1. lékařská fakulta Univerzity Karlovy Univerzita Karlova
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Malta 2008

IFMSA REPORT – JONATHAN MENON 6TH YEAR MEDICAL STUDENT LF1.UK

PLACE OF EXCHANGE: MATER DEI HOSPITAL, MSIDA, MALTA

DATE OF EXCHANGE: JULY 01, 2008 JULY 31, 2008

Having successfully passed the IFMSA examination in December 2007 I decided to choose Malta as my destination for exchange. My reasons for picking Malta were three fold. The first is that Malta is an ex-Brithis colony and I welcomed the opportunity to speak to patients in English. I felt this would allow me to improve my communication and interview skills with patients in my mother tongue. The second reason was that the Mater Dei Hospital is in fact the most modern hospital in Europe. It officially opened on the 29 June 2007. It serves the whole country and has 825 beds and 25 operating rooms. The third reason was to visit a country with a lot of sunshine.

When I arrived in Malta I was greeted at the airport by one of the local Maltese students who would then continue to look after me and the group for the remainder of the month. I was taken to my accommodation late in the night and met my following flat mates the next day. The accommodation was reasonably good. The exchange students lived in apartments which were located only 10 minutes walk from the hospital. Most of the apartments were modern and provided cooking facilities, shower facilities etc…. In fact the flats were private residencies hired out by the IFMSA Malta organization for the incoming exchange students. I roomed with five other flat mates from various countries.

The first day was spent sorting out administration in the hospital. Students were required to carry identification at all times and dress accordingly in the hospital. This meant smart attire – shirt, trousers and respectable shoes. The identification cards also entitled exchange students to food in the hospital canteen. This consisted of only a sandwich which was rather disappointing especially as warm food was prepared in the same canteen. During the first day I also met the consultant who I was attached to in the hospital. I was attached to the Obstetrics and Gynaecology department (O&G) and I met the consultant in the operating theatre. He explained what I could do during my stay and how to use my time effectively. He introduced me to his firm (i.e. his team of junior doctors) and everyone was very friendly.

The hospital facilities were nothing short of astounding. I spoke to many doctors whilst I was there and they told me it cost 1 million Euros a week to keep the hospital running. They also explained that the hospital costs were far exceeding the budget calculated by the government and they were not sure of the hospitals future. The hospital was 1 km long and designed in a ‘H’ shape. All the wards i.e. in patients were on the periphery of the hospital and all outpatient facilities and other facilities (shops, canteen, and church) were located centrally. A major differenceI noted between the hospitals here in Prague and those in Malta was the number of patients per room and the stark difference in privacy the patients received. Frequently during my studies in Prague I interview patients with another five patients within ear shot;  however , in Malta there are only ever a maximum of two patients in decent sized rooms. Each patient has access to a bedside monitor which was equipped with television, internet and phone service. The corridors were wide and the operating facilities were state of the art.

 

I enjoyed my attachment with the O&G department. A typical day started at around 8 am and kicked off with the ward rounds. The consulatant and his firm would go and see all the inpatients, all new admissions and all patients prior to surgery. Seeing as the consultant covered both Obstetrics and Gynaecology I saw a wide variety of cases. I interviewed many patients and also attended procedures in the operating room. I was very keen to assist in the operations. This slightly surprised me seeing as during my regular studies I have assisted on several occasions. So my time was mainly divided between the operating theatre and duties with the junior doctors.

In the operating theatre I saw the following procedures: total abdominal hysterectomy, hysteroscopy, dilation and curettage, incontinence surgery and caesarean sections. I attended the operating theatre about three times a week. An interesting point about medicine in Malta is come 1pm everything is finishing. Most doctors leave the hospital at 12:30 and do not return, leaving a skeleton crew to man the wards. Most of the senior doctors go off to their private work. The only department which remains open permanently is accident and emergency. In this light I thought I would try and get some experience in the A&E department. I managed to spend some days there, performing procedures such as IV cannulation and met some acute medical situations for example chest pain.

I returned to O&G after some days to continue my exchange in my allocated department. I was not the only student on the firm – there was one other student attached to my consultant which was nice because we were able to motivate each other. We often discussed patients with our consultant who was very receptive to questioning.

One major difference in medical treatment between Malta and Czech Republic is the attitudes and policies towards abortion. Malta is a very strict Catholic country and abortion is strictly illegal. I spoke to my consultant about this subject and he explained that women who want abortions get on the boat to Italy ( Sicily) for the procedure to be carried out. In this instance it is clear the role religion has on medicine. Many people argue this rule simply negates responsibility of the patients and just creates additional work load for someone else. Another interesting aspect of Maltese medicine is the complete lack of post graduate training. There are no programs designed to further the medical education in Malta meaning post graduates usually leave to the UK or other English speaking countries. This represents a large problem for most of the local students.

Altogether there were thirty IFMSA students on exchange in Malta during July. The exchange was very well organized and two of the local students would meet up with us very regularly to suggest social activities or just check everything was running smoothly. They organized many trips for us and social evenings out. It was also very useful that all the students, although in different apartments were very close to one another allowing good interaction and development of friendships. At the beginning of the exchange our coordinators handed us a spreadsheet with all the activities, events etc….happening in Malta at the time.

There were plenty of opportunities to travel around the island and to the neighbouring islands of Gozo, Comino and Sicily ( Italy).I thoroughly enjoyed my exchange in Malta and gained valuable experiences and broadened my horizons.


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