Rachael Morley shares her elective experience and some really useful tips on Canada and South Africa.
“When planning my elective, I was faced with a world of opportunity. I spent countless hours studying a world map deciding exactly where I wanted to go. There was an important choice to make on whether I wanted to visit a place for the particular benefits of practicing medicine there or for the tourism. I managed to hit upon a happy balance for both of my destinations, Vancouver for Hepatobiliary (HPB) surgery and Cape Town for Trauma surgery. This mix also allowed me the opportunity to compare and contrast two healthcare systems in very different countries.
Vancouver was an excellent city for surgical experience. Be prepared to work long hours and not be congratulated for it though. 12 hour shifts were minimum and I often worked 14+. Still on my feedback they told me I could have been there more. If you are able to brush this off, the experience is second to none. Having that much time in the hospital means that you can see yourself improving from day to day. As a ’medical student intern’ or ‘MSI’ you are part of the team and expected to act as such. I was in theatre every other day and was first assistant about a quarter of the time. The team really took an interest in my training rather than service provision and I got one on one teaching to improve my surgical skills. I have never noticed myself learning so fast, and that made everything worth it.
In terms of survival, I lived in an air bnb for the month and it cost me about £488 in total. This was the lowest end of rent. It was a 15min bike ride from the hospital and about 25mins to downtown, which was perfect for me. I would highly recommend getting a bike to travel around. I spent $150 renting one for the month which meant I saved myself an extra 30mins of sleep every morning and could go downtown for some social life after my shifts ended. The cost of public transport over a month was about equal, and a much less efficient way of getting around.
Things to do when not on placement
Outside of the hospital and beyond basic survival, you will need a social life to balance all the hard work. I was lucky in that I knew somebody living in Vancouver already and one of my friends from Manchester happened to have organised the same 4 weeks to go there. There’s so much stuff to do around Vancouver, mostly revolving around outdoor activities. We managed to get through a lot, from skiing to beach BBQs! Obviously, this depends on the time of year you go. There are endless amazing restaurants/cafés, hikes, amazing views around the sea wall and places like Whistler and Vancouver island are easy to visit at the weekend. There was not the same integration of medical students with each other as in other electives, so I imagine if I hadn’t known anybody this could have been a fairly lonely month.
Despite the obvious drawback of cost, if you want an elective to really give you some good surgical experience this is the one. I gained more surgical experience from this placement than Trauma in Cape Town and I Vancouver is an amazing city to live in. I would move there in a heartbeat if it were feasible.
This experience is not a cheap one. Just to apply to the programme they ask for a $250 non-refundable fee and there is no guarantee of getting a place. Luckily I got a place although I applied for vascular as my first choice but was given HPB instead. This actually turned out to be great experience too so don’t let that put you off. There were then hidden costs that nobody told me about before. See below for a summary.
Application fee (non-refundable) $250 (£135)
Elective fee (refundable) $250 (£135)
Malpractice insurance $325 (£175)
Mandatory medical £300
Royal college of physicians and surgeons registration $40 (£21)
TOTAL for elective placement £766
Bike rental $200 (£100)
Add on general living – prices for food etc are slightly cheaper than UK, but not by much so expect to spend roughly the same amount that you would in England.
For more information on applying visit: http://mdprogram.med.ubc.ca/visiting-student-elective-program/
Cape Town, South Africa
Cape town was a completely different experience to Vancouver, and as such I got my wish for having two completely contrasting placements. Keep in mind that if you want a trauma placement here, you will have to apply at least 1.5 years in advance and I would recommend getting emails out from 2 years before depending on what hospital you’re aiming for. The saying TIA (this is Africa – stated whenever something is generally inefficient) comes into play from day one of trying to organise the elective, replies to emails are slow and information difficult to gather. Persistence will serve you well and the hassle is worth it.
In terms of experience, all trauma happens at evening and weekends, so don’t expect a 9-5 placement here. Nobody ever really expected me to be in so you get out what you want to put in. I would recommend putting in a lot because you will never see trauma like this anywhere else. I worked a couple of ward rounds in the week then Friday, Saturday and Sunday nights with one 24 hour on call at the weekend too. This meant I was sometime awake for most of Saturday night to Monday morning. Obviously this is a lot of work but it was “self-inflicted”. This was when I got the best experience so preferred that over ward rounds. When I was on call I would typically scrub in as first assistant on 3 cases, this was mostly open laparotomies but I also got to do some open heart surgery. Time not in theatre I spent in the front room managing acute patients and suturing skin wounds, excellent practical experience.
Cape Town is extremely cheap. The placement cost me £600 for four weeks with accommodation included. Eating out was a maximum of about £5 for a decent sized meal and a drink. This meant that eating in was more of a novelty than eating out whilst there. There’s plenty of places to eat, beaches and mountains to climb so this city really caters to anybody. To get around you really need a car, I rented one for £5 a day plus petrol.
Living arrangements and social life
At my hospital, Tygerberg, the living quarters had a lot of international students and there was a really good social life. There is a Braai (South African word for BBQ) every Wednesday night and all new students are added to a Whatsapp group where everyone organises outings and activities. There’s a lot to do and people to do it with, so if planning by yourself this is an excellent placement for meeting people.
– Rachael Morley, FY1, North Bristol NHS Trust