Clerkship Experiences 2022
Claudia Peretó - San Raffaele Hospital in Milan
Hello! My name is Claudia Peretó and I am a medical student at UPF-UAB and Hospital del Mar (Barcelona). From April to the end of June I have done my Erasmus at the San Raffaele Hospital in Milan, specifically in the Department of General Surgery under the direction of Prof. Riccardo Rosati.
San Raffaele Hospital is an internationally renowned university and research hospital associated with the Vità-Salute San Raffaele University, a fully private university that is part of the Gruppo ospedaliero San Donato, the largest hospital group in Italy. In addition, the hospital has received a significant increase of interventions in oncological surgery associated with the digestive system, becoming the first Italian center for esophageal surgery since 2015.
During my internship I observed a large number of surgical procedures (including adrenal gland surgery), mostly associated with esophageal, stomach and colon cancer. I learned a lot about these oncological processes, the most frequent surgical techniques, as well as the characteristics and treatment of inflammatory diseases affecting the digestive tract.
On the other hand, I would like to highlight esophagectomy, because I had the privilege of seeing and learning how this complex surgery is performed by the General Surgery team and Prof. Rosati, who has an extensive experience in open and minimally invasive surgery of the digestive tract, and for this reason, this intervention is only performed in very few centers in the country.
In addition, I also had the opportunity to go to the hospitalization floor and the outpatient clinic, where the follow-up and treatment of the surgical wounds of the patients after surgery were performed. This is the reason why during the internship I appreciated the balance between the surgical and the clinical part.
Apart from the internship at the hospital, I have had an incredible experience on a personal level because this opportunity, given to me by AQG, has allowed me to travel around Italy, make new friends, see incredible landscapes, learn Italian, as well as enjoy the wonderful culture and the delicious Italian gastronomy. It has certainly been one of the best experiences of my life!
From my point of view as a student, doing an internship in another country is a great experience that offers the opportunity to grow academically, get to know another health system and explore another country, as well as live unforgettable experiences.
Alex Godó Jiménez and Pelayo Aguilera Fernández - Kings College of London
As part of the goal of expanding the interest of medical students in fields of surgery, there is great potential to the opportunity of travelling to other parts of the world and learning about different approaches to surgery. In oder to provide this opportunity for some of our students, we were able to set up an exchange with King’s College London Surgical Society, by which three KCL students and two AQG students travelled to our respective hospitals in order to take part in a two week intensive rotation at their specialty of choice.
This experience was incredibly enriching for the students involved, allowing them not only to expand their knowledge and interest in medicine and surgery, but also to immerse themselves in a new environment. Some of the strongest points in the program, according to the participating students, were the kindness and inclusivity they experienced at their host hospital and the wide range of surgeries they were able to observe.
This exchange was an amazing experience for everyone involved, as well as a big opportunity for AQG and KCL Surgical Society to build bridges and expand internationally. It would have not been possible without the support of Dr. Manuel Pera and Dr. Chandak Panjak, whom we thank dearly.
Here is a small paragraph recalling the experience from some of our participating students:
“Travelling and pursuing a career as a doctor has always been my ultimate goal. Spending 2 weeks at the beautiful Hospital del Mar, Barcelona was amazing. After taking a year out to complete a research Master’s, I fell back in love with medicine! I chose OBGYN for its unique combination of medicine and surgery. Most of my time was spent in the operating theatre watching hysterectomies to remove cancers. I also got a chance to use a state-of-the-art robot to help the surgeons with their laparoscopic procedures, sit in on consultations and gained interesting insights into the Spanish healthcare system. I recommend anyone wanting to undertake some experience abroad to take the leap! You do not have to wait until your elective to learn what other doctors are doing across the pond”
“I have spent an amazing time during this KCL-AQG 1st edition exchange! I have been so welcomed by the Neurological Surgery Deparment, I have learned a lot during this twoo weeks and also I spent some time visiting the city. I would 100% recommend this experience to the every medical student eager to learn how other healthcare systems works”
“I am very grateful for this unique experience, not only I got the chance to see all the varied and different procedures plastic surgeons perform on their daily practice, but I also had the incredible opportunity of living in one of my favorite European cities: London. The exchange was enriching in so many ways! I want to give a big THANKS to all the amazing, kind and so talented people I met during my stay. And to the reader, if you ever have the chance to do clinical rotations outside your country, don’t doubt for even a second and take it!”
Marta Victoria Alvarez Yustes -Karolinska Institutet
Karolinska Institutet is one of the most famous and foremost research centers in Europe. It has been ranked as the 5o best medical university in the world by QS Top Universities. It features research areas in cancer, hematology, cell, molecular and structural biology, endocrinology, neuroscience, developmental biology, healthcare sciences and aging. The institution selects the laureates in the Nobel Prize in Physiology and medicine each year.
I had the opportunity to stay in the Övre Buk department, upper gastrointestinal department, for two and a half months. The group is formed by 4 surgeons or kirurger, nurses or sjuköterska, läkare residents and students. Their main focus is on gastric and esophageal cancer. Nonetheless, they also treat achalasia, hernias, inflammatory, genetic diseases and other acute procedures. They also work with dietists and palliative doctors and nurses. Furthermore, they have consults with other specialists, such as plastic surgeons, urologists, digestologists, endocrinologists, nefrologists...
My day to day on the team started with the ward round. The team would discuss each patient individually: the lab results, the results of any imaging the patient may have had… After the discussion, we would visit each patient and interview them each day regarding new symptoms, their feeding schedule, any worries the patient may have...
Following, the surgeries would begin. On Mondays and Wednesdays the smaller surgeries would take place. In these days they would perform esophagus dilations, stent placements, acalasia interventions, eso-sponge placement... On Tuesdays and Thursdays the big operations would happen. The main operation would be total or partial gastrectomies, esophagectomies, hernia repairs, CPRE, fistula reconstructions... Apart from that, some of the surgeons would have a clinic in the afternoon or morning. In the clinics the patients would come for a first visit, a follow up after a big or small procedure.
In spite of these scheduled interventions, every day there was a doctor on call. That meant that he/she had to take on every acute surgery that may come to the emergency room; such as esophagus perforations, self-injury incidents like bleach ingestion...
One of the most interesting skills I was able to develop during my stay was the ability to do ultrasounds. I learnt how to do a basic gallbladder ultrasound in which I would look for gallbladder stones or other signs of blockage of bile flow. Another kind of ultrasound I learnt was the E-FAST examination, it is a protocol designed to detect fluid (peritoneal or pericardial), hemothorax or pneumothorax. The FAST examination is divided in 4 sections: perihepatic, pericardia, perisplenic and pelvic. And the E-FAST includes the anterior and lateral pleural spaces to evaluate hemothorax and pneumothorax.
I was also able to improve my basic surgical skills. They let me scrub in many surgeries. In some laparoscopic interventions they let me control the camera. On others I could practice my stitching techniques and other times I was able to staple the main incision.
Furthermore, on the ward rounds I had to do physical examinations and anamnesis to most of the patients. In general surgery it is important not to focus just on the gastrointestinal system but to take into consideration the body as a whole. The upper GI interventions can cause many complications that might involve other systems in the body such as pneumonia, diaphragmatic hernias, abscess, fever without source..
Apart from my day to day at the hospital, I feel like a very important part of my erasmus experience has been getting to know another culture, Sweden.
In Sweden, they value tranquility, nature and self time, whilst in Spain we tend to be more outgoing, have parties...I would want to point out the way they preserve nature. Near Stockholm city, the capital of the country, there are a lot of natural reserve. Some are as big as the city itself. One of my favorites was Tyresta. This encourages people to go more outdoors and be in contact with nature. Which can help not only to appreciate it but also has a benefit in people's mood.
I would like to finish this memoir by encouraging every student in Europe who has the chance to live this experience. It has been life changing to develop new relationships that allowed me to learn from different cultures and backgrounds. You develop a more open mind by listening to other people's opinions in a different environment than the one you are used to. Also you get to learn how hospitals work in other countries and you value how things are done at both places. It is the perfect combination of learning experience and personal development.
Spring semester 2022
Lucía Pastor and Adrián López - St. James’ Hospital of Dublin
Hello! Our names are Lucía Pastor and Adrián López. We have been members of the Gimbernat Surgical Society throughout our whole career in Pompeu Fabra University, and we have done a surgical clerkship inside the Erasmus program in the St James’ Hospital of Dublin (Ireland).
Our ten week experience in the Upper Gastrointestinal Surgery Unit, under the supervision of Prof. John Reynolds, has been really profitable since we have not only learnt new concepts about gastrointestinal surgery but also practiced our skills in theatre.
Some of the tasks we were involved in our daily week were visiting patients in morning rounds, taking histories and examining patients, learning and participating as second or third surgeon in some common general surgery procedures, such as laparoscopic scholecistectomies and inguinal hernia repair, and also some more complex ones including oncologic surgery, esophagectomies and gastrectomies. We have broadly improved our suturing technique as well as starting to feel more comfortable in the surgical area.
Our experience has been sharpened by an extraordinary team who made us one of them since the first moment, and let us participate in many parts of the patient’s medical assistance.
On the other hand, we made met really nice irish people and visited many places from the lovely city of Dublin. And also, it was even a nice opportunity to improve our English!
Without any doubt, we recommend taking part in international clerkships like this. We would finally like to thank Prof Manuel Pera and the Gimbernat Surgical Society for organizing this incredible opportunity.
Spring semester 2022
Joana Clivillé Pérez - Beaumont Hospital; Dublin
Hi! I’m Joana Clivillé Pérez, a human biologist and a 5th year medical student. I have just come back from Dublin and I’m already thinking of going back. I spent three months doing an internship in the surgical Upper Gastrointestinal unit of the Beaumont Hospital, and I couldn’t have been happier with Mr. William Robb and his team. I was so comfortable with the country and the people, that I decided to stay in Dublin for the summer to work as a Healthcare Assistant!
Beaumont Hospital is located at the North part of Dublin and it’s associated to the Royal College of Surgeons in Ireland (RCSI), one of the best Medical universities in Ireland. Complementary to my rotation in the Upper GI team, I could attend voluntarily to many seminars and lectures that were so useful to review multiple medical concepts and, indeed, I met several medical students with who I still keep in touch quite closely.
From the very beginning, the team welcomed me as one more of them. Apart from teaching me surgical concepts, I took active part in all the surgeries we had, such as esophagectomies, cholecystectomies, hiatus hernias, appendicectomies, GIST extirpations, etc. During all these surgeries, I could learn how to use the laparoscopic instruments by performing small parts of the surgery such as introducing the gallbladder into the laparoscopic retrieval pouch and, of course, I improved my suturing skills by closing the surgical wounds in every surgery.
Likewise, I could also learn transversal skills that in our country are usually performed by the nurse team, such as withdrawing bloods or introducing urinary catheters or nasogastric tubes.
Apart from going to the theatre three days per week, I also attended the morning ward rounds every morning at 6:45am, multidisciplinary team meetings and some endoscopic procedures. One of the things that surprised me the most is that in Ireland, the vast majority of the hospitals work with charts instead of computerized clinical data, so I had to adapt to a completely different type of working modality.
One day per week we had outpatients clinic. After a couple weeks shadowing, I started visiting patients by myself, which was not only a big responsibility but also a great chance to improve my communication skills.
Last but not least, I had time to go out almost every evening and meet people from all over the world that nowadays I can call best friends. During the weekends, we used to travel all over Ireland and discover all the stunning landscapes it has to offer over a pint of Guinness.
I can’t be more grateful for the opportunity that Dr. Manuel Pera offered me. I joined the Gimbernat Surgical Association when I was at my first year of Human Biology, so I’ve taken part of it 7 years now, and it has probably been the best decision I ever took in my university life as it has brought me not only superior surgical skills, but also a huge network of colleagues, friends and experiences that I will never forget.
Clerkship Experiences 2019
"Hi! I’m Miriam Cazador, a 6th year medical student at Hospital del Mar (Barcelona) associated to UPF-UAB. I spent last July doing an elective abroad at St James Hospital in Dublin, for one month I was able to live the everyday of the surgical Upper Gastro-intestinal Unit, under the supervision of Prof. John Reynolds."
St James’ is one of the largest university teaching hospitals in Ireland, which is associated to Trinity College. St James’s Hospital also is the national centre for oesophageal and gastric cancer in Ireland, therefore there are a large amount of cases and it is a very busy team.
My schedule included many different activities such as ward rounds, endoscopic procedures, multidisciplinary team meetings, clinics and surgery. My favourite days were Monday and Friday, because they were Surgical theatre days. I could scrub in at almost all surgeries, being first and second assistant at open and laparoscopic procedures, and even doing some stitching at closures!.
I am very happy for the fact that I could learn about oesophageal cancer and see many esophagectomies, procedure which is centralised to be performed by a few hospitals (by a team of experts), and is not performed at Hospital del Mar. I want to thank Dr Manuel Pera for making possible that I lived this huge opportunity and, also thanks to Prof John Reynolds, who is a distinguished surgeon with a considerable experience in surgical, academic and research fields who welcomed me on his team.
Besides the academic activity, I also had a great opportunity to discover Ireland, with its great history, traditional culture, incredible natural landscapes and warm people (among them, a few medicine Trinity College students, with who I became friend).
I joined the Gimbernat Surgical Association on my 2nd year of medicine degree and became part of the organising committee on my 4th year. Since last year I am part of the Directive Committee of the Society as I am especially interested in surgical specialties.
As student and a member of the Society, I consider the possibility of doing a surgical elective abroad one of the strengths of the Society and a great opportunity for learning while you are enjoying and discovering a new country and his Health System.
"Hi! My name is Victoria Puchades and I’m a 5th year medical student. I had the opportunity to undertake a clerkship at the Royal Surrey County Hospital in Guildford (Upper-GI Surgery Unit).
It has been a great experience. During my clerkship, I was able to see different aspects of an upper-GI surgeon’s job.
I spent time in clinics, theatre, guard changes and ward rounds, as well as endoscopies.I was able to scrub almost in every surgery and sometimes to help a little bit.
I consider that I have learnt a lot during my clerkship, especially with Dr. Shaun Preston and Dr. Rodrigo in theatre during the weekly esophagectomy.To discover a different health system was really compelling, I learnt a lot about the NHS England (National Health Service) and its functioning.
During the weekends I was able to travel around England and explore new places such as Oxford, Brighton or London.
Erasmus Experiences 2019
"Hi everyone! We are Miranda and Sílvia, two 6th year medical students from UAB-UPF. During the last term, as a member of the Gimbernat Surgical Association, we were given the opportunity to spend 3 months abroad in Erasmus with Professor Thomas N. Walsh, a renowned upper GI surgeon who works in 3 different hospitals in Dublin. "
Professor Thomas N. Walsh is an excellent surgeon and teacher. He was very kind with us and he organized a wide ranging schedule. We were mainly in Connolly Hospital but we also went with him to The Bonsecure and Hermitage Hospital. We also spend two whole weeks at the Emergency department, where we improve our communicative and physical examination skills.
As part of the team, we scrubbed and assist in major and minor surgeries, attend to the meetings and ward rounds, help performing endoscopies, go to multidisciplinary meetings and to outpatient clinics. We really improved our surgical skills! This training allowed us to know better how is the day life in a surgical specialty, something very important to make a decision in the future.
Apart from that, we also had time to travel a lot and get to know Ireland, an amazing country with warm people and amazing landscapes. We will come back for sure!
With no doubts, we recommend you this opportunity offered by AQG, for us it is been an unforgettable and enlightening experience.
"Hi! I’m Mar de Pablo, a 6th year medical student at UAB-UPF. I’ve had the opportunity of staying 3 months at the Upper-GI Unit, under Professor John Reynolds at St James’s Hospital in Dublin. "
The hospital is in association with Trinity College Dublin and is the national center for oesophageal and gastric cancer. I am lucky because I have learnt a lot while feeling completely part of the team. I could take part in many different activities: ward rounds, endoscopic procedures, multidisciplinary team meetings, outpatients clinics and major and minor surgeries. At ward I was capable of assisting and following the patients like one intern more, and at theater I could assist in the surgical procedures.
Apart from the academic activity, I had time to discover Ireland, an amazing country full of incredible landscapes and warm people.
I would strongly recommend this experience, and I am happy to be contacted if further details are needed!"
"Hi! My name is Eva Alberch and I have just finished my 5th year of the degree in Medicine. During the last term, I had the opportunity to do a placement at the Royal Surrey County Hospital in Guildford, specifically at the Upper-GI Surgery Unit under the mentorship of Mr. Shaun Preston. He is one of the most skilled European surgeons, not only in the surgical treatment of oesophageal cancer, but also in laparoscopic surgery. "
For 10 weeks, I had the chance to experience the daily work of a surgeon. I could daily attend to the guard changes and ward rounds, as well as to outpatients’ clinics, endoscopies, MDTs (Multidisciplinary Team meetings) and M&M (Mortality and Morbidity) meetings and the annual general meeting. However, what I enjoyed the most was the time I spent at the theatre, where I was able to scrub up and assist from the first day in all the surgeries. I was even given the opportunity to put the pleural drains and cut the rib in the oesophagectomies!
Mr Preston was very kind with me and he organised a wide ranging schedule so as to see as many different surgeries as possible. I used to attend to either Hepatobiliary and Colorectal surgeries once a week, in which I was also able to scrub up. Moreover, I spent two whole weeks at Breast Surgery Unit where, not only I could attend to breast surgeries, but also to clinics and some radiology and minimal invasive procedures.
Finally, this training let me understand the organization of a foreign health system, the NHS, and familiarise with its way of work.
The integration in a new team and hospital with a different language was a challenge for me, but I was lucky to meet a team in which I felt welcomed from the very beginning. I have no doubt that it was one of the best experiences in my life from both academic and personal point of view. This is the reason why I would strongly encourage any medical student interested in surgery to go abroad and live it.