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Experiences at King's College Hospital, London

Date: February 10, 2012

School of Medicine, College of Medicine, Student, Po-Chi Liao
Editor, General Education Center, Associate Professor Beryl Ching-Hwa Lee

When I received the certification to have clerkship rotation in King’s College Hospital in London, U.K., I was very excited. Although my visit to King’s College Hospital is short,  the experience did not let me down: I not only learned the clinical knowledge, but found differences between medical and educational systems of Taiwan and those of U.K.. During my visit, I found many advantages and disadvantages of British national health system, which make me re-examine NHI (National Health Insurance) in Taiwan.

King’s College Hospital:
King's College Hospital, located about four kilometers southern to Thames rivers in London, Deanmark hill, is one of the four trauma centers in London and one of London's largest and busiest teaching hospitals, with a strong profile of local services primarily serving the boroughs of Lambeth, Southwark and Lewisham.  As a result, I had opportunites to contact many traumatic patients and observe difficult cases during this period.

My team:
My elective course in King’s college is offered by orthopedics and trauma department.There are three members in my team, including an attendant doctor, a senior doctor, and a junior doctor. My supervisor, Mr. Phillips, from Wales, U.K., is expertise in hand surgery,  delay union, and nonunion of bone. The other two are Nadeen and Keba. Nadeen, a mix of Indian and Pakistani senior doctor is now in his final year of specialist training. Keba is a Gambian junior doctor who came to the U.K. as a medical international student 10 years ago after he graduated form senior high school in Gambia. He is now in the second year of specialist training. It is interesting for me to notice that London is just like a melting pot. In addition to local Britons, I saw many medical staff members of different races and from different countries, for instance, doctors form India or Pakistan, nurses from Philippine, Hong Kong, Japan and so on. Working in London is just like working in the United Nations.

Operation theater:
Operation room in the UK and European countries are known as the theater and are divided into the major theater and day surgery room, located in two different buildings. Quality of the medical service is very high. It’s not surprising that in such an advanced country, the devices and tools are advanced but the most impressive part to me is quality of the medical staff, such as circulating nurses, scrub nurses and so on. They are extremely familiar with the surgical procedure and patient's condition. In my opinion, it is the maturity of medical training system and the good cooperating atmosphere that enhance the whole medical environment to a great extent. In contrast, the heavy loading and stressful environment in Taiwan deter students from becoming medical doctors.

Outpatient:
There are also many differences in outpatient system. In the U.K. to see a doctor, a patient must make appointment. It is reported that it would take about a week or so to see a doctor. It would be very hard for a Taiwanese to imagine the Britons must wait for such a long time to see a doctor. However, convenience of the medical system in Taiwn leads to medical resource abuse  and many related problems. For instance, it is very possible for a doctor in Taiwan to see more than 60 patients in a single morning, which severely reduces the time a patient is allocated. . I found doctors in the U.K. have around 20 patients in the same period of time. Therefore, they could spend more time with each patient, in comparison with their counterparts in Taiwan. Doctors in the UK spend their time talking to the patient, explaining the disease, and doing health education. They also do physical examination in detail. As a result, the patient would understand his condition and the disease progress much better. It is also noticed that the more time the doctors spend with patients, the fewer lawsuit cases they are involved.

Conclusion:
What I experienced in the U.K. inspired me to think more. For example, no matter how organized the health care system is, still there are disadvantages. It seems that increasing medical budgets and medical disputes are universal problems. All in all, I do appreciate this opportunity in London, which opens my eyes to a different medical system and broadens my horizon. Due to the visit, I learn to value what we have; I remind myself to try my best in the current medical system. To sum up, the most important lesson from this elective course is to reinforce my role as a doctor and to inflame passions in me toward my career.

(Chinese Version.)

【Photos】

King's College Hospital
 
group photo of my team
       

 

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