Jan 2023 Update

6-week O&G Elective in Grenada

I recently undertook a 6-week elective in obstetrics and gynaecology (O&G) in Grenada, in the Caribbean. Grenada is a tri-island state, consisting of mainland Grenada (population 112,000) plus the smaller islands Petite Martinique (population 1,000) and Carriacou (population 10,000). I was based at St. Augustine’s Medical Services (SAMS), a private hospital with 12 beds based in the St. Paul’s area of Grenada, around 10 minutes from the capital city, St. George’s. The placement was organised through Caribbean Elective and consisted of shadowing SAMS’ O&G doctor, Dr Hurtado, in clinics, surgery and on the small ward in the hospital. There were also opportunities for other activities such as a Down’s syndrome outreach event and volunteering at a snorkel beach-clean up collecting debris off the ocean floor. We were in the hospital most mornings, but afternoons were free for exploring the gorgeous island… and spending a LOT of money at the beachside cocktail bar opposite our hotel! I had many thought-provoking experiences and enjoyed comparing my observations to that of women’s healthcare in the UK. Having trained in the UK’s universal state-funded healthcare system, I found it interesting to witness health-seeking behaviours that occur in the private sector, such as women demanding specific tests during their clinic consultation or presenting late with huge uterine fibroids as they could not afford the surgery. If I had to come up with some negatives: the cost of living in Grenada is very high, particularly if trying to eat healthy food like we were. Additionally, my placement was mostly observational – there were limited opportunities to clerk patients or perform procedures (although I did get very good at speculums). Overall, this was a truly unforgettable experience that I would recommend to anyone looking to organise an O&G elective with the perfect balance of work and fun.” – Eve Miller, Bristol Medical School Ambassador with permission from Elanor Brooks

4-week O&G elective in Antrim Area Hospital, Northern Ireland

“The placement rotation I enjoyed the most during Year 4 was within Obstetrics and Gynaecology at South West Acute Hospital. Understandably, it was also the module I found the most difficult initially because the material was very new to us as students, and it was quite content heavy. However, I have always loved taking on the challenge and immersed myself completely during year 4 into this specialty. Attending placement every day and witnessing the information I studied, in a patient context sparked a keen interest that I aimed to pursue. Thus, further exposure in various clinics, delivery suite and theatres, in addition to speaking with my senior colleagues, I decided that I wanted further exposure in this field for my summer elective.
This report will cover my Year 4 Summer Elective experience at Antrim Area Hospital in the field of Obstetrics and Gynaecology. I seek to reflect on all that I have gained over the last 4 weeks and look forward to applying this into my future clinical practice. I believe this experience encourages me to continually improve my interactions with fellow colleagues and patients respectively, whilst building further knowledge in this speciality, which I am looking forward to work and specialise in. During the first two weeks of my elective, I spent time on the wards. Ward rounds enabled me to appreciate the importance of good communication between healthcare providers and their patients. Patients were able to express their concerns and questions freely towards the consultants who were able to reassure and direct them towards a suitable management plan. I also practised my history taking and examination skills as well, which was a good refresher after exam season! During the next two weeks, I was in clinics as well, antenatal and gynae. During my gynae clinics, I was able to appreciate how sexual health is very important to the mental health of women. Many women came in fearing they might have cervical cancer, dyspareunia etc, and thus it was very comforting to see how the healthcare team were able to listen to them, reassure them, and organise a structured management plan to alleviate their worries.
After attending the gynae-assessment unit and researching further into conditions such as endometriosis, I was able to reflect on how these disease processes work. Thus, following up on these patients when they came in for laparoscopic/ diagnostic procedures, I understood how management plans including surgery can boost quality of life for our patients. Furthermore, labour ward and delivery suite were run very smoothly by the midwifery team and the nurse-in-charge. The opportunity to ‘assist’ in surgeries including Caesarean sections was a privilege and I felt very much part of an amazing multidisciplinary team. Teamwork is essential in Obs and Gynae in every domain. This was very evident when I attended the clinical governance meeting during my elective. It was very refreshing to see various health professionals come together to discuss about how we should continually strive to improve the healthcare we deliver to our patients. After discussing with my seniors, I appreciated the numerous audits/QI projects that are conducted and implemented within Obs and Gynae here in Antrim. I registered my interest should any more opportunities arise here, or in the Ulster Hospital, where I will be on attachment in Year 5. I believe that continuous improvement will help our health service not only provide healthcare tailored for our population within Northern Ireland but will do so in a way to appreciate social and cultural factors whilst managing the resources that we have efficiently.” – Varghese George, Queen’s University Belfast Ambassador