Desember 12, 2023

Global Perspective of Medicine: A Journey of My Medical Electives in Faculty of Medicine Ramathibodi Hospital, Mahidol University Thailand

As a medical student, the medical electives experience is one of the most meaningful moments in my medical life. For me, this trip was not just an academic assignment, but a real adventure that opened the door to the world of medicine.  It was a wonderful opportunity and experience for me to be able to travel to other countries to study medicine. This article is my personal memoir of the medical elective, a new journey that offered a unique experience, a global perspective, and a journey I will never forget.

The Faculty of Medicine Ramathibodi Hospital is an integral part of Mahidol University, located in Bangkok, Thailand. It is known for its commitment to medical education, cutting-edge research, and healthcare services. Elective students can engage with clinical cases, medical professionals, and healthcare practices so as to enhance students’ practical skills, broaden their clinical exposure, and foster a global perspective on healthcare.

I chose 4 weeks for this elective program, starting from the first and second week in the critical care medicine (ICU) department. We elective students from abroad were warmly welcomed by the staff to the doctors and residents who assisted us.  In this department we observed and evaluated patients for 2 weeks. There were many medical cases that I got here, including pneumonia, COPD, CHF, Sepsis, ARDS, and many more that I can’t mention one by one. We also had the opportunity to see and learn about the procedures that are often performed on ICU patients such as how ventilators work, bronchoscopy, ultrasound, X-ray, CVC, Intercostal Drainage, and so on. The staff, medical students, doctors, residents, and supervisors did their best to give us easy explanations regarding the patient’s actions or cases. Several times we also had small discussions related to complicated patient cases in the ICU. ICU is a place where critical things come, teaching me many things, from observing monitor charts attentively to feeling the urgency of every medical decision made. Every day brings new stories, new challenges and new knowledge. I am not only learning about complex medical practices but also gaining a global perspective on the health challenges here. Having the opportunity to share insights with medical staff in the ICU opened my eyes to diversity in the context of healthcare.

Two weeks have passed, it’s time to share experiences in a different department, emergency medicine (ER). The activities carried out in ER are very diverse. Not only observing in the emergency room but we can do activities with doctors, residents such as attending conferences, emergency simulations, workshops, and field trips.

On the first day we were given an explanation related to management in the ER, then went around to find out the rooms that we could later observe because the emergency was quite crowded and limited so not all of us could observe at the same time. We got the opportunity to visit an affiliated hospital which is quite far from Bangkok with a trip of about 1.5 hours, namely Chakri Naruebodindra Hospital. The purpose of our visit was to learn about the medical campus and the technology used there. Then, we simulated emergencies for cardiac and obstetric patients by being given a case and we as elective students did a primary survey and secondary survey for the patient. We also had the opportunity to perform ECG and ultrasound and interpret them. Another activity that provides enough knowledge is attending conferences. During the conference we were able to listen and learn about emergency related material. One of the materials discussed is the Mass Management Pre Hospital Conference, which discusses activities, medical transfers, weather and conditions while there, population, medical team, the nearest hospital to the place, regulations, risk assessment, and medical treatment. Another resident activity that we participated in was spot diagnosis, which is knowing emergency cases by guessing systematically starting from diagnosis, differential diagnosis, treatment, and patient management. Observation was also part of our activities. We did it in the examination room where we could see patients coming in with various complaints and doctors providing treatment and conducting examinations systematically and responsively. While in the examination room, I was able to apply my clinical skills during preclinical here because the examination was not much different. The next activity was the ambulance workshop where an explanation was given regarding the zone and observation room. Then we explained some of the equipment and drugs that are carried and are in the ambulance. Then, we had a brief discussion related to patient cases using the ambulance. On the last day of the elective, I had the opportunity to do a field trip to the snake farm to learn and know the types of poisonous and non-poisonous snakes and how they affect the human body. Then, we had the opportunity to find out how snake fluids are extracted through saliva and learn about antivenom which is important in Thai medicine.

In Emergency Medicine, I was given the experience of entering a high-pressure environment where I was immersed in the medical reality. Every moment counts and decisions must be made quickly and appropriately.

During the 4 weeks spent in Thailand, I did not just get an academic achievement, but a process of building my personal character. As a future medical professional, I will take this valuable experience with me on my future journey in the world of medicine in Indonesia. Medical elective is not the end, but the beginning of a long story that continues to grow.

By : Nahdah Aulia Aziz