June 23, 2013
I just finished another
great week at Victoria and got the chance to do and experience a lot of new
things. In terms of procedures, I got
the chance to put in an IV line, perform a paracentesis on a patient with right
heart failure, and perform a lumbar puncture on a patient with suspected
meningitis. It is such a great
opportunity to get exposure to these types of procedures so early in my medical
training, because I don’t get a lot of hands-on training as a pre-clinical
medical student. Since I am interested
in emergency medicine, I have done a lot of shadowing in the ER and have seen a
lot of lumbar punctures performed, and I always thought it was a cool
procedure. I was so excited when my
preceptor handed me the kit and told me that I could do the procedure, and it
was such a great feeling when I pulled the stylet out and CSF dripped out on my
first try!! (I realize how nerdy that sounds but it’s true) I also watched my preceptor perform a fine needle
aspiration of a lymph node of a patient with a possible lung cancer, and he
said the next time is my turn to do it!
On Thursday, I went
with my preceptor to Groote Schuur Hospital (where the first heart transplant
in the world was performed!!) and watched him present one of his patients for
dialysis. In the US, dialysis is readily
accessible and if I am not mistaken, it is free. This is NOT the case in South Africa. I believe that Groote Schuur is the only
public hospital in the Western Cape that offers dialysis treatment and they
have very few spots available. So, in
order for a patient to be put on dialysis, the doctor has to present the
patient’s case to a board, the patient gets categorized based on his/her
current medical and social standing, and then the board decides whether or not
to accept the patient into the program.
It is a very stressful process for both patient and doctor, and there
are tons of patients with end stage kidney disease that are denied
treatment. Learning about the whole
process was definitely shocking, because in the US, we are very fortunate that
patients and doctors don’t have to face such problems.
On Friday, I got the
chance to watch the University of Cape Town sixth year medical students take
their practical exams. The medical
school testing process is very different in South Africa. At KU, the majority of our testing consists
of multiple choice tests on a computer.
In South Africa, the students have written exams, but they also have a
lot of oral and practical exams. In the
exam that I watched on Friday, the students examined four different patients,
all currently in the internal medicine ward.
I believe the four cases were stroke, heart attack, right heart failure,
and bronchiectasis. The students got ten
minutes to take a history and examine the patient, and then they had to present
the case to a doctor who then asked them various questions about their
assessment, differential diagnoses, and their plan for treatment. I’m sure this testing style really helps the
students to perfect their clinical skills, but I’m sure glad that I was the one
observing and not taking the test!
This past week has yet
again been a great learning experience and I’m excited to see what this fourth
and last week brings!
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