Our students avail of highly-prized elective opportunities at home and abroad. These electives allow students to explore in further depth topics of relevance to their degree programme. As part of our summer elective series, medicine student Kate Irvine reflects on her time in Penang General Hospital, Malaysia.
I was very privileged and honoured to have been selected for the elective in Penang General Hospital this summer as part of the 2011 Clinical Elective Scholarship Programme. I wish to thank UCD for this amazing opportunity; I value this experience highly and I hope it will stay with me forever.
I was interested and excited at the prospect of experiencing another medical system; I felt this would broaden my understanding of the world and medicine as a whole.
Having chosen a four week elective in neurology I was excited and interested to work with some of the most experienced doctors in Asia, and to see if their clinical methods differed much from ours, and also if the profile of patients differed much from that over here. Finally after a rigorous year in college, I knew that I needed a change of scene and looked forward to experiencing the multicultural society of Malaysia. All of my hopes and expectations were exceeded.
The neurology department in PGH runs very similarly to departments here. The clinics got progressively busier during the morning; initially the consultant and one other doctor are in attendance. This was our opportunity to use the empty offices to take histories and examine the patients. Malaysia has an interesting history that has left it with three main languages as well as cultures, Malay, Indian and Chinese. As a result of this and its colonial history, many of the people speak English as well as their first language.
As a result, clinics are very dynamic and interesting, often with multiple languages being spoken in one history. Many of the doctors speak more than one language, and in our team each of the languages that we encountered was spoken by at least one doctor. Clinical notes are always written in English. English speaking patients were chosen for our cases; in the last week two Malay medical students joined us and we took histories and completed some exams through translation.It was an interesting experience, and it helped me realise how much we depend on language to properly understand our patients and build rapport.
As the other doctors arrived back from rounds we presented our cases, gave them back their desks and started observing their history taking and exams.We were always included by any of the doctors and consultants on cases with unusual and interesting signs to observe. The patients often brought a CT or MRI with them, and we were taught to interpret these also.
The teaching ward rounds were just that, and every doctor on the team attended, not wanting to miss the opportunity. They were large, with maybe 13 people crowded around a bed listening to the consultant. They took a few hours, and were very informative, and as always we were very much included. The hospital wards are divided into specialties, and although initially they look quite different they are actually very similar to those in Ireland.
The patients were amazing, polite and very open to talk to us and willing to have us examine them, knowing that we were medical students. Many of the inpatient cases were quite sad and serious; young ischemic stroke secondary to hypertension, or vascular disease secondary to diabetes mellitus, and other cases of long term care post stroke.
We also had the opportunity to get involved in some research with our consultant Dr Eow. My research involved looking at the relationship between Myotonic Dystrophy (types 1 and 2) and the Indian population and comparing incidence in mainland and island populations.
Within the teaching hospital setting we also attended grand rounds, one week a speech therapist took us through their work with autistic children, and the second week a forensics doctor taught us how to appropriately deal with sexual abuse cases and not ruin evidence. In the latter the law is very different to Ireland and it was interesting to observe these differences.
Our Penang class mates took total care of us, particularly AJ and Jason. From the moment we arrived in Penang they took care of us; picking us up from the airport, sorting out accommodation, and making sure we had something fun to do each evening and that we experienced as much of Penang as was possible in the time that we were there.It was truly an honour to have been able to spend time with them. Their hospitality was second to none. The country as a whole is a perfect destination, culturally exotic, yet totally accessible to the English speaker.
I cannot recommend this elective enough. To work in such a different culture, to be included on the team, to have colleagues from diverse cultures and training, practicing the same medicine as you; I really enjoyed it. It helped renew in me my desire to do medicine and it opened up my horizons far beyond what I expected.