medicine

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.

Blog

Poem: At the Forefront


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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

Blog

Medical School Can Be Tuff


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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.

Medics’ Inn

Blog

Medical School:Have A Kit Kat…Take A Break!


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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.

 

Photo Credit: Photo Pin

Medics’ Inn

Blog

My Clinical Experience So Far


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I really enjoyed the experience of working in a clinical environment. I was excited because it felt unreal, I’d fought hard to get into medical school and I was potentially standing in the environment I would be working in in the near future. It gave me that extra encouragement from time to time when I doubted if being a doctor is the right profession for me. A lot of the time it did make me upset, I spoke to a lot of people who suffered with chronic illnesses and the description of their physical and emotional pain made me feel down. A lot of what I thought about medicine came from the media; there are also times when the doctor has to tell family members of their recent loss. Speaking to someone who describes their chronic pain really hits home how emotionally draining this profession will be and medical school can be. In a way it has taken me from childhood to adulthood, my faith also. There is so much pain and suffering in the world, it reinforces my belief that God really has a plan.

Photo Credit: PhotoPin

Anonymous

Year 1 Student Doctor

Blog

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

Graduate Medicine? What to consider


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Are you thinking about studying medicine as a second degree or as a mature student? Here are 3 things to definitely consider!

 

1.Money!

All over the world, obtaining a medical degree is not cheap! So the wise thing to do would be to count the cost first before you embark on this journey!

Tuition fees? Living costs? Travel costs? Books, resources, etc? Can you really afford to study medicine for 4-5 years?

Medical schools provide a variety of financial support for mature students, there are also many organisations and charities that could provide financial support. The important issue is to be fully aware of the financial responsibility of your decision and how this may have an impact on yourself and those around you. It would be a horrible thing, to leave the medical programme because of insufficient funds.

 

2.Be sure

Be sure a career in medicine is what you truly desire. Healthcare experience before your application is essential, but as well as this, have a real good look at the life of a junior doctor in your country. Is this the kind of working life you want? The hours? Team dynamics? Career trajectory?

(Keep in mind, aspects of professional practise may change by the time you qualify as a doctor.)

Know what you’re getting into.

 

3. Be open-minded and connected

Sometimes, being a mature student amongst 18 year olds or 20 year olds can bring a sense of failure or insecurity when in fact it is a strength. You have previous experience in higher education, a degree, life experiences, a career etc. Be open to meeting new people, you will soon find out, students are unbothered about the fact that you have done a previous degree or are several years their senior, because in reality everyone is starting at the same level – year 1 of medical school. Also, it may help to connect with other mature or graduate students, a problem shared is a problem halved (most of the time).

 

If you would like to study medicine as a second degree or as a mature student please leave your questions and comments below. You can also contact us privately with your questions.

If you are currently studying medicine as your second degree, or have ‘been there, done that, got the t-shirt and the debt that goes with it’, please share your experiences below for someone else to be enlightened!

Medics’ Inn