I The Elective Experience: Groote Schuur Hospital

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In CMUL, 5th year is what most people look forward to. This is because it is allegedly ‘stress free’ and it’s also when we go on medical electives.

What is a medical elective? To some it’s just time to go to London and take pictures in the snow #NoShade, To some it’s time taken off school to learn a trade. But according to Wikipedia, it is a placement undertaken as part of a medical degree. The content and setting of the placement are largely decided by the student undertaking it, hence the name. In basic terms, you get to spend a certain amount of time in another hospital, either at home or abroad and in a field of your choice. Just to see how things are done outside your home hospital.

For me, it is One month of Emergency Medicine at Groote Schuur Hospital of the University of Capetown and another month of Surgery at Kenyatta National Hospital of the University of Nairobi.

I just finished the first leg of my elective at Groote Schuur Hospital and I’m currently en route to Kenyatta.

This elective for me was an eye opener. I learnt so much and I got to appreciate a system that actually works unlike what we have back home. I’ve always known that when it comes to healthcare, Nigeria is still in the cradle. But being compared to what I saw at Groote Schuur, healthcare and even medical education in Nigeria is not even a foetus yet. A morula is more like it.

Apart from some instances of racial prejudice, I had helluva time. I did procedures that I wouldn’t have dreamt of doing until I become a house officer. Basic things like Blood collection, Lumbar Puncture, Setting up I/V lines, Pleural taps, ECGs, ABGs and blood cultures which are considered house officer duties back home.
I was actively involved in patient care, clerking and formulating management plans, Patient counselling and so on. Unlike where I come from where I’m practically just an observer watching the doctors talk over my head.

I got to appreciate;
-The patient record system that allows you look up patient information even from another hospital in the province. No issues of misplaced case note or the records staff are on strike.
-Laboratory system that allows you request investigations on a monitor and then view the results when they come back in. Blood results, X-rays, CT scans and all sorts. Results come back within a few hours depending on how booked the lab is. You can also look up previous investigations that were done in other hospitals. All this instead of having the house officer/patient’s relatives chase results up and down like headless goats.

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Above is a CT Angiogram of an Abdominal Aortic Aneurysm (Triple A). You don’t get to see one everyday.

-Ambulance/paramedic services that seemed effective enough.
-Intercom system which is just so basic and makes things easy. Instead of sending people up and down to deliver messages, just make a simple phone call.
-Response to consults. When you request a consult from another specialist, they respond in less than an hour to review the patient but back home requesting a consult is like applying for visa. Especially when it comes to the surgeons.
-Health Insurance. There was no issue of you have to deposit before we treat you. Or we need to put up a line so we have to send the family to buy cannulas, drugs, I/V fluids before anything can be done. ‘Everything’ was in place. I never observed out of pocket spending.
-A referral system that works. This means patients don’t present at the tertiary hospital with headaches. There’s a hierarchy of referral from GPs to general hospitals and then tertiary hospitals.
-Tap water. This may seem petty but in our wards and clinics we sometimes have to employ the use of buckets of water. During this elective, I was washing my hands like every 5 seconds that you wouldn’t believe we don’t have running water where I come from.

At one point I told my friend Kafa that The Resuscitation area of the Emergency Room looks just like our ICU back home. I wondered what their ICU looked like.

While I was busy appreciating the opportunity and bountifulness in the hospital that is Groote Schuur, then came another elective student from Austria who was totally appalled by the system there. She sometimes went; “It’s really difficult when you don’t have all the right things to work with you know?” Just because she didn’t find something inconsequential like a basket to put her blood collection kit in. She also felt that she wasn’t getting enough procedures to do. You see, one man’s heaven is another’s dustbin.

With this, I’m wondering how our leaders manage to sleep at night after going abroad and seeing how their health systems work and not even try to improve what we have. Instead our hospitals just get crippled-er and crippled-er; Plagued by incessant strikes and corruption.

I just pray change comes to Nigeria soon enough and I’m more convinced now than ever that I want to be part of the change in the health sector. -Even though I’m lazy.

xx

-‘Kemi

PS: Discussing the students and doctors will be a topic for another day.

Also, to medical students: if you’re ever looking to do an elective, I suggest you do it in Emergency Medicine/Trauma you get to see many diverse cases, learn how to manage them and get to do more procedures.

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16 thoughts on “I The Elective Experience: Groote Schuur Hospital

  1. This got me excited about electives! I still have a while sha but I’ll definitely be looking into EM/Trauma. Great post πŸ™‚

  2. Hi! I was searching for experiences from medical students in Groote Schuur hospital and I found your blog. Like you I am going to do an internship in the Emergency ward soon and it seems like you have had an incredibly rewarding experience. I am from Holland and as you might imagine the health system is like that in Austria, but I hope to learn a lot and will appreciate any opportunity to gain knowledge. I was wondering if you have any tips or advice for during the internship? what did you think of the patients and doctors? Had you had a lot of experience with the practical procedures? In any case thanks for your blog and for making me even more excited to go! Good luck with everything, Anusha

    1. Hi Anusha, Thanks for reading…
      You should just try to learn from anyone possible and clerk as many patients as possible. The patients come on droves on most days.

      (Most of) The patients are receptive to medical students and the doctors were really helpful and they taught really well.

      I had minimal practical experience beforehand.

      Hope this helps πŸ™‚
      Make sure you visit the heart of capetown museum before leaving and go up the Table Mountain.
      All the best!

  3. Hi Lagos couch potatoe,

    Im trying to get in touch with groote schuur hospital, to organise a medical elective, with Ms Paschaline Jacobs but the email id I have for her seems to be invalid, are you able to send me the email contact you might have used to organise your elective at the hospital. The email id i have for her is Paschaline.Jacobs@uct.ac.za

    I hope you are able to help me out. Thanks very much

    Regards
    Sue

  4. Hey there,
    I just found your blog and think it is amazing!
    I am also a medical student from Canada. I would really like to do a clinical elective in cardiothoracic surgery at Groot Schuur in 2017, when I will be in my last clinical year. I wanted to know how long did it take before they replied to you? Did you send any documets like your resume in the first mail? also if they don’t reply to my email, could I call them directly? (sorry too many questions) thank you!

  5. Hey there, I just found your blog and think it is awesome and really helpful πŸ™‚
    I am a medical student from Canada and would like to do a clinical elective at Groot Schuur Hospital. I just to know, how long did it take before they replied to your email? Did you send any documents (like your resume or a form) in your first email? If I don’t get a reply, do you think it is ok if I call them directly?
    Thanks!

  6. I got an answer, saying that the elective for international students is not possible at the moment due to a review of the programme. It is only possible for SA students. Does anyone know a time, when the application is possible again? 😦

  7. I like your write up. I’d be graduating from Uniport Med. School next year and I’m looking to do my housemanship in another African country… I remembered Perry’s post about her elective experience and where she referred to you and another colleague doing yours in other African countries, and decided to read your experiences. You’re a year ahead of me, and should have begun or are about beginning your housemanship… Can you make good recommendations for me based on your knowledge? And a helpful advice would go a long way, too. I would really appreciate. Thanks in advance. πŸ™‚

    Ps- Preferably not South Africa πŸ˜ƒ

    Pps- You didn’t talk about Kenyatta. How was your experience?

    1. Thank you for reading! I’m not sure about MDCN regulations regarding internship abroad. I couldn’t get much information from their website when I was researching that option. I also couldn’t reach them telephonically.

      I started housemanship 2 months ago. All I can say is that you should start preparing links for an internship placement ASAP.

      Kenyatta was equally great. You can read about it here: https://lagoscouchpotato.wordpress.com/2015/02/27/the-elective-experience-kenyatta-national-hospital/

      All the best!!

      1. Thanks for responding. I made inquiries, it’s not allowed. I also saw the post on your Kenyatta experience later. It sounded great.

        Cheers.

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