MEDICAL WOMEN’S FEDERATION
Tavistock House North, Tavistock Square, London WC1H 9HX
Tel: 020 7387 7765 email:
@medicalwomenuk
Name / Rebecca RobeyProject title / Clinical haematology
Location of your Elective / Emory University, Atlanta, Georgia, USA
Contact details for your elective (eg. Website address or email address of your project co-ordinator) /
What did you achieve? / For my medical school elective I undertook a four-week clerkship in Haematology at Emory University, at their affiliated hospital, the Atlanta Veterans Association Medical Center. The generous bursary awarded to me by the Medical Women’s Federation helped me to fund this opportunity.Overall, the placement proved to be a fantastic learning experience, and I now feel in a strong position from which to pursue my intended career in Haematology.
Would you recommend this location / project to others? / Yes. Emory is a fantastic university with a strong medical school and excellent reputation for research, partly due to its links with the USA’s Center for Disease Control (CDC). I hope to have a career as a clinician scientist, combining patient care with clinical research.
Further comments (eg. Travel advice, tips for organising an elective similar to this etc.) / My elective was arranged through an exchange programme between my home university, Kings College London, and Emory University. Being part of an exchange programme meant that I did not have to pay the usual fees required by Emory, which made the venture much more financially viable for me.
Would you be happy for you feedback form to be available on our website? / Yes without email address
Further comments (eg. A review of your trip) max. 500 words. / I spent time with both the inpatient and outpatient services, and through these saw patients with many of the most common haematological conditions, both malignant and non-malignant. I took responsibility for my own inpatients, clerking new patients, presenting to the Attending Physician and, with their guidance, formulating a management plan and documenting the consult in the patient’s notes. I then reviewed the patients daily, checking their test results, doing a physical examination and presenting them on the daily ward round.
I was lucky to see an unusual case of a rare disease, POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal protein and Skin changes). I was the first person from the Haematology team to clerk this patient, and was involved in the investigation and diagnosis of his disease. It proved to be an interesting case, with several useful learning points about the management and investigation of patients with unexplained and refractory symptoms. I therefore volunteered to write up the case with help from the Attending Physician, and we have submitted it for publication in the journal, BMJ Case Reports.
In addition to clinical activities, I attended teaching sessions and departmental meetings, including a weekly multidisciplinary ‘tumour board’, radiation oncology case discussions, and grand rounds.I spent time with the haemato-pathologists, learning about basic morphology of normal and abnormal blood and bone marrow.
I was also interested to observe some of the differences between the English and American healthcare systems. I had the opportunity to discuss issues regarding health insurance and payment for treatment with both physicians and patients, an experience that very much reinforced my belief in the National Health Service.
I worked closely with the team’s physician assistant (PA), which was interesting in light of the current drive to recruit American PAs to the UK, in an attempt to address issues of staff shortage. There has been some backlash in the British medical community against this, with objections to the fact that PAs do less higher education and training than doctors and are being offered higher salaries than junior doctors. My experience, however, was entirely positive. Our PA was extremely knowledgeable and competent, and, far from threatening the role of the junior doctors, provided invaluable support. Moreover, whilst the junior doctors rotated through the department every couple of months, the PA was a permanent member of staff. She therefore not only provided a valuable source of information and training for each new wave of junior doctors, but also provided the patients with a constant presence through their long treatments.
Altogether, the bursary awarded to me by the Medical Women’s Federation provided me with a fantastic opportunity to gain an in-depth experience of the clinical specialty of Haematology. It also gave me an interestinginsight into one of the most technologically and academically advanced and progressive healthcare systems in the world, but one that is very different from the NHS. I feel I gained a deeper understanding of the American healthcare system, and of its strengths and weaknesses compared to the NHS.