Visiting student electives - student experience

Every elective placement at the Faculty of Medicine and Dentistry is unique. Australian student Louise Killen undertook a Gastroenterology Elective Term placement at St Barts Hospital in Janaury 2011, with Dr Sean Preston. Below she describes her experience during her month-long placement and offers some hints and tips to students considering a visiting student elective.

My visiting student elective experience, Louise Killen

I am an Australian medical student, studying at UNSW in Sydney. I had a really fantastic time during my month-long Gastroenterology Elective Term with Dr Preston!! It was honestly one of the best months of my life. I would jump at the chance to do it again, and would recommend it to anyone wanting to learn a lot (not just medicine) in one of the world's best cities.

I've written this post to help prospective students, so you can see what I got up to and hopefully give you some handy tips too.

There was a lot on offer at The Royal London Hospital ('The London') in terms of learning experiences. Some of my favourites were:

Attending Clinics

The Monday morning gastroenterology clinic at The London was a great opportunity to see a wide range of gastroenterology patients (inflammatory bowel disease, irritable bowel disease, GORD, achalasia, coeliac's disease... just to name a few!). It was a great chance to observe the symptomatology of the different disease processes, and to see what the treatment options for the patients were. 

There is also a Thursday morning gastroenterology clinic at St Bartholomews Hospital ("Barts"), which runs in a similar way, and it's great to gain some experience in another hospital too. I also enjoyed the liver clinic - I got the chance to brush up on some viral hepatitis, autoimmune hepatitis, Gilbert's syndrome... the list goes on!!).

"Scopes"

Dr Preston encouraged us to see some gastroscopies, colonoscopies and ERCPs. It is really good to see the 'theatre' side of gastroenterology, which is such a contrast to clinics and ward rounds. It's one of the big draw cards of gastroenterology as a specialty, in that it is a Medical discipline with a fair bit of hands-on work. 

It is definitely worth observing some scopes, both to see some interesting pathology (and brush up on your anatomy!), and to get a better appreciation of what the day-to-day work of a gastroenterologist is like.  

Teaching ward rounds

Dr Preston runs these on a Monday and Thursday each week for the 3rd-year and 5th-year students and you're more than welcome to join in! 

It's great to hear about the patients on the wards and you can present any patients that you've clerked and get some feedback on how you went! While there's a big emphasis on teaching in these rounds, they're a working round too, so you get to observe how the patients are managed (much more memorable this way than just reading a textbook!).  

Regular working ward rounds

You also get to take part in the regular ward rounds, which are a bit faster-paced (but still with plenty of informal teaching thrown in by the Registrars and House Officers too). There is a wide range of patients on the list, especially on the 'post-take ward round' (after Dr Preston has been on call), including lots of general medical patients (falls, strokes, urosepsis, COPD, lung ca, pulmonary fibrosis... again the list goes on!!). These are worth attending on any mornings that you're not in clinics/watching scopes.

Bedside Tutorials

Dr Preston took us to see some interesting patients and he helped us a lot with our clinical examination skills (very handy for final exams!!!). It was also good to get to meet some of the local students - our group was really friendly and full of advice about places to go/things to see and do in London in our spare time.

Clerking patients

We were encouraged to clerk as many patients as possible, both on the wards and in clinics. I found that I learnt so much and was made to put all that I was learning into practice, as the one actually asking the questions. You realise that you have picked up an awful lot of gastroenterology from observing the clinics/ward rounds, but there's always also a lot of room for improvement.

Going to the wards and clerking patients by yourself can seem a bit challenging at first (especially as The Royal is such a huge hospital and I found it a bit difficult to navigate at first!!), but you eventually learn your way around, and you definitely learn a lot each time you practice!! 

Experiencing a hospital on 'the other side of the world'

This is a great experience. I found that the medicine and the basic hospital staffing structure etc were pretty similar to home, just on a much larger scale! The doctors, nurses and allied health staff were lovely and very helpful (especially if you explained you were from overseas!). 

It was really helpful to gain a broader understanding of medicine, health and disease, in a setting not too different from home, but definitely different enough to make me notice and think 'I wonder why we do this/that in Australia and why we/they do it differently here?' It makes you evaluate things that you always took for granted and keep an open mind in terms of the many different ways there are to do things.

Accommodation 

I stayed at the John Harrison House, which is a 2 minute walk from the main hospital building and clinical school buildings, and approximately 5 minutes from the Whitechapel London Underground ("tube") station, so it was very convenient! The rooms were simple (similar to a college room), with a bed, desk and shared bathroom between two people, and shared kitchens on each floor, as well as a laundry in the basement. It's also very affordable! There's no internet available, but you can use the clinical school computer room/printing facilities.  

Food 

There are several convenience stores nearby (including Budgens which is right near the tube station and open 24 hours), and there's a Sainsbury's just near the Whitechapel Public Library. 

There are also lots of good and affordable places to eat nearby - I really liked Marrakesh (delicious paninis and sandwiches), Needos (get the £10 grill special and share between two people - yum!), and Beigel Bunnies (inside the clinical school building) are all great for lunch. Needos is good for dinner too, but we found that we usually ended up exploring other areas of London at night (as the tube is so convenient, and there are so many other parts of town to see!!): Chinatown, London Bridge, Liverpool St were some of my favourite areas. 

Things to do in your spare time in London 

There are too many things to write here. Dr Preston recommended we buy the Time Out magazine (definitely worth it) which comes out weekly and tells you all the major exhibitions and events going on that week. I loved going to markets: Borough for food, Spitalfields for clothes/souvenirs, Portobello Road for clothes/accessories/silverware. 

There are so many galleries and museums too: Tate Modern, Tate Britain, National Museum, National Portrait Museum, Victoria and Albert Museum, British Museum, Science Museum, Natural History Museum. Wandering around Knightsbridge is fun (see the famous Harrods!), and Fortnum and Mason on Piccadilly will make your mouth water! 

And on a sunny day go for a stroll around Big Ben, the Houses of Parliament and Westminster Abbey, or St James Park, or the Kensington Gardens...Shopping on Oxford St and Regent St is fun. And you definitely have to see a show while you're here too (Phantom of the Opera was fantastic!). 

There is so much on offer - I wish I had had a year or two instead of only a month! 

Outside of London 

Being from Australia, I wanted to make the most of my time over on this side of the world, so Dr Preston let us take a couple of long weekends for trips to Amsterdam and Paris. This was definitely a highlight too. Amsterdam is such a dynamic place - all canals, museums, beautiful architecture history during the day, and then its infamous nightlife once the sun goes down! 

And Paris - what can I say - it's a magnificent place, and so close to London! I recommend going with Eurostar because you can head straight from Kings Cross/St Pancras station and you arrive at Gare du Nord in Paris - it so easy! Overall, I had a really amazing experience and would recommend it to anyone!