The elective is one of the things I looked forward to most before I started medical school. It is a program which allows medical students to experience healthcare settings anywhere around the world in whichever specialty. Most medical schools offer a month to even 6-month rotation for students to experience the world and different specialties of choice. Although most medical schools have their elective scheduled in final year, my medical school offered this at the end of fourth year. This had its advantages and disadvantages – it was good that I could end the long and dreaded fourth year with an exciting elective experience but there weren’t many places available for me as a lot of them required completion of core rotations!
Although it differs from school to school, I had to submit my elective location by the end of November. I started my research early at the start of fourth year as I already knew where I wanted to do my elective – in America. Unfortunately, not many places were open due to Covid, especially for a surgical rotation. I eventually applied to the Florida International University visiting medical student programme and obtained a position in general surgery for a month.
After submitting malpractice insurance, transcript, and letter of recommendation (truly a long and tiring process), I finally got a confirmation email stating my elective location which was at Hialeah Hospital. Hialeah is in Miami and boasts its cultural diversity with many Cuban immigrants. Naturally, a lot of patients spoke Spanish as their first language and Spanish was used widespread in the hospital as well. Although I learnt Spanish during high school for three years, I still struggled to follow some jokes and comments in the hospital due to this language barrier.
My preceptor was Dr. Jose Lamas, a general surgeon who has practiced in this field for more than 40 years. On days where he had outpatient clinics, I shadowed other surgeons in Hialeah Hospital such as Dr. Werner Andrade and Dr. Raul Mederos who are experts in Bariatric surgery. One other medical student from Shanghai and three other medical students from the Caribbean medical school were also rotating in the same specialty which was an intriguing as I had the opportunity to learn the medical education system in their respective countries through discussion.
My daily routine was as follows:
06:00- Wake up.
08:00- Check the board to see the surgery listing. Decide among medical students who wants to scrub into which surgery and read up upon relevant topics.
08:30- Scrub into surgery and receive teaching in between surgeries.
13:00- Grab a quick Cuban lunch at the hospital cafeteria.
16:00- Help surgical technicians finish the last patients.
20:00- End of day (Depending on list).
During my rotation, I had a chance to visit the surgical pathology team within the hospital and observe the next steps following surgical resections of specimens. It was interesting to see how carefully the pathology team would check the margins and notify the surgeons whether additional resection was needed or not. Every Friday, I also had the opportunity to observe and assist in endoscopy/colonoscopy procedures with Dr. Andrade who would pose some challenging yet intriguing questions to stimulate our clinical judgement skillset! We also had a chance to play around with the DaVinci robot and experience first-hand how robotic assisted surgeries allowed for a better view of the surgery and provide surgeons with an extra hand compared to when the surgery is done laparoscopically.
The elective allowed me to experience the American healthcare system and made me look at the NHS with a more critical eye. Both healthcare systems have its pros and cons. For example, before experiencing the system, I always associated NHS with a long waiting line, but I realised that it is still the same in US even with private healthcare. However, I was amazed to see how the US was faster in adopting new technologies that may complement healthcare, possibly due to being privately funded.
On weekends I explored the city with the other medical students. Miami was a nice area to visit in May with South Beach (SoBe), Key Biscayne, and Brickell being one of my many favourite places. If you’re the type of person who enjoys good food, these places are also fantastic places to expand your taste buds!
All in all, it was a wonderful opportunity as a student who was born and raised outside of the UK and USA to experience both healthcare systems. I would fully recommend applying to elective programmes in specialties that you are interested in or in countries that you potentially want to move to in the future.
Finally, through this experience I made some amazing friends from all over the world. I am especially thankful of meeting XingJie, Katie, MJ and Raj who were also doing their general surgery rotations at Hialeah hospital. I would also like to thank the Hialeah Hospital staff who were very welcoming and allowed me to experience many different things.
Seunghee Han is a final year medical student at University of Birmingham with an interest in plastic surgery and surgical innovation. In her spare time, she enjoys travelling, going to the gym, and watching musicals.