Archive for May, 2007

Medical Elective: Little Details on Arrival

First thing of course is to settle in, unpack the luggage and hang up the shirts and ties. That’s all part and parcel of traveling.

So the first thing is to head to the medical office of the university you’ve applied to. Probably there’ll be an office where one can speak to the electives officer one applied to and likely communicated via email/telephone with over the past few months. Then, it’s time to settle a few things.

1. Reporting time, venue and person

A teaching hospital is affiliated with the university, but any particular department in hospital isn’t completely part of the university. Therefore, one has to also report to the particular office/physician of the hospital in question. Particularly in surgical disciplines, the first contact may very well be in the morning ward rounds around 6.30am.

Dress neatly (for men, long-sleeved shirt, tie, dress pants, labcoat). Bring along a cup of coffee (e.g. from Tim Horton’s, if in Ontario, Canada) for the registrar/chief resident/consultant. It never hurts to make a good first impression.

Oh, and try to meet the mentor/supervisor as soon as possible.
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Hiatus for Traveling

Hello, hello. It’s been a fantastic 6 weeks of electives, but now I’m going to take the opportunity to travel about Canada. Time and internet connection might or might not be in short supply, so I’m going to just going to write entries on an irregular basis. Not that I haven’t during this busy elective (and post-elective gatherings). Cheers!


Medical Elective: Final Thoughts on Neurology

Neurology and Neurosurgery are similar in so many ways. They’re like Cardiology and Cardiac Surgery. They’re like General Surgery and Gastroenterology. They’re like identical twin brothers… except they look really different, and actually have different genes.

Those are some of the most redundant, useless statements I’ve ever made.

I found Neurology both fascinating and frustrating at the same time. Fascinating because the diagnosis and sheer variety of pathologies was so varied, yet frustrating because it’s so time-consuming. A complete neurological examination, undertaken with both looking for pathology and the localisation of that pathology, takes a lot of time. To complicate matters, it is very dependent on the cooperation of the patient.

This short rotation in Neurology has helped greatly, not only in terms of theoretical knowledge, but giving exposure to how the hospital/physician has to gather the services of multiple disciplines. The speech therapist, PT/OT, medical social worker, family physician, fellow specialists, rehab hospitals and long term care (LTC) institutions.

So yeah, it was pretty awesome.

J. out.

Medical Elective: Final Thoughts on Neurosurgery Elective

The Neurosurgery elective was a thoroughly enjoyable experience. The focus of neurosurgery has never been about ward work, and it is reflected in the highly efficient speed rounds that are performed in the mornings. The patient care would have been impossible without the highly capable nursing staff who write down patient issues on clipboards on the top of the chart trolleys, allowing the neurosurgeons to assess and make changes as soon as possible.

Much of the rest of the day is spent doing one of three things – consults (inclusive of the ER), clinics and OR (Operating Room, OT here mostly means Occupational Therapy). As a medical student, there was not a great deal of expectation placed on me, so even though I obtained a pager from the administrative office, it wasn’t really used much. Having a choice and little stress was great.

Neurosurgery is for someone who can make on-the-spot decisions and survive in a high-stress situations. ER consults can’t wait; as the patient’s GCS score starts plummeting from 14 to 3 rapidly. It’s for someone who can put in crazy hours a day and still find balance in life.

Most of the surgeries are either about saving lives (low-risk) or about preventing neurological decline (high-risk). These “risks” are largely because neurosurgical operations are in delicate regions where the risk of creating a neurological deficit are very real. In the comatose patient on the brink of death, this is not as major a consideration (especially in terms of litigation, for the practical-minded) as in someone who’s come in for aneurym clipping or elective laminar decompression. All of them are challenging…

Except for maybe muscle biopsies. Anyway.

It was a fantastic 4 weeks and yes, J.’s would love to be able to do neurosurgery, tough as it is.

Overseas Electives: Meeting New Friends

J. has the remarkable fortune of having at least one relative at the place he did his overseas elective. Besides the obvious practical advantages of having a place to crash [at], a car NOT to crash, a guide to the city, presence of laundry/scrub cards, a person to share in the chores, one of my favourite is being introduced to friends of the relative. Otherwise, J. would probably have had a harder time of meeting people, this period of time being when most university students are off for break, the 4th (Final) year medical students unofficially graduated while awaiting convocation, and not connecting entirely with the people in hospital.

As it was, however, the first night he touched down, he was already introduced to his brother’s close bunch of friends, which included an enthusiastic, humourous chap who befriended J. readily.

It was through these friends that J. gained a feel of medical student life in Canada as compared to Singapore.
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Toronto’s CN Tower

You know what they say, you go up one tallest-tower-in-the-world, you’ve gone up all of them.

Nevertheless, the day J. went to Toronto to meet JoT and girlfriend, the four of them (four? how do you do the math?) went to the CN Tower – Canada’s Wonder of the World. It’s 553 metres tall and is the world’s tallest tower, but not the world’s tallest building.

Here it is.

CN Tower

Well, the view at the top’s amazing. There was a funky glass floor (it’s only about 4 metres by 8 metres) that allows you to look straight down at the little ant-like people beneath. Other than that, no surprises. Costs about CA$25.99 to go to the observation deck, glass floor and Sky Pod (it’s a higher level observation deck). However, be prepared to wait 30min to enter the elevator to the Sky Pod.

If you’ve been to Shanghai’s Oriental Pearl, gone up KL’s Twin Towers or Taiwan’s Taipei 101, you might want to save your money. Then again, the view’s different in each of these countries. J. particularly enjoyed looking out at the Toronto Islands, the Island Airport and just far off into the horizon, imagining he was looking towards Niagara Falls.

Review: Marble Slab Creamery (in London, ON)

The brothers met up with a lawyer friend from China for some tasty ice cream! Instead of settling for the cheap tub of ice cream in the refridgerator, they decided to drop by the North Row branch of Marble Slab Creamery (there’s another one Downtown):

The place was largely open space with a few seats pushed towards the wall and storefront. The reasons were obvious even from the parking lot – there was a long, long queue that curled about within the shop. Part of it might have been the proximity of the cinema, part of it might have been the fact that they sell darn good ice cream. The place sold ice cream or yoghurt in waffles cones/waffle cups/cups mixed with “mixins” like Klor bar, strawberries and the like. Also available are brownies, cakes and apple pies. The emphasis, of course, is on the ice cream.
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