After enjoying my surgical rotations as a medical student and considering surgery as a potential career pathway, I wanted to explore surgery during my elective. I was keen to do this in a new environment outside of the UK to explore how infrastructure, resources and education inform a healthcare system. This creates a different surgical environment with unique learning opportunities.
After a lot of research, I decided on Vietnam. A contrasting healthcare system along with the rich history, changing landscapes and the reasonable cost of living made it an attractive destination. My placement took place in Hue Central Hospital, Vietnam; a top tier tertiary care centre and teaching hospital located in central Vietnam. Here, I undertook a four week placement; two weeks spent with the abdominal surgery team and two weeks with the orthopaedic surgery team.
During my placement, a valuable lesson stood out the most for me; confidence comes from practicing skills, being involved in the team and having the right resources. Here’s how they helped me build my confidence.
Involvement within a surgical team
Over the course of my elective, I worked closely with the two surgical teams. This involved attending the morning multidisciplinary meetings, ward rounds and ‘on-call’ opportunities. It also included scrubbing into theatres and assisting in a range of operations.
Outside the clinical setting, I would take the same breaks with the team, join them for lunch and be invited to department events outside the hospital. This gave me a great sense of belonging, something I hadn’t experienced before in the UK.
As a medical student in the UK, I have found myself switching constantly between medical specialities and trying to juggle clinical exposure with book learning, assignments, and clinical skills. However, during my elective, I found myself feeling like a valued member of the team. It was inspiring and gave me a greater understanding of the role and working demands of individuals in the team. It also made me appreciate the interactions between these members.
Photo credit: Alexander Chan
I was able to build a relationship of trust between myself and members of the team, maximising my learning opportunities. This included being able to assist and perform surgical skills within the theatre; an opportunity I haven’t been able to explore in the UK. However, as a student, I understood my role was still primarily one of learning, and was aware I could be a drain on the doctors and the team. It was a constant area of reflection during my elective.
Practising surgical skills
After building a relationship with the team, I found myself in a position to practice surgical skills in theatre. From scrubbing in, to assisting and suturing. Initially, I was surprised by the small number of theatre staff present. There was no scrub nurse and only an anaesthetist present – sometimes one anaesthetist was shared between two operations.
I was delighted to be assisting, with good demonstrations and support offered by the surgeons to encourage me to develop my surgical skills. However, there were ethical dilemmas that surfaced during this whole experience. I was worried about the impact my learning was having on patients; I was unable to gain verbal consent personally due to the language barrier. I therefore relied on the surgeon to gain consent on my behalf. These were interesting areas to reflect on upon return.
Planning an elective alone can be daunting. However, it was one of the most rewarding and memorable experiences I have had to date.
Resources and equipment
The stark contrast in equipment was clear from what I’ve seen in hospitals in the UK. From the beds used on the ward to the equipment in theatre. However, one case highlighted to me how easy it is to take the standard equipment available in UK hospitals for granted. After I had scrubbed ready for theatre, I glanced around and realised all the surgeons had glasses on. The mask with a safety visor I was used to seeing in the UK was not available and I didn’t have any eye protection.
I got the consultants attention and pointed at my eyes, explaining I was worried about the risk of exposure to blood. He gestured to me to cover my eyes and look away. The surgery continued. After the operation, I realised I had put myself under unnecessary risk and purchased some safety glasses for subsequent operations. It’s a piece of equipment I would highly recommend taking on a surgical elective.
Top tips for travelling solo during an elective
Planning an elective alone can be daunting. However, it was one of the most rewarding and memorable experiences I have had to date. Having never travelled on my own before, I had my doubts and was very close to changing my elective plans because of it. But it was what I wanted and urge anyone who has their doubts to give it a go.
Photo credit: Alexander Chan
Here are my top tips that will hopefully help when arranging and undertaking your elective.
- Don’t be scared of travelling alone, even it’s your first time – there’s a first time for everything and travelling alone means you can go to the destination you want to and undertake the elective you want to without compromise.
- Planning is key – just because you are travelling on your own, doesn’t mean you have to plan alone. Ask for advice from people who have been to the country or hospital before. There are lots of great online resources around visa, immunisations and safety.
- Your phone is your friend – contacting friends and family, booking accommodation with apps, navigating unfamiliar places with Google maps and capturing pictures. Your phone really does make you a pro solo traveller, and without it, I would not have been able to manage as easily. Take good care of it!
- Be flexible – just because you planned your elective thoroughly, doesn’t mean your travel itinerary has to be rigid. Travelling to hostels and meeting new people makes you feel like you’re not alone. Many of them will already have plans, so why not join them for a while?
- Stay safe – personal safety is always a worry, especially when alone. Make sure you are in close contact with people at home and send frequent updates. Having a way to easily contact your placement staff is also vital. As well as good communication, not wandering alone at night and keep valuables hidden is a good start.
Alexander Chan used his reflective report for the University of Birmingham elective assignment to help create this article.
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