Practical training program at King's College Hospital, London

Date: February 10, 2012

School of Medicine,College of Medicine, Student, Yen Chen Lin
Editor, General Education Center, Associate Professor Beryl Ching-Hwa Lee

St Thomas' Hospital, known as where Florence Nightingale worked, is a world famous medical institution. I am really honored to take the elective program in the vascular surgery department in this hospital. Due to the western-style diet and smoking issue, the majority of people in England have some problems of the cardiovascular system. And my consultant, Miss Rachel Bell, who has worked in this special area for over 25 years, is a famous doctor in this regard. Therefore I could see various cases in just four weeks in London.

Medical students there are quite different from those in Taiwan. They spend a lot of time taking lessons in King's College London. Unlike students in Taiwan, they do not need to participate in a team while they take the clerkship. They would receive a schedule of all the clinics, meetings, operation date and examinations on the day of arrival just as I did. The following is an example.

0800~0930 Academic meeting
1000~1130 Consultant Ward Round
1330~1630 Endovenous Procedure
0800~1630 Vascular Surgery Theatre  [Theatre = Operation Room]
1000~1330 Outpatient Clinic
1330~1600 Endovascular Theatre
0800~1630 Luke ward (Vascular Surgery Ward)
0800~1000 X-Ray Meeting      
1000~1630 Luke Ward (Vascular Surgery Ward)

After receiving the schedule, medical students there can choose what they want to see and learn. Since they have to take care of almost everything in the ward immediately after graduation, medical students in St Thomas' Hospital are willing to take medical history, do physical examination, and practice clinical skills. Actually, they are more ambitious than most students in Taiwan; however, clerks in China Medical University Hospital (CMUH) outperform them in terms of logic of history taking.

According to the rules of National Health Service(NHS) system, patients who want to go to hospitals like St Thomas' Hospital need to go to see a General Practitioner(GP) or family doctor) first. If the GPs think it is necessary, the patients will be referred to higher level hospitals. However, they are usually in the waiting list since there are limits of the patient quantity in outpatient clinics. Thanks to the quantity control, doctors have enough time to take full history and do detailed examination for every patient. In this sense, I think the quality of outpatient clinics in the UK is much better than that in Taiwan. Here is one more thing special: After discussing with the patient, doctors have to record the patient's condition in a tape. This is a simple record, which will be sent to the patient’s GP so that the GP can realize his condition when the patient goes back for follow-up.

Vascular Surgery is a department which is combined with Cardiac Surgery and therefore is called Cardiovascular Surgery in Taiwan.Since I did not have chance to go to cardiovascular surgery department in CMUH during my fifth grade, everything in the UK is fresh to me. During this month I saw the operations of aortic dissection, aortic aneurysm and many other operations of arteries and veins. I also got the chance to scrub my hands and participate in an above-knee amputation. In addition, I saw some endovenous procedures and endovascular surgery which are done by radiologists in Taiwan.

Unexpectedly, Miss Bell took a leave just before my elective course ended. As a result, I did not have the chance to say thanks and goodbye to her in person. In my opinion, the key point of taking elective programs abroad is not how much knowledge you could gain during this short-term period, but the extent of change of your thougts after seeing different worlds, different countries, and different cultures.

Initially, there are two main reasons why I want to receive clinical training in England. The first is that I hope to improve my oral and written English skills. During the four weeks, I practiced English not only in the hospital but also in the other areas in London. Consequently, my English proficiency is improved. The second is that before entering my internship, I want to broaden my horizons by experiencing a new culture and a different healthcare system. As noted, the NHS system in England is really different from the Health Insurance in Taiwan. The elective program is truly an eye opener and I am really glad to have this enriching learning opportunity. I think I got more than what I had expected.

(Chinese Version.)


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