IN THE THEATRE
Dr Robert E. Gross once stated in his textbook entitled The Surgery of Infancy and Childhood: “Those who daily operate upon adults, even with the greatest of skill, are sometimes appalled or certainly are not at their best when called upon to operate upon and care for a tiny patient. Something more than diminutive instruments and scaled-down operative manipulations are necessary to do the job in a suitable manner.” It is important to note that surgical trainees often approach the paediatric surgical patient with trepidation and fear. Importantly, these same trainees typically complete their paediatric surgical rotations with profound respect for the resilience of young children to undergo complex operations, and with an appreciation for the precision required from their caregivers, both in the operating room and during the perioperative period.
It was a Wednesday morning and I had just arrived at the corridor of Evelina London hospital building (Level 2) where I came across the receptionist. She was a beautiful lady from Zambia but have lived most of her life in the UK. With a broad smile, she asked if I was the medical student from Sierra Leone and I nodded, yes! She continued stating that one of the doctors had left a message for me to scrub into theatre that day. The operating room (OR) was situated on the ground floor (named as Reef Theatre). I quickly grabbed a scrub suit and jumped into the elevator down to Reef 2. I felt very anxious as I had wanted to see how amazing the theatre looked like. Upon arrival at Reef, they were preparing the patient for anaesthesia and my consultant told me to observe the intubation procedure. I observed keenly taking note of every step and asking as many questions as I could. The operation started and lasted for well over 30 minutes. We were closing a colostomy on a 2 year old girl. It wasn’t the most extensive of surgeries but it was great for an introduction and as I had another 3 weeks left on this elective (Paediatric Surgery) placement and I’m looking forward to many more experiences in the OR. One of the scrub nurses warned me: ‘make sure you have some breakfast before coming to the theatre.’ I never realised what she meant until the day I spent 5 straight hours in the OR, with an empty stomach. So many good memories of my time in the OR. I remember the first day I saw a heart beating through a foramen (of Morgagni) during a diaphragmatic hernia repair in a neonate. It was a very extensive operation performed by one of the consultant Paediatric surgeons, Mr Yardley. On diverse days, I spent them in the OR learning procedures and observing surgical treatments of different disease conditions in children. Some of the procedures I saw included: anorectal manometry, colonoscopy, Bronchoscopy, Laparoscopy and many others. The surgeons at Evelina were very knowledgeable. I could still remember Dr Kufeji explaining to me the dangers of reducing a Gastroschisis. She explained that care must be taken to prevent increased abdominal pressure during the reduction, which will lead to compression of the inferior vena cava, renal compromise, and abdominal compartment syndrome.
Aside from my clinical encounter, I also took time to follow opportunities on the KCL website where I signed up for some seminars and other meetings at Guy’s campus. I was present at the KCL (FoLSM) Inaugural lecture series where I got the chance to hear from King’s newly elected Professors, all of whom have made significant contributions to education and research at a very highest level. I learnt a lot about the significance of research and clinical academia.
On a different occasion, I also attended a journal club meeting. This was an interactive club for all students in the sciences wishing to interpret scientific literature and think critically about science and medicine. Part of my plans is to introduce a journal club in COMAHS which I hope to achieve with the little ideas that I gained from the meeting.
I followed a lot of events online. I was also fortunate to attend the Royal Society of Medicine training on Heart Failure and Cardiac imaging. It was a lecture event for doctors but I took the chance in order to gain some inspiration and interact with senior colleagues in the medical profession. It was truly an educative and inspiring event for me.
Traveling to London for my medical elective was one of the most glorious experiences in my life. To see the world and interact with health professionals from the advanced part of the world is a great feeling. I have to say here that I was amazed by the people I met, the atmosphere and of course the food I ate. London is a beautiful place with diverse culture. I didn’t have the time to see everything but was fortunate to visit a few places: London Eye, London Tower, Buckingham Palace, Westminster Abbey, Monument, St. Paul’s Cathedral, British Museum to name a few. Even though it was my first time in London, I certainly didn’t find it that difficult to get around the City, many thanks to Google Map (and Citymapper mobile App)! Living in London is quite expensive so it is always good to prepare well before making the trip. We had to arrange accommodation for ourselves and this is one area I think KSLP can help future students with. Providing support letters for fundraising can be an option.
During the weekends I visited family members and old friends and sometimes I went to the Pub, restaurants and parks. I joined Paddy to see my first live cycling event on one of the weekends at Lee Valley Velopark. It was always a great time going out with Paddy because I’ll meet new friends and make more contacts. My consultant and all the doctors I encountered at Evelina were very accommodating. Throughout my placement they have given me the chance to learn from them. The KCL staffs at the elective section were very helpful as they always provided us with prompt information that is needed and everything else went on smoothly. Towards the end of my stay, I also visited the KSLP London office (Global health office) where I met Molly and Max. Molly and I spoke about my experience in London; what was different and the areas they could improve on for future students. We also talked about my student involvements in Sierra Leone. As I happen to lead the medical students’ association, we talked about some of my immediate plans and the areas they could render support when I get back home. I enjoyed the meeting; we had coffee and took pictures in the end.
ADVICE FOR FUTURE STUDENTS
Undertaking your electives in the UK is not only appealing but also the chance to learn and see a whole new side of medical training. During your placement with KCL, you will face many opportunities so make the most out of it. Below are few recommendations for future students to have smooth and great time, based on my experience:
1. During your preparations for your trip, make sure to read about the UK and the hospital you have been placed for your electives. If you have been told who will be your supervising consultant, make sure to contact them beforehand. This will help you in planning and setting your goals and objectives.
2. Have all your vaccinations and lab tests completed; Hepatitis B and all other records of immunisation including a CXR (to show you are free from TB).
3. Visa processing can be daunting, so make sure you apply as early as possible, probably 3 months before the start date of your placement or as soon as you receive your Confirmation of Acceptance for Studies (CAS) information. And before applying for the Visa, read thoroughly the UK Visa application guide (or Guide-toEntryClearance-form) which you can get online. Ask for help from colleagues that have gone through similar process.
4. Whilst in the UK during your placement, do not limit yourself to opportunities in the hospital. Always visit the KCL website. There are many learning opportunities you could sign up for including seminars, workshops, journal club meetings and the likes. But always make sure you take excuse from your supervisor or more so go during your free time.
5. Finally, do a reflective report of your elective placement. This will serve as a feedback to your supervisor, so make sure you reflect honestly about your experience; be it positive or negative.
Firstly I thank God for keeping me safe throughout my elective period. I would like to thank KSLP for providing me the opportunity to undertake my medical elective in the UK. I’m also grateful to Suzanne Thomas for her patience and great administrative support during preparations for my trip.
I would not have had a great experience in the UK had it not been for Patrick Howlett. I’d like to thank him immensely. I would also like to thank my friends particularly Waheed and Foray for always been there for me. Nothing I’d do without support from my family: my parents, brothers and my one and only little sister, Kadija. Lastly, I’d like to express my gratitude to my supervisor, Dr Kufeji for all the lessons and mentoring and also to Dr Neeli and Dr Hemanshoo and all the other doctors that helped me throughout my stay at Evelina.
MOHAMED BELLA JALLOH
Final year MBChB Student
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