by Work the World

Often students tell us of rare and tropical diseases that they’ve only read about in the past. Whether it be differences in the treatment of patients, unseen diseases or progressed pathologies, an overseas placement can provide a fascinating learning environment. We have asked this question a few times but we always get some really interesting answers… What has been your clinical highlight this week?

In Sri Lanka after three weeks on the surgical ward Julie’s really built up the trust between herself and her local colleagues “I'm treated as a team member.  I had my own patients for wound care management and contributed to a burns victim dressing. This was a new approach, which had a good effect on the staff and patient as dressing time became less dramatic.”

Ashleigh has also focussed on building relationships with the local staff

 After my first week I feel much more settled in the Physio department. Having made friends with many of the staff during lunch hours etc. I’m really starting to get a unique glimpse into Sri Lankan healthcare”

In Nepal Lisa mentioned that she “saw snake bites over the face of a child, which is very rare in the UK. I also saw another child age 8 with bronchitis who had a collapsed lung and the parents couldn't pay for any expensive tests, so he was just on medication as means of treatment.”

Two nursing students are up in the village this week, gaining some experience in rural health care. Rare pathologies are often presented even later in rural areas so we’ll be sure to get some comments from them next week but you can read a past student’s experience here.

Thomas, a third year medical student in Ghana tells us about a medical condition rarely seen in the UK. “Burkitt's lymphoma is a paediatric cancer which is noticed as the swelling of the lymph nodes (glands) in the neck or groin. The treatment highlighted perfectly the difference in health care delivery.”

In the physiotherapy department, Rory tells us that he gets a new insight into treatment every day. For example “a patient who fractured his pattella was operated on in the theatre; pins and wire were used to fit the knee cap into its original position.” And still within the theatre, Natalie witnessed her first leg amputation.

Charlotte working on the labour ward was amazed at the amount of births she saw and admitted that “child birth was very emotional but the experience will stick with me for life". Our student midwives added that they were also fascinated by the improvised procedures of their local colleagues.

In Arusha Laura said “I have really enjoyed spending time at the antenatal clinics. It has been great to improve my clinical skills when examining pregnant women; particularly measuring the SFH. I also got to use a pinard stethoscope to auscultate foetal heart rate which I haven’t been able to do before as most places use ultrasound now”

Lindsay, one of our physio students has had a great time working in the Outpatient Clinic.

“We’ve been encouraged to take on our own caseload which means that we have been with the same patients for six weeks now. It has been a great learning experience following them through their rehabilitation”

Rachel had the opportunity to take notes on the ward round “It’s given me a better understanding of what was going on as the team had to explain each case to me and they seemed to appreciate the extra pair of hands”

A case that stood out for Hannah in Dar es Salaam was that of a 2 year old boy who was admitted after he’d eaten some rat poison pallets, “his mum wasn’t sure how much he’d taken, so our clinical examination findings were important in guiding what we did to manage him. The intern and I examined him and noticed he had pinpoint pupils not responding to light. So we decided to give him Atropine (I helped calculate the correct dose) in order to counteract the effects of the rat poison. Luckily it worked. He made a full recovery and was discharged the following day!”

And finally, Lucy is a fourth year student in Argentina and her highlight this week has been an unusual surgery she witnessed while doing her Paediatric Anaesthetics placement. "When I asked what surgery they were doing next, a doctor said 'we're removing the bar'. I thought I’d got it wrong, so I asked again 'the bar?' to which the doctor replied 'Yes, the bar'. It was a little boy with pectus excavatum (hollowed chest), and they had placed a bar to hold the superficial structure. In this surgery, they were removing the bar. It was the first and probably last time in my life that I'll see something like that."

So, some fascinating cases... One of the most common questions we receive here in the UK is about what students can expect from their placement on a day to day basis. It is often hard to say as each placement is tailored to each individual student and the experience they have depends on being pro-active, enthusiastic and asking lots of questions. But we thought we’d get some feedback from our students overseas to find out whether they could shed any more light on this subject. This week we are asking “What is the structure of a typical day on placement?” See you back here next week with the answers.

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