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1. Name and Matric Number.

Muhammad Haziq Kamal Ariffin, A191975

2. How is the progress so far?

As I enter Week 2, the experience has become even more engaging. I learned a wide range of surgical skills and observed several operative procedures. Unlike Week 1, this week I was exposed to cases such as surgical repair of pectus excavatum, VATS decortication for chronic hemothorax, and an emergency thoracotomy performed for hemostasis in a patient with chronic hemothorax.

In addition, my supervisor recommended several books in thoracic surgery for me to study. Through both reading and observing operations in the theatre, I gained a more comprehensive understanding of thoracic cavity anatomy and developed deeper insights into thoracic surgical practice.

This week also marked my second meeting with the Malaysian Embassy in Serbia, where we discussed how I could contribute my experiences here back to the Malaysian community while enhancing my personal growth. Furthermore, I attended my first session as an exchange medical student in the Endocrine Surgery Department, which aligns with my strong interest in both endocrine and general surgery. There, I observed a total thyroidectomy performed for a patient with papillary thyroid carcinoma.

3. Points to remember from Week 2

One of the most memorable experiences this week was observing an emergency thoracotomy. The patient was an obstetrics and gynaecology surgeon at the hospital who sustained a stab injury that resulted in chronic hemothorax. The operating theatre was filled with her colleagues, and the hospital assembled its best thoracic surgeons to manage the case. I was fortunate to have several residents explain the procedure to me step by step, which allowed me to understand the surgical approach in great detail.

4. Your feelings and thoughts

I am very satisfied with my progress this week, both inside and outside the hospital. I gained deeper knowledge of thoracic surgery and attended my first day in endocrine surgery—two specialties I am highly passionate about. My circle of international friends is also growing, and I have taken the opportunity to explore Serbia independently to better appreciate its culture.

5. One good thing from what you did that you can practice now.

I was able to observe and practice chest tube insertion and removal. This is a fundamental and essential procedure for all junior thoracic surgery residents, and I feel more confident after gaining hands-on exposure.

6. Any difficulties or concerns and how you coped

Being far away from my loved ones has been challenging. However, my international friends in Serbia have been very supportive, and we often spend time together since many of us are on this journey alone. Modern technology has also helped me stay connected with my loved ones back in Malaysia, which makes coping much easier.

7. Plan for next week

My plan is to further strengthen my knowledge in both thoracic and endocrine surgery, attempt to scrub in during operations, and refine my clinical reasoning skills. I also aim to build new friendships while deepening my understanding of Serbian culture and people.

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Week 2 in General Surgery - UKC Maribor, Slovenia

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Week 2 in General Surgery - UKC Maribor, Slovenia

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1. Name, Matric Number, Date

Danesh Rao A/L Prakash Rao, A196177, 10 - 15th of August 2025

2. How is your progress?

This week, I met my mentor who introduced me to the abdominal surgery department, OT schedules, and the hospital management system at UKC Maribor. I attended CME sessions at 7:30 am daily, joined ward rounds, and engaged in discussions with my colleagues regarding medical procedures, despite the language barrier. I observed a laparoscopic gastrectomy for a patient with a gastric tumour, learned basic suturing techniques on mannequins, and gained insight into the 6-year medical program in Slovenia compared to Malaysia’s 5-year program.

During the national and summer trips, I visited historical places in Slovenia and neighbouring countries and had the opportunity to discuss medical knowledge and share experiences with other exchange students from different countries. One highlight was a trip to Ljubljana, the capital city of Slovenia 🇸🇮 where I enjoyed exploring the old town along the Ljubljanica River and seeing the Triple Bridge (Tromostovje). We travelled entirely by public transport, which was clean, efficient, and easy to navigate.

3. Points to remember from Week 2!

• Structure and workflow of the abdominal surgery department.

• Navigating the hospital management system.

• Observing surgical steps and teamwork in laparoscopic gastrectomy.

• Importance of CME sessions, ward rounds, and proactive engagement.

• Practising suturing skills on mannequins.

• Differences in medical education between Slovenia and Malaysia.

• Value of discussions with exchange students to learn about different medical systems and social backgrounds.

• Slovenia’s public transport is reliable and well-connected.

• Architectural and cultural heritage of Ljubljana.

4. My feelings and thoughts

I feel more confident and integrated into the team. Observing laparoscopic surgery allowed me to appreciate precision and teamwork, while discussions with other exchange students broadened my understanding of global medical practices. Visiting Ljubljana and exploring its history enriched my cultural perspective.

5. ONE good thing from what I did that I can practise now!

Applying suturing skills learned on mannequins and actively engaging in discussions with colleagues and exchange students to improve knowledge and teamwork skills.

6. Any difficulties/concerns? How did you cope?

• Difficulty: Language barrier in daily communication.

• Coping method: Asked for clarification in English, observed closely, and relied on non-verbal cues.

7. My plan for next week (Week 3)

• Assist in more open and laparoscopic surgeries.

• Refine suturing techniques and laparoscopic instrument handling.

• Continue participating in CME sessions, ward rounds, and discussions.

• Learn more about Slovenian healthcare and surgical training programs.

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Week 2 In General Surgery, Rabat Morocco

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Week 2 In General Surgery, Rabat Morocco

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1. Your name, matric number, date

Muhammad Fahri Bin Bukhari

A191969

11/7/2025

2. How is your progress?

By the 2nd week, most of the hospital’s staff were already familiar with our presence. We were allowed and encouraged to clerk and examine the patients in the ward. However, due to the existing language barrier (most people use Derija in their daily conversations, which is a Moroccan dialect with a mix of Arabic/French/Amazigh), I was always kindly accompanied by my friends or other incoming students whenever I saw a patient.

We were able to witness a laparoscopic appendectomy in the Operating Theatre. Based on my own experience observing operations in HUKM, I noticed many similarities and stark differences between Malaysian and Moroccan surgery. One of my takeaways is that Malaysia, or HUKM specifically, is better staffed and the sterile field is more well maintained. However, the tenacity and spirit of the healthcare professionals in saving the patient are the same in both countries.

During one of the surgeries, due to unexpected circumstances, the patient woke up while the resident was still wrapping up the procedure (suturing the laparoscopic insertion site). One of the exchange students and I helped to calm the patient down, and all went well.

3. Points to remember from Week 2!

Language barrier is ever-present, and it shouldn’t be an excuse for not taking good care of the patient. Lastly, even with limited manpower and resources, we should always do our best to help them.

4. Your feelings & thoughts

Seeing the stark differences between Malaysia and Morocco, especially in the healthcare system, made me reflect on what I should be grateful for and the areas of improvement we can focus on. We need to be aware of the inner workings and how the system benefits the public, and not be complacent. There are always pitfalls and challenges we have to overcome.

5. ONE good thing from what you did that you can practice now!

Patient-centered care is always the goal in being a doctor.

6. Any difficulties/concerns? How did you cope?

Mostly, I miss Malaysian food, family, and friends. However, apart from the hospital, we visited many tourist attractions in Morocco, namely Marrakech and Rabat. These trips were very exciting and fun, and they helped a lot with curbing my homesickness.

7. Your plan for next week (Week 3)

To continue going to the hospital and learn as much as I can.

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1. Your name, matric number, date

Name: Alyssa Azzarina binti Mohd Aziyan

Matric Number: A192133

Date: 13/7/2025

2. How is your progress?

Academics:
This week at the regional hospital, I noticed that one of the most frequently encountered conditions is clubfoot, also known as pied bot. I’ve deepened my understanding of the Ponseti method, including its various stages, and had the chance to observe a percutaneous Achilles tenotomy. It was fascinating to see them perform the procedure using a syringe needle to lengthen the tendon.

We also saw numerous fracture cases, particularly supracondylar fractures, and learned about their management. I observed techniques like brochage en croix and technique en Judet, which are commonly used to stabilize pediatric fractures.

Other surgeries I got to observe included orchidopexy, where an undescended testis is mobilized and fixed within the scrotum. I also saw a case involving urethral stenosis, where a silicone urethral dilator was used, though unfortunately, the procedure was unsuccessful. They're currently waiting to borrow cystoscopy equipment from another hospital.

Outside the OR, we regularly attend case discussions and academic sessions with the professors, which include daily case presentations and anatomy reviews. These sessions are really helpful for consolidating our clinical learning.

National Social Program:

Over the weekend, we traveled to Essaouira and met local medical students and other exchange students from Casablanca and Marrakesh. We did quad biking and surfing, which was such an exhilarating experience. I even managed to stand on the board a few times while surfing!

Beyond the fun, I had the opportunity to network with students from different countries and exchange perspectives on healthcare systems, which was really enriching. We stayed in a riad, which is a traditional Moroccan house with an interior garden, and I was truly captivated by the architecture and cultural richness of Morocco.

3. Points to remember from week 2!

Supracondylar fractures can be categorized as either flexion-type or extension-type, and are further classified into four stages based on displacement and contact.

ECMES or ESIN (Elastic Stable Intramedullary Nailing) is commonly used for long bone fractures like those of the ulna and radius, where flexible nails are inserted into the medullary canal to stabilize the bone.

New French terms I picked up: je ne parle pas français, pas de douleur, droit (right), gauche (left).

In Arabic/Amazigh: samhiliyya makanarsh arabiyya (Sorry, I don't speak Arabic), machi mouchkil (No problem).

4. Your feelings & thoughts

Although waking up early to catch the 7 AM bus can be exhausting, I’m still very motivated and excited each day. This pediatric surgery internship has given me valuable early exposure, especially in orthopedics and pediatric surgical procedures, which I’ll encounter more deeply in my fourth year. I really hope to apply the knowledge and hands-on skills I'm learning here in my future clinical postings.

5. ONE good thing from what you did that you can practice now!

I learned how to properly apply a cast (plâtre). There are two main types; the standard one and the "American cast" (the blue-colored one), which requires gloves due to the chemicals it contains. The steps include:

1. Holding the cast roll with one hand at the end and the other at the roll itself.

2. Dipping it in water for about 6 seconds (or until bubbles stop), then squeezing it.

3. Applying it evenly over the limb without stretching the material.

I also learned correct positioning for cast applications:

For clubfoot, ensure a 90° knee angle and 60° ankle dorsiflexion.

For arm fractures, make sure the hand is aligned straight with the ulna and radius.

6. Any difficulties/concerns? How did you cope?

Since I haven’t done my orthopedic rotation yet, I initially struggled with classifying different fracture types and understanding their respective treatments. To address this, I studied reliable online resources and asked the residents for clarification. Thankfully, they were incredibly supportive and always willing to answer our questions.

7. Your plan for next week (Week 3)

Next week, I plan to attend more surgical operations, study fracture classifications more in-depth, improve my ability to interpret radiographs, and understand the corresponding treatment and management plans.

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1. Your name, matric number, date

Name: Pang Yi Xin

Matric number: A196089

Date: 7-13 July 2025

2. How is your progress?

In Week 2, I started attending the surgery clinic in the hospital. There were more patients this week. Although I couldn’t understand the language, I received consent from the doctors to translate the patients' conditions. The doctors were very kind, they were always ready to answer my questions and explained clearly what problems the patients faced and how they planned to manage them.

3. Points to remember from week 2!

Axillary lymph nodes dissection:

On Monday, I observed an axillary lymph node dissection on a 56-year-old man who had been diagnosed with melanoma that had metastasised to the axillary region. Therefore, he underwent this operation. It was fascinating to observe because it’s rare to see this procedure performed on a male patient.

Tracheostomy:

On Wednesday, I witnessed a tracheostomy being performed on an 84-year-old man who had suffered an accident and was in a vegetative state. He required a tracheostomy for prolonged airway support. I was amazed because the anatomy around the trachea is very complex and delicate. The surgeons had to be extremely careful to avoid injury to the thyroid isthmus and surrounding vessels.

National trip of Slovakia:

From Friday to Sunday, I joined the national trip to Poprad, organized for exchange students in Slovakia. I met students from many countries including Alex from Estonia, Matthew from Canada, Jack from Indonesia, and others.

On Friday, we went rafting in the Dunajec River. The water was freezing, and we almost felt like we were going to freeze too!

On Saturday, we hiked in the High Tatras. Unfortunately, it rained midway through the hike, but we still enjoyed the breathtaking scenery. Although hiking in the rain was challenging, the view made it all worthwhile.

On Sunday, we visited the Castle of Stará Ľubovňa — a historical site where we learned about Slovakia’s rich heritage.

4. Your feelings & thoughts

This week has been an eye-opening experience. I finally had the chance to observe surgeries I hadn’t seen during my clinical years in Malaysia. It truly felt like a golden opportunity to catch up on things I missed before, and I’m very grateful for it.

The national trip to Poprad was also one of the highlights of my week. Meeting other international medical students gave me a sense of connection and perspective, we all come from different backgrounds but share similar goals and experiences. Rafting and hiking allowed me to appreciate Slovakia’s beautiful natural landscape, and visiting the historical castle added cultural depth to the journey. Although the weather wasn’t ideal, the shared laughter, challenges, and scenic views made the trip unforgettable. It was a refreshing break from clinical work and reminded me of the importance of balance in life and medicine.

5. ONE good thing from what you did that you can practice now!

I’ve learned the importance of clinical observation and surgical anatomy correlation. Watching surgeries helped reinforce my anatomical knowledge and showed me how crucial it is to understand anatomical landmarks in real practice — something I will definitely carry forward in my future clinical rotations.

6. Any difficulties/concerns? How did you cope?

The language barrier continues to be the biggest challenge. Many patients and some hospital staff speak only Slovak. I coped by using translation apps and body language to communicate where necessary. Thankfully, some doctors could speak English and were happy to explain important points to me. I also started learning basic Slovak phrases to help with daily communication, which has made interactions a bit easier.

7. Your plan for next week (Week 3)

For Week 3, I plan to attend more operations especially for those operations that I never seen before. In addition, I plan to keep improving my Slovak vocabulary, especially common clinical terms, to enhance communication with patients. I also hope to learn about preoperative and postoperative care of patients.

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1. Your name, matric number, date

Name : Lee Jing Ning

Matric Number : A196083

Date : 7/7/25-13/7/25

2. How is your progress?
This week, I had the opportunity to observe an axillary lymph node dissection. I was both impressed and surprised, as it was my first time seeing the internal structure of a lymph node and learning what causes it to become enlarged in lymphadenopathy. I also observed a tracheostomy performed on an elderly man who now requires lifelong ventilatory support after a motor vehicle accident left him in a vegetative state.

Additionally, I found out that my hospital mainly focuses on abdominal cases, so I’ve seen more hernioplasties and cholecystectomies compared to other types of surgery. This has given me a clearer understanding of the hospital’s surgical focus and has helped me better anticipate the types of procedures I might observe.

From Friday to Sunday, I joined a national social trip organized by the local committee to a small town called Poprad, which is about four hours away from my city. During the trip, we did several activities including rafting, hiking in the High Tatras—a mountain range highly recommended by Lonely Planet—and visiting the Stará Ľubovňa Castle.

It was truly an amazing experience. I had never tried rafting before in Malaysia, so this was my first time, and it was thrilling! The views during the hike in the High Tatras were absolutely breathtaking. Although it rained halfway through the hike, the sun came out later, and despite it being summer, the weather was cold—making it perfect for hiking. At the Stará Ľubovňa Castle, we got to learn about Slovakian history and the cultural significance of the castle itself. It was a great combination of adventure, culture, and bonding with other exchange students.

3. Points to remember from Week 2

First exposure to axillary lymph node dissection and lymphadenopathy.

Observed a life-saving tracheostomy and learned about care in chronic ventilated patients.

Gained insights into the hospital’s surgical focus on abdominal procedures.

Experienced outdoor adventure activities (rafting and hiking) for the first time in Slovakia.

Learned about Slovakian history and culture during the castle visit.

4. Your feelings & thoughts
This week was a mix of excitement, learning, and personal growth. In the hospital, I was able to witness procedures I had only read about, and it deepened my understanding of surgical decision-making. Outside the hospital, I pushed myself to try new experiences and stepped out of my comfort zone, especially during rafting. I'm grateful for the balance between clinical exposure and cultural exploration that this exchange program offers.

5. ONE good thing from what you did that you can practice now!
One key thing I learned was the importance of knowing the indications for procedures like tracheostomy and lymph node dissection. Understanding the rationale behind surgical interventions is something I can apply immediately in my clinical reasoning and case discussions.

6. Any difficulties/concerns? How did you cope?
One challenge this week was the language barrier during surgery. Some of the discussions were in Slovak, which made it harder to follow the details of the procedures. However, I coped by asking the surgeon or residents for a brief explanation afterward, and I also did some reading on the procedures in my own time. Additionally, hiking in cold weather with light gear was physically challenging, but the group kept each other motivated, and we took breaks as needed.

7. Your plan for next week (Week 3)
Next week, I hope to observe more surgeries—especially those I haven’t seen before, like bowel resection or laparoscopic procedures. I also want to spend more time understanding pre- and post-operative patient management in the wards. Outside the hospital, I plan to explore more of the city, try local food, and continue engaging with fellow exchange students to learn about their experiences and perspectives.