well as studying for a degree, you have begun your training for the career. Your career starts now.
You have now adopted a culture where juggling numerous extracurricular activities is the norm; you turn down more social events than you’d like; your term/semester begins with, is interrupted by or end with 1-3 assessments or exams! The list goes on. Only other medical students/student doctors understand this way of life. Although your family and friends are very proud of you, there is an air of disappointment. Even though you try to explain the structure of your course, the emotional demands, the time constraints, your goals and aspiration, “they just don’t get it”.
But remember you are not alone on this journey, there are hundreds of students just like you in the country, and there are thousands of students around the world in your position (some worse off). Stay true to your convictions and try to maintain a healthy balance of things. Know your priorities. Remember, medical school is but for a season; how you handle medical school is an indicator of how you will handle life as a doctor.
I was given the opportunity to be the surgeon’s assistant for a left inguinal hernia repair procedure. I felt honoured because I had no previous experience with the surgeon but nevertheless gave me this opportunity. This opportunity sowed a seed, I have discovered my interest in surgery and as I have progressed through the Junior Medicine and Surgery unit I have seen this interest develop even more. This is one of the few occasions since the beginning of my clinical placement that I have more than a mere medical student but part of the medical team.
Although this opportunity was given to me by a senior surgeon, I had to enthusiastically seek out this opportunity and make myself available. Enthusiasm is most certainly a tool that every medical student should possess, as well as a stethoscope.
I hope to explore this interest even more and seek such opportunities as I progress through the medical programme.
Anonymous, 3rd Year Student Doctor
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In medical school, you adopt the ‘work hard’ culture, but it is equally important to remember the culture of relaxation. Sometimes, the moment you sit still, you feel a sense of guilt for not doing ‘something’. The truth is, in Medical School, there will always be ‘something’ for you to do. There is always work to do; this could be revision for an up-coming exam, research for a written assignment, follow-up work in the lab, staying after working-hours to practise a particular clinical skill, spending some time in theatre, preparing for your next tutorial/lecture/lab project – these demands do not include the extra-curricular activities you have picked up along the way or paid work. Sports, dance classes, creative workshops or conferences that require the submission of a paper/abstract/poster, etc. The list is endless. The list will continue to be endless. So it is import to relax and truly switch off. Put to one side the daily, weekly and monthly demands of medicine for a moment and just relax.
Have a break. Enjoy the break.
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