Monday, April 25, 2011

International Medical Elective In Thailand

My good friend and Chief Resident just did an elective in Bangkok, Thailand. She is someone who very much embodies what HOSPITALstyle is all about; class, professionalism, healthcare lifestyle, and all around good doctoring. She shares her amazing experiences with us. A bit longer than the usual post, but well worth the read! This is what she writes...

ENTER DR. JULIA SUN LEE-
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Buddha at Ayyuthaya
Being in a four year emergency medicine residency program has its benefits, despite what naysayers might have to offer. One of those benefits is being able to schedule electives into your curriculum that are catered to your interests. Luckily, for me, I was able to set up an international emergency medicine rotation in Bangkok, Thailand at Mahidol University, Ramathibodi Hospital during my PGY-IV year. This came as a follow-up to my PGY-III year elective rotation at Nahr-Bita Hospital in Ghana, West Africa.  

Having a background in Public Health with a focus on Global Environmental Health, I felt that taking the opportunity to schedule a few international electives during my residency training would afford me an invaluable resource in allowing me to connect clinical pathology with what I had learned in my textbooks.  Not only that, but I was able to travel halfway around the world to practice medicine, interact with the locals and cultivate my experiences with the cultures I had previously only read about.  

It was truly a life-changing experience, and one that I would recommend to all who have the chance to do so. 

Ramathibodi Hospital
  This past April, I spent a month working in the Accident and Emergency Center at Ramathibodi Hospital in Bangkok, Thailand. The purpose of my elective was to witness the development and advances of the Thai emergency medicine residency program, which is only 5 years old, and to learn about the patient population & pathology that fills their ED.  

After a very long flight with very little sleep, I ventured into the wards of the unfamiliar hospital, confused by the writing and the dialect that awaited me. 

I was surprised to find out that most of the Thai residents and attendings spoke English of varying aptitude, and every single one of them were willing to translate or explain the Thai charting/documentation and presentations to me.  Lectures were often presented in Thai, but written in English allowing me to follow the topics easily. 

Ramathibodi Hospital
The hospitality of the residents and staff was almost overwhelming: from taking me to pray at the Buddhist Temples in the city of Ayyuthaya, to a night time venture in Yaowarat (the Bangkok China Town), to the numerous medical procedures done in the ED – everyone was always helping me to understand their approach and keep me a part of the team. 

I was able to attend their Simulation Labs, perform bedside procedures, run microscopy tests, visit the Thailand Red Cross Center and Queen Saowapha Memorial Institute, (formerly the Pasteur Institute) Snake Farm where anti-venin is harvested.  



Dr. Julia Sun Lee (third from left)
I experienced the Thai culture, not as a tourist, but from a Thai native’s perspective and in this setting, it was quite easy to form friendships quickly in such an environment. After only 2 weeks, a first year resident invited me to her moonlighting job on the weekend where she worked as a single coverage physician at a beach hospital in Koh Larn, an island off the coast of Pattaya. I was also able to visit another hospital in the southern region of Thailand on the island of Koh Phi Phi off the coast of Phuket right after the major flooding in South Thailand. 

I met residents and medical students from all over Thailand as well as Japan. I learned about their medical system and pathway of medical education and was invited to share with them a presentation on the US structure of emergency medicine residency and delve a bit into fellowships offered in our specialty.


The experience I had during my overseas travel was absolutely incredible. It allowed me to see how emergency medicine is practiced in different settings around the world, often in areas of diminished resources and funding as compared to the US. 

It also allowed to me to appreciate the quick availability of our resources that we have here, but causes me to step back a bit when approaching my patients. “Is that CT scan really necessary?”, or “What will that blood test tell me that I can’t already determine from the physical exam and history?”, I’ll find myself thinking. Of course, ours is a different setting and the dynamics of our approach to each patient is subject for another article. 

Ramathibodi Hospital. Bangkok, Thailand
What I got from Thailand was for greater than what I gave. I travelled across the world to help people, but I believe I was the one who received the most. 

I had an invaluable experience that enables me to catch a glimpse into lives that are so different than mine, but share in the same basic needs and emotions, which define the human condition. It gave me the chance to reconnect with the reasons why I went into medicine in the first place…something that often seemed remote back in Brooklyn when I was seeing the patient brought in for alcohol intoxication the third time that month complaining of leg pain and demanding a sandwich.

Having done my overseas electives, I now know that travelling abroad and providing medical care to those in need outside of the US will be a integrated part of my stateside medical practice in the future.  Being able to incorporate international settings into your medical education broadens your mindset and allows you to cater your residency experience to what you are most interested in.   

You’ll be able to form life-long friendships and expand your global network. Not to mention, the food, travel and stories you collect along the way are major bonuses – something you keep with you for life!
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EXIT DR. JULIA SUN LEE

Julia- Thank you so much for sharing your amazing experience on HOSPITALstyle.
If you would like more information about setting up a Thailand elective, send and email to HOSPITALstyle@gmail.com.