In July 2017, I undertook a four-week medical elective hospital placement in the Czech Republic. Since my training for the past four years has consisted of placements in the same two hospitals, travelling to a non-English speaking country was something of a shock to the system. However, it has truly enriched my experiences as a medical student, as well as giving me a massive confidence boost.
A medical elective is a mandatory placement undertaken by medical students, usually after completing their final exams. You are free to choose both the location and the content of the placement, with most completing it abroad. You do, however, have to organise it yourself, and there is much heartache in applying to dozens of hospitals and medical schools and receiving a steady stream of rejections.
It was therefore with relief and delight that my friend and I both received an acceptance from Charles University in Prague.
The department that accepted us was Rheumatology, which we chose in order to gain an insight into inpatient treatment of fascinating chronic conditions such as SLE (also known as lupus) and systemic sclerosis.
On our first day, we were to meet the head of the department at 7AM, which meant a 5AM wake up. Far earlier than we were used to at home, we caffeinated ourselves and began our 30-minute walk to the hospital. This was probably the scariest day of the whole elective.
When we arrived at our designated meeting point, we were led, without introductions, straight into a morning handover meeting. At least, that’s what we guessed it was. The meeting was completely in Czech, and since we were told that we only required English for this placement, we had believed that there would be someone to interpret for us.
We were quite mistaken! We sat in the back of the room, feeling utterly out of place in a sea of white clothing, as we were not yet wearing the white lab coats we had been instructed to bring. We did not exchange any words, but were telepathically communicating our shock. Had we made a mistake? Were we supposed to have learnt Czech before coming here? Would we understand nothing that was going on around us for the whole four weeks?
Fortunately, the answer to all of these questions was no. After the meeting ended, introductions were made (in English) and we were assigned to two doctors. Although mortified that we were separated (yes, I know we’re going to be working doctors in one year…) we were nevertheless pleased to finally understand something that was going on. We got our white coats on, and followed the doctors.
On the ward, I met a Czech medical student who turned out to be quite essential to my placement, as she helped me with translation.
We turned taking blood pressures into a double act, with her making introductions and apologies for my lack of communication, and I smiling excessively and repeating the various phrases that I had picked up – hello, sorry, I don’t speak Czech, thank you, goodbye. The patients were friendly, and I felt pleased that everyone was being so welcoming, but alienated by the language barrier. I realised more than ever the importance of communication skills, as I was not able to connect with any patient the way I could in the UK.
Each day, I joined the ward round, seeing some rare conditions that I had only read about in textbooks. I turned my lack of linguistic understanding into a bit of a game, attempting to guess the diagnosis just by observing the patient, before the Czech student or doctor whispered translations into my ear. Through this, I realised just how much can be learnt by the simple power of observation.
It also struck me how beautifully unifying medicine is; despite being in a different country, the skills and knowledge needed to help patients remained the same. This gave me a whole new appreciation for my medical education and training.
I was also able to discuss medical education with other Czech students, and learnt that the degree there is 6 years, consisting of heavily focused pre-clinical years and a year working as a nursing assistant, before progressing to clinical years. Their course seemed more comparable to a traditional course, and they were shocked to learn about PBL, which does not appear to exist in the Czech Republic.
I really enjoyed my placement in the Czech Republic. Medical students only attend in the mornings, which gave us plenty of time to travel around the area. As well as learning a lot about medicine, I gained a true appreciation for the importance of effective communication with patients.
The doctors and students were very welcoming, and I certainly gained a lot by going outside of my comfort zone, particularly in terms of confidence. If I can survive in a hospital in a foreign country, surely I can do anything back in the UK!
Words: Mariam Al-Attar
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