Introducing Electives! USA


For the past month or two, we’ve been asking for your elective reviews and, now, we’re pleased to present our new series of posts: Introducing Electives!  Every week for the next few weeks we will be publishing a brief report of an elective destination from a fellow Manchester medical student.  We hope to provide you with a taste of what could be expected from an elective in every continent.  We are extremely grateful to the students who have provided these short accounts.  If you’re reading this and you also want to submit you’re elective report, please do get in touch!  For our first entry, Yousef Majeed travelled to California, USA.

 

“I chose to do my elective in Burns & Plastic Surgery in Sacramento, California. Here, I spent eight weeks on a clinical observership working at both the University of California, Davis Medical Center, and Shriners Hospital for Children, Northern California.

My interest in Burns & Plastic Surgery grew from a student selected project I undertook whilst at University. Since then, I knew that I wanted to gain further exposure to this exciting field and saw the elective placement as the perfect chance to do so. I also saw it as a great opportunity to compare the UK health system to that of another well-developed country, which in my case happened to be the USA.

I was very fortunate in arranging my elective. After finding that placement-after-placement was already fully-booked, particularly in surgery, I contacted a surgical registrar who had been a supervisor of mine for my University project. By chance, he was in Sacramento at the time and kindly introduced me to the Burns & Plastic Surgery team there. As such, the placement itself was free, however there were a few requirements of the US including proof of recent TB tests.

My time in Sacramento was divided between ICU ward rounds, clinics, and operating lists, as well as formal teaching sessions and time spent shadowing surgical interns. I learnt about various aspects of burn management, from the initial assessment and resuscitation in A&E, to wound dressings and skin grafting in theatre. The mechanisms of injury were diverse, ranging from meth-lab and hash-oil explosions to deliberate abuse of vulnerable children. The experience was distressing at times, particularly when patients were sick, however it was very rewarding to see the patients doing well later down the line.

Thanks to the welcoming nature of the attending surgeons, I was encouraged to take quite a proactive role by following and presenting patients in the ICU during rounds, seeing my own patients in clinic, and scrubbing in theatre to assist. Rather than just being an observer, this allowed me to practice a number of skills such as wound debridement, suturing and wound closure, and application of skin grafts. Looking back, I was very lucky in the number of opportunities and experiences I had.

In terms of accommodation, the best options are either Airbnb or to rent a room from a member of the staff at the hospital. The hospitals typically have a roster of people willing to let a room for a very reasonable price and those I came across were friendly and welcoming. I stayed in an Airbnb just over a mile from the hospital in Midtown, which cost around £30 per night all-in, and living costs including food and transport were comparable to the UK. In hindsight, as the days were long and started early, living even closer to the hospital would’ve been a huge bonus, so make sure you organise this early while there’s still good availability! Both intra- and inter-city transport links were readily accessible and reasonably priced making it easy to get around.

Despite being the capital of California, Sacramento was quite a slow-paced city. Nevertheless, there are many smaller districts of the grid-based city with a variety of attractions, bars and restaurants. In downtown Sacramento you can visit the State Capitol and park, and a short walk away is also Old Sacramento and the American River trail. Outside of Sacramento, San Francisco and Yosemite National Park are a 2h and 3h drive, respectively.

My experience in California is something that I will never forget. Not only did I learn a great deal about the management of a patient with burns, but I met a lot of great people along the way who have further motivated me to pursue a career in surgery; it was definitely a reaffirming experience. I will certainly take the knowledge and skills that I learnt in Sacramento with me during my time as a Doctor, and I hope to put these into practice at some stage in my career.”

– Yousef Majeed