September 21, 2023

Clinical Clerkship Program in CHU de Caen, France

In order to undergo the Kuliah Kerja Nyata (KKN) block, the Faculty of Medicine, Universitas Airlangga (FK UNAIR), gives its students the option to undergo this activity in the form of KKN Penyetaraan, a program that is offered for students to carry out student exchange activities abroad as a form of KKN.

This July, I joined the professional exchange program or often referred to as clinical clerkship offered by the Center for Indonesian Medical Student Activities (CIMSA) Universitas Airlangga for the class of 2020. This activity was held in Caen, France starting for the period  of July 3rd to the 28th,  and became an important activity in the framework of the implementation of clinical clerkship program hosted by The International Federation of Medical Students Associations (IFMSA) with the Association Nationale des Etudiants en Médecine de France (ANEMF).

The Professional Exchange Program is a full education program that offers internships to medical students abroad. Each year, around 13.000 students from more than 90 countries travel around the world to discover new health systems, new cultures, and promote global health and cross-cultural understanding.

Center Hospitalier Universitaire (CHU) de Caen, also known as Caen University Hospital, is a large public hospital located in Caen, Normandy, France. This hospital is one of the largest and leading medical facilities in the region and serves as both a teaching hospital and a general hospital. CHU de Caen offers patients a variety of medical services and specialty services. These services include emergency care, surgery, oncology, cardiology, neurology, pediatrics, obstetrics, psychiatry, and many other medical and surgical disciplines. As a university hospital, it is also involved in medical research and innovation. As a university hospital, CHU de Caen plays an important role in medical education and training. The hospital is affiliated with the University of Caen Normandy, and medical students, as well as resident doctors, receive practical training and hands-on experience in various hospital departments.

The first day of my internship at the hospital, I was placed in the Orthopedic Surgery and Traumatology department. The hospital itself is very big, but fortunately there were no language difficulties as the majority of the hospital staff could speak English. All doctors, residents and nurses are also very kind and friendly. Every day I was invited to participate in various activities at the hospital, from attending doctor’s consultations with patients to observing emergency surgeries.

Almost every day the orthopedic surgery department always holds a staff meeting which was attended by all department staff, from the head of the department, the junior doctor on duty, interns to senior chiefs. On this occasion, several doctors had their turn to present their cases to the head of the department and discuss them starting with the chief complaint of the patient, the diagnosis, to the management of therapy. This meeting  usually lasts around 30 minutes – 1 hour, depending on the number of doctors presenting that day. After finishing, then the doctors and other staff continue their activities on that day and usually after that I can join the doctor’s activities.

Furthermore, during my study in Caen I had learned a lot about the French healthcare system, with it being one of the most highly regarded healthcare system in the world. France runs a statutory health insurance (SHI) program that offers all inhabitants access to coverage. Employee and employer contributions, as well as a rising amount of specified taxes on a variety of income, are used to fund the system. The two main programs that offer SHI have the same coverage and benefit policies and are both focused on the agriculture industry. At the national level, funds are consolidated with the potential for program-to-program subsidies. A significant part is also played by voluntary, supplemental private health insurance (VHI). Nearly 95% of people have access to VHI, with 10.5% of people receiving means-tested subsidies and 8% of lower-income people receiving full subsidies. Around 83% of overall health spending is covered by SHI, with the remaining 17% coming from private insurance and out-of-pocket (OOP) expenses. France offers a wide range of benefits and has modest OOP costs. However, some products, such as dental and optical equipment, are not covered by SHI due to cost constraints. SHI pays for over 90% of hospital care expenses, but just 44% of ambulatory (outpatient) care expenses for non-pharmaceutical medical supplies.

I am very grateful for the opportunity given to join the SCOPE exchange program in CHU de Caen, France. I gained a lot of experience and knowledge while at CHU. Before joining this program, there were still many things I didn’t know about like hands-on clinical skills and knowledge. However, after joining this program, I got a lot of guidance and more knowledge that I will bring and apply when I become a young doctor. I also realized that through this program a lot of knowledge about different applications of the national health system in France and Indonesia and also about the various medical cultures that exist there. Also new understandings like intercultural learning and also exchanging culture, thoughts, and language with the other incomings or exchange students while I was there. After completing this program, I feel more motivated to learn and to be able to develop myself to become a better doctor and improve my teamwork skills for the future.

Sources:

  • Professional exchanges (scope) (2023) IFMSA. Available at: https://ifmsa.org/standing-committees/professional-exchanges/ (Accessed: 07 September 2023).
  • Chu Caen Normandie – centre hospitalier universitaire caen normandie (no date) CHU Caen Normandie – Centre Hospitalier Universitaire Caen Normandie. Available at: https://www.chu-caen.fr/ (Accessed: 07 September 2023).
  • France Health System Information (no date) World Health Organization. Available at: https://eurohealthobservatory.who.int/countries/france (Accessed: 07 September 2023).

By: Indriani Putri Paramitha