University of Alberta Medicine 2012

Medical, Sri Lanka Kandy

There I was, sitting at the top of the hill overlooking the picturesque city of Kandy as the sun was setting in the backdrop.  The sky was a bright orange that stretched as far as the eye could see, the temperature was warm but not uncomfortable and there wasn’t a hint of breeze.  Mother nature was surely on my side this evening.  As I sat there I asked myself: how in the world did I end up in paradise?

I thought of how the day was welcomed with a wonderfully prepared breakfast buffet with some of my newest (and now best) friends from around the world.  

Then when I left for work I was able to banter with my taxi (tuk tuk) driver, who had become a genuine friend since arriving, about how badly my new Irish friends and I were going to beat his team in a friendly game of Cricket later that week!  

I thought of work that day where I managed to go from interviewing a boy (and his mother) with tri-ventricular hydrocephalus progressing since birth, secondary to his Russell Silver Syndrome, to my experience in the OR that afternoon for an emergency decompressive craniectomy in a previously healthy young man with a middle meningeal artery torn at the pterion.  This is a procedure I’d seen several times back home, but never with the chart note “fell 6 feet from top of tree” (thanks to the excellent work of his surgeon, his life was saved and woke up perfectly fine).   All of these events in one day led me to this moment, a moment I was sure was zen.  

But none of it would have been possible without the help of the good people at Work the World. As a medical student from Canada, an international elective is not a required component of our education, nor is it easy to accommodate.  The process of registration takes at least six months and often much longer.  To say it’s tough to figure out an appropriate time in our education to head over, to take the required pre-departure training during our already hectic schedules, to establish and complete all the preparation materials and gather approval for the elective from all the proper sources, is an understatement to say the least! Eventually you get through it if you want to though.  But then comes big questions like “where will I go?”, “what will I do?”, “how will I possibly arrange it?”.

At the University of Alberta, we have a newly established Division of Community Engagement that houses a Global Health office.  These fine people offer some options for international electives but they are select and limited to only a few locations around the world.  Once I decided those options weren’t for me, I looked for a third party organisation that could help me set up the elective I wanted. That’s when I met Work the World.

From the moment I first talked to Simon at the WtW headquarters, I knew this was the company to travel with.  Their service was top notch right off the top and they were backed by a strong history of positive student reviews.  My passion is the neurosciences and I was easily able to arrange a four-week elective in Neurology (two weeks) and Neurosurgery (two weeks).  I chose Sri Lanka initially because of the strong student reviews and availability of the program I was interested in, but would only later learn it is arguably one of the most beautiful and welcoming countries in the world.  

The process of setting up the elective through WtW was smooth and easy.  Any question I had was easily and promptly answered so I never had to worry about it while I was busy with rotations at home.  WtW set me up with my elective, provided me room and board, one of the most amazing chefs I’ve ever had (seriously better than many high end chefs back home), a network of people who could arrange anything I needed once I was there, and a meeting place for like-minded students from all over the world.  From the perspective of the people, the country, the site-seeing and experience outside the hospital, I could not have asked for a better experience!

A group of us went travelling every weekend to different sites around Sri Lanka (of which I’m sure other people have written extensively about) and we spent many weeknights playing games in the house, heading out to the market, going out for dinner, or heading to the pub/bar for a few drinks.  The social atmosphere was fantastic and it was truly exciting to mingle with such an eclectic group of individuals from all corners of the world (though predominantly the UK). 

The Sri Lankan model of learning is based off the UK model, which is very different than our style of learning.  In North America, we generally do an Undergrad (at least) in some field, which takes 3-4 years after grade school.  We then follow that up with medical school. Medical school itself is then divided into pre-clinical (course based learning through lecture, anatomy labs, small group learning and more) and clinical (ward based learning where the vast majority of time is spent in the hospital).  This is contrasted significantly from the UK model where students often enter medical school directly from their A-levels (about equivalent to our last years of grade school and possibly first year of undergraduate) and then proceed to learn clinical and course based medicine simultaneously.  In this respect, a North American medical student who is entering or are in their clerkship years, will often be older than the average UK medical student on a placement (I was a year or two older than most medical students there).  I certainly wouldn’t take this as a deterrent to an elective in Sri Lanka though. From an elective standpoint, I had an absolute blast.  I saw diseases that are rarely, if ever seen at home on a daily basis. I met incredibly intelligent preceptors and fellow medical students that taught me substantially and were very excited to do so.  The clinical skills I obtained here are far better than we get at home (too liberal on our imaging, I guess) and the approach to health in a resource limited setting were two components that I will personally take home with me as I continue my training in Canada.  I felt grateful for the opportunities I had to learn, and once they became more comfortable with my skills, the opportunities I had to do.

From an experience standpoint, Sri Lanka is second to none.  The country is absolutely stunning in so many ways and I could have easily spent another month there travelling.  The staff associated with Work the World genuinely care about your experience, are constantly asking your opinion about what you like and what needs to be improved.  They work incredibly hard to ensure you have the experience you want to have.  I honestly cannot say enough good things about Work the World for my experience there, other than I would have paid much more for an experience like that.  In terms of having an opportunity to meet and mingle with students (medical, nursing, PT, midwives) from around the world, I think you’d be hard-pressed to find an equivalent program to Work the World.  Having travelled there alone, the opportunity to make friends with guys and girls who I will likely keep in contact with for years to come was incredible.  It was so interesting to hear all the stories and perspectives and reflect on what is good and maybe not so good about the Western and even North American points of view.  In one month on this elective, I feel I matured significantly.  I learned lots of medicine, saw some amazing sites, met some incredible people, and most importantly learned to truly appreciate my circumstance.  We are so lucky in North America for every little thing we have and it’s incredible how much we take for granted.  This elective opened my eyes, as I’m sure it will for you, should you decide to pursue it.

As the last of the orange sky crept behind the mountaintop and darkness grabbed hold for the night, I noticed something I hadn’t yet seen during my time there.  The stars.  I stared at the stars for a long time that night thinking, wondering how the stars looked back home that night?  Would my family and friends be looking at the same stars I was?  I was exactly half way around the world, almost the furthest distance I could possibly be from home, and yet I felt exactly like I was home.  I was learning, I was relaxing, I was laughing and having the time of my life with new friends (who came to feel like old friends), and I was soaking up one of the most amazing and unique experiences I have and will have in my life.  Thank you to everyone at Work the World including staff, students, and locals for allowing me to have such an incredible experience.  If you are a North American medical student considering an international elective and are still reading this (firstly, kudos for sticking in there), then I can almost guarantee you’ll have an extraordinary time in Sri Lanka.  At the very least, it will be an experience you will never forget!

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