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MRIC Global Essay Contest: My medical exchange experience in Czech Republic

Author:Oumayma Lahjouji

5th year medical student at Faculty of Medicine and Pharmacy of Fez in Moroccothe Institute of Medical Faculty, Comenius University

My name is Oumayma Lahjouji, and I am a 5th year medical student at the Faculty of Medicine and Pharmacy of Fez in Morocco.

Since my first year in the Faculty, I have been a member of the “FeMSA” Fes medical student association, and I gained experience working in this association as its president in 2017/2018. Thanks to this great association, I had the chance to meet many foreign medical students who came for an internship at my hometown’s university hospital. When I met them, I always asked each one the same question: “How is the medical education system in your country?”

I was always fascinated when someone came from a country with an entirely different structure of medical education or health care system from ours in Morocco.

I was surprised to learn that in almost all other countries, medical studies take six years. In Morocco, it can take from seven to eight years to get a diploma as an MD. The first two years are dedicated to pre-clinical lessons, and from the third to fifth year, we have hospital rotations between six departments annually. Each working day, we have clerkship in the mornings from 8:30 am to 12:00 pm and lectures in the afternoons from 2:00 pm to 6:00 pm. During the sixth and the seventh years, students train and have internships either in a department at the university hospital or small hospitals in the suburbs. Some countries like Tunisia have the same structure of medical education.

On the other hand, according to the exchange students, in Romania, Bulgaria, and Germany, it is typical to have three pre-clinical years and have clerkships and lectures from the fourth to the sixth year. Furthermore, in Denmark and Norway, students can enter the university either in winter or summer. After they start clinical practices, they have six months of lectures and courses and then switch to six months of clerkships in various departments.

However, after asking several students, I finally realized that it would be better if I experienced the lifestyle of a medical student in a foreign country and learn more about the medical education system there, which is why I arrived at Vaclav Havel-Prague airport on the 1st of August 2017. I had never been to any countries in Central Europe, and I had no idea what was waiting for me there.

I got the opportunity to do an internship in the Department of Gynecology and Obstetrics at Hradec Kralov? University Hospital, which is one of the best and most modern hospitals in the Czech Republic. I had to wake up at 6 am from day one in the new city to be at the hospital at 7 am. My contact person, who was a Czech volunteer student whose role was to take care of me during my exchange, had to introduce me to my tutor. After the short introduction, I officially started my clerkship and joined him and the other residents for hospital rounds. They usually discussed the cases of hospitalized patients and determined whether they needed to change treatments or do some other examinations.

I was very excited about this experience in the new city, but it was a bit difficult to adapt to a new lifestyle. For example, I had to become a morning person. In the Czech Republic, the hospital rounds for students generally started at 7 am. Because I was used to waking up at 8 am in my hometown to be at the University at 8:30 am, the first week was a bit torturous. The hygiene standards at Hradec Kralov? Hospital were higher than the ones we have at my university. The hydroalcoholic solutions were in every corner in the corridor of the patients’ ward. The hospital also had a strict dress code. The students and all the medical staff had to dress completely in white, including shoes. In Morocco, we can wear any scrubs in any color, and we do not have to change them after wearing them outside the hospital.

The highlight of my exchange was observing a robotic surgery performed with the Davinci Xi robotic system. I was in gynecology and obstetrics, but they didn’t have a surgery scheduled with the robot that month. However, my tutor generously gave me permission to observe a robotic surgery in the urology department. Before the operation, I had a small discussion with the surgeon, who told me that they have 5 surgical robots in the Czech Republic. The DaVinci Xi is one of the most developed ones in the world. He also told me about the benefits of robotic surgeries: shorter hospitalization periods and smaller incisions, which reduce the risk of infections, blood loss, and recovery time.

I was amazed watching the surgeon sitting at the control console, which was one and a half meters away from the patient, and the robot replicating his hand movements to remove a prostatic tumor. Immediately after the surgery, the nurses came toward the surgeon with a cake in their hands. I first thought that it was his birthday, but then they explained to me that he had just come back from Strasbourg, where he had studied robotic surgeries, and that this operation was his first one at this hospital.

This experience was also unique for me because robotic surgeries are not developed in Morocco yet, and after seeing how amazing the results are, I am already dreaming about the day when we will be able to do such an advanced surgery in my country.

During my stay in Hradec Kralov, I learned some other interesting facts about the health care system in the Czech Republic. For example, it is in the list of top European countries using angioplasty as a first-line treatment for myocardial infarctions. In Morocco and even in some other European countries, including Greece, Romania, and Turkey, the number of patients who receive a primary angioplasty is insufficient. Although the number of patients who receive thrombolysis is a bit lower than in the Czech Republic, the majority of patients do not get any reperfusion treatments, either because of the long time that patients take to come to hospitals or the limited number of facilities that can perform an angioplasty.

Myocardial infarction is the leading cause of death in countries with high and middle income, but infectious disease is the most prevalent cause of death in lower-income countries. I think the developed angioplasty in the Czech Republic demonstrates how great their health care is.

In conclusion, I would also like to mention that besides a fantastic professional experience, the exchange in a foreign country enriched my life with many lifelong friendships. I encourage everyone who wants to know about various health care systems and medical education to experience an exchange as there are always more things to discover and see.

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