Monday, July 24, 2017

An Elective in Cuba and Peru: The Preparation

Hello! I am currently in Cusco, Peru, starting the 6th week of my elective. I've decided to write this series of blog posts, instead of just my elective report, to allow more space where I can express myself in greater details, and to share my experience to whoever/future medical students who may appreciate this. 

For those of you who are not very medical profession-inclined, a medical elective is something (very fortunate) medical students do towards the end of their 5/6-years of medical school. During the electives weeks, we are allowed to go, literally, anywhere in the world, where there are medical professionals willing to give us supervisions during our practice. The main purpose is for us to see the world, instead of just hiding in our mountain of books and to learn about other health care systems and medical practices around the world. I think it's a particularly important part of opening our minds, especially for the medical students who have been studying and living in their own country for their whole lives. 

Our goals for our elective

The preparation for this medical elective started about 2 years ago when we first started our 4th year. Kevin and I decided to do our electives together and instead of going back to Malaysia or Singapore (where most Malaysians and Singaporeans would prefer to go for their electives), we decided we would like to do something different, something 'once-in-a-lifetime' because after all, when we start working next year, when will we have 2-months long holiday to do whatever we want again? So instead of choosing where we can learn 'proper first world medicine' eg in Australia, UK or US, we tailored our elective so we could experience cultures and healthcare systems which would be wildly different from what we have experienced. And maybe for once, put ourselves out of our comfort zone. As for proper medicine, that can wait... we have at least 40 years of working life ahead! :p 

Where should we go?

'The world is your oyster!' we were told once during our elective preparation session in clinical school. We will have plenty of opportunities in the future to go to places in Asia, US, UK and Australia, whether for medical practice purposes or research purposes. To be able to complete our elective in prestigious universities in the US (eg Harvard, Stanford, Yale, John Hopkins) would be great for our knowledge and CV, however, when we checked the elective prices for those universities, our eyes popped. Is the price worth it? What will we gain from paying that ridiculous amount of 'registration fee'? 

So we decided to park 'US elective' aside. And we were left with mainly Latin America, Africa and the Middle East. I have been hoping to see Machu Picchu and Kevin loved Latin America when he first came here a few years ago. So Latin America it is! 

Peru was the top of our list. But spending 8 weeks in 1 country seems a bit dull to us, so we've decided to choose another country for half of our elective. Our main alternatives were Bolivia and Cuba. And somehow, charmed by the photos of 'Capitolio' and the old American cars of Cuba on google, we've decided to go for Cuba.

I took this. Not from Google. Proud of that. 

Ok, so our touristy interests aside, these are the things you should consider when choosing an elective destination:
  • Safety - in general, and in clinical practice
  • Costs
  • Availability of supervisions in specialty of your choice
  • Language
A good starting point on what to consider for your elective - the MDU's booklet

Contacting our hosts

When we did our research on which hospital to go, we had no idea on which hospital actually caters/welcome elective students. Besides, some hosts were notoriously bad in replying to emails. Fortunately, we found 2 very brilliant, organised and responsive organisations that provide elective packages which met our interests: 
  • For Cuba - Cuba Medical Electives, which has sadly closed now. However, you're encouraged to search for other hospitals in Cuba from Atillo
  • Medics Away - who also provides elective packages to many other countries in the world. 
With their help, we managed to secure places in hospitals of our preferred destinations without much fuss. I will talk more about hospital, accommodation, food and tourist attractions in detail in another post. 

Many people opted to organise their elective independently. While feasible for developed countries and countries which you've already known the hosts, it may be a bit hard to know exactly what is suitable. We've tried another Peruvian elective company, Mundo Verde, before Medics Away. However, after spending 1 year trying to arrange our elective and not getting any response from them 2 months before our elective, we've decided to switch to Medics Away. Fortunately, Medics Away is very very responsive and made arrangements for our whole elective within 1 week's time. 

Language classes

Important when you are trying to understand what your patients are talking about!! 
Most parts of Central and South America speak Spanish. I knew zero (really!) Spanish before year 4. I was fortunate as I was able to take a Beginner's Spanish course, with a slight medical twist, as part of my student selective component (SSC) in my clinical school. After the course, I've decided to learn Spanish on my own by doing grammar books and watching medical Spanish series (Centro Medico). I was nowhere near as good as Kevin, who did 4-5 years of Spanish course, of course. And I knew I will have a hard time following what's going on in the hospitals, but I had to learn! Just imagine, after these 2-months of elective, I will be able to understand a whole new language! 

There are several Central American countries which speak English eg Trinidad and Tobago and Belize. These are popular choices among my peers. Otherwise, you're always welcome to visit Malaysia or Singapore! We speak English and we are quite 'exotic' too! (lol) 

Funding

I shall not dwell much on this as there are plenty of ways to earn your way to your dream elective. From bursaries and grants of Royal Colleges and specialty societies to University Grants, you can easily search for fundings from google. I was fortunate enough to be able to pay my whole elective from my savings and Kevin's college paid for most of his trip. 
I will talk about our specific budget in each country in the other blog posts. 

Flight 

This is a major cost to consider when planning your elective and best booked early. We booked our flight 8 months in advance and managed to spend only approx. £900 per person (London-> Havana-> Cusco -> Lima -> London), with 30kg luggage allowance. 

Vaccination 

This also another major factor/cost to consider. We visited our University's Occupational Health to disucss about this 6 months before our trip as they tend to get really really busy as summer approaches. I spent about £250 getting vaccinations for Rabies and Yellow Fever, and prophylactic tablets for Malaria. The Rabies jabs come in 3-doses and require at least 1 month to complete, and it lasts for 10 years once completed. As for the Yellow Fever vaccination, it supposes to cover your whole life. 



That's it for the advance preparation we had. I will talk about our Ultimate Packing List next! 

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