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Week 1 of clinical ep in HUCA , Oviedo , Spain

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Week 1 of clinical ep in HUCA , Oviedo , Spain

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1. Your name, matric number, date

TAN LIK XIANG

A196144

9th of August 2025

2. What have you done?

Monday (4th of August 2025) –

Today is the first day of our elective posting. The person in charge gave us a tour around the hospital (Hospital of Central of Asturias-HUCA) and then gave a lecture about the healthcare system in Spain>

Tuesday (5th of August 2025)

It was my first time meeting my supervisor from the Department of Anesthesiology. He gave me a tour of the operating rooms at HUCA, explained the rules, and introduced me to some basic knowledge of anesthesia

Wednesday (6th of August 2025)

Today there was a workshop on robotic surgery. I had the opportunity to practice coordination using a surgical robot called Da Vinci

Thursday (7th of August 2025)

Observed 2 surgeries -Protuding ears ototplasty and Periauricular fistula removal

Friday (8th of August 2025)

I did ward rounds with my supervisor, learning about pre-anesthesia considerations and which patients are suitable or unsuitable for surgery

3. Points to remember from week 1!

  Understand the layout and functioning of a hospital setting.

-Gain insights into how the healthcare system operates in a different country (Spain), which broadens your global medical perspective.

-Learn the specific rules and protocols of the operating room (OR), which are crucial for patient safety and teamwork.

-Get introduced to the fundamentals of anesthesia, including its principles and practical considerations.

-Develop hand-eye coordination and familiarize yourself with advanced surgical technology like the Da Vinci robot.

-Understand the role of robotics in modern surgery and how it can enhance precision and outcomes

4. Your feelings & thoughts

My first week of elective posting has been both exciting and enlightening. Meeting my supervisor and touring the operating rooms made me realize the importance of strict rules and protocols in ensuring patient safety. I felt curious and motivated while learning the basics of anesthesia, which is a new and fascinating field for me.

The robotic surgery workshop was particularly impressive — getting hands-on experience with the Da Vinci system gave me a glimpse into the future of surgery and made me eager to learn more about advanced medical technologies.

During ward rounds, I appreciated how much thought goes into evaluating patients before surgery. It made me feel more responsible and aware of the critical role anesthesiologists play in patient care.

Overall, this week has deepened my interest in anesthesiology and surgical care, and I feel excited to continue learning and growing throughout this elective.

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

At first, I felt a bit overwhelmed by the strict rules and unfamiliar environment of the operating room. The technical terms in anesthesia were also challenging to grasp initially. To cope, I made sure to ask my supervisor plenty of questions and took detailed notes during tours and workshops. Observing closely and reviewing the material afterward helped me build confidence step by step.

6. 2 words to describe elective posting progress so far

Eye-opening and Engaging

7. Your plan for next week (Week 2)

For next week, I plan to focus on deepening my understanding of anesthesia procedures and patient assessment. I want to actively participate more during ward rounds and try to observe different types of surgeries to broaden my exposure. I also aim to improve my technical skills and familiarize myself further with surgical equipment and protocols.

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Week 1 of Clinical Elective Posting in Independent Public Clinical Hospital Number 4 in Lublin, Poland

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Week 1 of Clinical Elective Posting in Independent Public Clinical Hospital Number 4 in Lublin, Poland

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1. Your name, matric number, date

Name: Ashley Kon Ai Li

Matric number: A195326

Date: 8th August 2025

2. What have you done?

I arrived at Lublin Glowny train station on 2nd August 2025. My contact person (Alice) kindly welcomed Alia and I at the train station. She even brought her dad to help us with our luggages. After we got settled into the dormitory, she drove us to the nearest grocery store and explained how to use the public transport and told us other spots to buy our necessities.

On 3rd August, which was a Sunday, I mostly stayed in the dormitory and got settled into my room and learned how to use the stoves and microwave in the dormitory kitchen. In the evening, I took the bus in Lublin to a church for my Sunday prayers.

On 4th August, all the exchange students had to go to the local courthouse to take our certificate of good conduct which was mandatory for the hospital. After that, we explored Lublin by going to the Old Town and visiting Lublin Castle. In the evening, we attended an ‘Upon Arrival Training’ organised by the Lublin IFMSA committees. They explained the general rules in Lublin and in the hospital and also taught us basic Polish words. After the training, we went grocery shopping. We had to buy ‘Crocs’ as it was mandatory in the hospital.

On 5th August, we finally met with our supervisor from the Cardiosurgery department. We immediately hopped into the operation theatre and observed an aortic valve replacement (AVR) surgery. It was interesting as it was my first time watching cardiosurgery. We also attended an intubation workshop organised by the IFMSA Lublin committee. They taught us the different types of intubation.

On 6th August, we observed a Wheat procedure which was a combination of AVR and ascending aorta replacement. It was also an interesting and intricate surgery.

On 7th August, we observed a Transcatheter Aortic Valve Implantation (TAVI) procedure which was minimally invasive compared to open heart surgery.

On 8th August, we observed a mini AVR which was done in around 2 hours. It was amazing to see the lead surgeon perform the surgery so quickly. However, we did not learn much as there was a language barrier. We tried asking questions but most of the doctors did not speak English and were struggling to answer our questions.

3. Points to remember from week 1!

From the moment we entered the hospital, there were many differences noted between our healthcare system and also Poland’s. For instance, you were not allowed to wear your scrubs from your home. You had to wear regular clothes and shoes from home and then change into your scrubs at the hospital. You also weren't allowed to use ‘outside shoes’ in the hospital.

4. Your feelings & thoughts

To be completely honest, I am feeling a little demotivated about the learning experience as the doctors were unable to teach us due to the language barrier. However, I’m hoping the subsequent weeks will get better.

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

The language barrier is a huge difficulty. Most of the doctors, nurses and even medical students did not know how to speak English. Alia and I had to read up about the surgery beforehand so that we could get a little understanding about what was going on.

Another concern is that there aren’t many operations happening in August as 1 out of 2 operation theaters for the Cardiosurgery department was getting renovated for the whole month. Therefore, there were less surgeries scheduled for this week. Furthermore, most of the surgeries were the same which is aortic valve replacement.

6. 2 words to describe elective posting progress so far.

Hopeful and exciting

7. Your plan for next week (Week 2)

My plan for next week is to see more variety of surgeries and to shadow our supervisor during ward rounds. I hope to be able to learn more next week.

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Name: Nur Alia Safiah binti Ahmad

Matrics number: A195284

Date: 8th August 2025

2. What have you done?

Ashley and I arrived at Warsaw Gdańsk* train station on 2 August and took a train to Lublin on the same day. We were supposed to stay one night in Warsaw and travel to Lublin the next day, but unfortunately, we got scammed by our Airbnb host. The room had already been occupied for a month, yet she still accepted our booking through Agoda. So, we decided to check into our dormitory one day earlier.

Luckily, my contact person (CP), Alice, was available at that time to pick us up from the train station. Her father even helped us carry our big luggage. After registering at the dormitory, we went to Biedronka for grocery shopping.

A) 4 August (Monday): In the morning, all the exchange students went to the court to settle our good conduct certificates. I’m not sure why this hospital requires our criminal records. In the evening, we had our upon-arrival training.

B) 5 August (Tuesday): Our first day at the Independent Public Clinical Hospital No. 4 in Lublin, under the Department of Cardio-Surgery. We were supervised by Dr. Marek Jankiewicz and observed two aortic valve replacement procedures.

C) 6 August (Wednesday): Basically, we watched the same procedure for the whole week. It was quite boring and there wasn’t much to learn because most of the doctors could not speak English. I would not recommend my juniors to do their elective posting here in Lublin. Maybe hospitals in bigger cities such as Kraków, Warsaw, or Wrocław are better, where doctors can communicate in English.

D) 7 August (Thursday): We watched a transcatheter aortic valve implantation (TAVI). Luckily, some of the doctors there spoke English.

3. Points to remember from Week 1
I ate sweet potatoes for an entire week because that was the only vegan option for our free daily meal. I also made new friends from different countries.

4. Your feelings & thoughts
I feel a bit uneasy because wherever I go, people seem to stare at me for wearing a hijab. Thankfully, my friends are so nice and understanding.

5. Any difficulties/concerns? How did you cope?
In Lublin, it’s very hard to find halal food, so I usually have to choose vegan options like sweet potatoes or spinach dumplings—while watching Ashley and Keona (my Indonesian friend) eat pork steak. The weather in Lublin doesn’t feel like summer at all. I wasn’t prepared for the cold and didn’t bring any jackets. The locals say this is the coldest summer in Lublin.

6. Two words to describe elective posting progress so far
Winter holidays

7. Your plan for next week (Week 2)
Ask my supervisor to teach us more about cardio surgery, join him for ward rounds, or go to the orthopaedic department to watch surgeries.

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Name: Alissa Hannah Binti Farizal

Matrics no: A185503

Date: 30th June 2025

What have you done?

After my surgical posting exam, I jumped into packing for my exchange in Italy. It was my first time having to pack a luggage bag to fit one month's worth of belongings, however I was trying to be mindful of what I threw into my bag since I did not want to overpack and burden myself later on, as I will be travelling alone. Choosing clothes for sightseeing, and formal ones to wear at the hospital, food, and medical instruments, it was overwhelming. However, with the help of my family members, I managed to complete my packing in one night.

On 23rd June, my family and I boarded our flight from Kuala Lumpur to Rome, with a 5-hour transit in Dubai. I was thrilled, as it was my first time flying to Europe. The flight was long, and I felt restless halfway through the journey, but once we landed in Rome in the morning, the excitement of being in a foreign country started to kick in. My exchange is set to be in Verona, however my family and I planned a 1-week trip around Italy before I began my exchange journey.

Upon arrival, we were greeted by our tour guide and loaded all our belongings into a car we rented for the trip. Without much hesitation, we began our journey to the city centre as hotel check-in was not until afternoon. My family and I went sightseeing around the city including the Colosseum and Vittoriano. As we were having lunch at a restaurant nearby, my sister received notifications of unauthorized transactions being made from her debit card, which eventually led us to suspect that our car was broken into. We went back to our car to find a window being smashed, and all our luggages and bags stolen. From then on, our entire day was spent on making a police report, and buying basic necessities such as clothes, skincare, and food.

It was an eventful first-day in Italy, however we somehow moved past the incident and tried to make the best of what we had. We continued to travel across Florence, Pisa, Cinque Terre, Venice and Verona. Due to the incident that happened, we gradually bought more clothes and necessities we needed to continue our trip, and for me to continue my exchange.

Points to remember from week 1

This week has taught me the importance of being mentally and emotionally prepared for unexpected events. Even though I had meticulously planned and packed everything I needed for my exchange, the theft incident reminded me that not everything is within our control. I’ve learned to stay adaptable and calm in high-stress situations. Another key takeaway was the value of support systems. My family’s presence was comforting and played a big role in helping me navigate through the incident. Lastly, despite the setback, being in a new country with a different culture, language, and environment was an eye-opening experience that deepened my appreciation for travel and global exposure.

Your feelings & thoughts

Initially, I was feeling excited and full of anticipation—both for the trip and for my elective posting. However, that quickly turned into shock and frustration following the robbery. I felt helpless and worried, especially about how I would continue my exchange with most of my belongings gone, including my white coat and stethoscope. Upon the contract I was given for my exchange, the period was supposed to be for a month, however due to the unforeseen events, I had discussed it with Dr. Syamsa and my contact person from IFMSA, and agreed to reduce my exchange period into two weeks as it would lessen the burden on my parents to support me financially. It took a few days, but I tried to remain optimistic, reminding myself that material things can be replaced and that the experience itself holds greater value. This week reminded me that challenges are part of the journey, and how we respond to them shapes our growth. Overall, I’m still grateful to be here and determined to make the most of my exchange in Italy.

Any difficulties/concerns? How did you cope?

The biggest difficulty this week was losing all my belongings on the first day. It was a distressing and overwhelming experience, especially in a foreign country where I was unfamiliar with the systems and language. One of my concerns was not having enough clothes or essential items to last the entire month, particularly for the hospital setting. I coped by prioritising what I needed the most, sticking to a strict budget when repurchasing, and relying on the support of my family to help me rebuild what was lost. We also reminded each other to stay grounded and safe. I kept reminding myself of the purpose of this exchange and used that motivation to push forward.

2 words to describe elective posting progress so far

Eye-opening: This week has truly been an eye-opening experience. From the very beginning—packing my luggage with careful thought, boarding an international flight, and setting foot in Europe for the first time—everything felt new and exciting. I was exposed to a different culture, language, and way of life. The historical architecture, local customs, and even the hospital environment I briefly observed from the outside were vastly different from what I’m used to in Malaysia. But what truly opened my eyes was how quickly a situation can change—from joyful sightseeing to a challenging crisis when our belongings were stolen. It reminded me that travel isn’t just about pretty sceneries; it’s about adapting to real-life situations, learning from them, and gaining perspective beyond the classroom or hospital walls.

Resilient: Despite the overwhelming loss and emotional shock of the theft incident, I realised how much inner strength and resilience I was capable of. It would have been easy to let the experience ruin the entire trip, but I chose to focus on what I could control—staying calm, being resourceful, and moving forward. Instead of falling apart, my family and I worked together to problem-solve, repurchase essentials, and find comfort in each other’s company. The fact that I still managed to continue travelling across Italy and prepare for my elective speaks volumes about the resilience I didn’t even know I had. This experience, though difficult, has made me emotionally stronger and better prepared for any unforeseen challenges during the rest of my elective posting.

Your plan for next week (Week 2)

Next week marks the start of my clinical attachment in Verona. I plan to familiarize myself with the hospital layout, get to know the coordinators and local mentors, and understand the daily workflow. I also intend to introduce myself to the team I’ll be working with, learn the expectations, and ensure I am respectful of the local clinical culture. Outside of the hospital, I aim to explore more of Verona, slowly settle into my new routine, and perhaps journal about the medical and cultural experiences I encounter. I hope to begin clinical observations and gradually immerse myself in hands-on learning wherever appropriate.

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Clinical Exchange in the Department of Paediatric Orthopaedics

Name: Adam Iskandar

Matric No: A195840

2. What have you done?

Tuesday (2 July) – I arrived at Lisbon Airport and took a bus to Coimbra, where my contact person kindly fetched me from the bus station. Later that day, I went grocery shopping with my roommate, Silvan Kaufmann from Switzerland. He’s in the Swiss Army, super reliable, and really funny. Best part? He’s a great cook so I just happily eat whatever he makes! At night there was an orientation to help the exchange students adapt nicely here in Coimbra

Wednesday (3 July) – I walked to Hospital Pediátrico (Unidade Local de Saúde (ULS) Coimbra). There I met Dr. Emanuel Homem, my supervisor from Paeds-Ortho for the first time. He’s very friendly and honestly also very cute. He gave me a tour around the hospital and got me a pair of scrubs. He also introduced me to his residents and the other specialists.

Thursday (4 July) – I joined the outpatient clinic in the paediatric-orthopaedic department. I observed my supervisor managing patients and performing knee examinations and it was a good learning experience.

Friday (5 July) – I went into the operating theatre and watched a few laparoscopic arthroscopies. It was my first time seeing the procedure done live and I learned a lot about the setup and techniques.

Saturday (6 July) – Took a day trip to Aveiro, then went surfing with friends at Figueira da Foz beach. The waves were amazing and the vibe was great.

Sunday (7 July) – Tried paddleboarding for the first time at a spot in Coimbra. It was surprisingly calming and a great way to end the week.

3. Points to remember from Week 1!

A good smile and firm handshake can go a long way in communication even when you don’t understand what’s being said.

Got to observe a different healthcare environment, which was one of my main objectives for this posting.

The healthcare system here in Portugal is relaxed, respectful, and well-organized. There is minimal stress or tension in the workplace compared to what I'm used to seeing.

I'm grateful to experience this now, knowing that realistically I’ll be working in Malaysia for most of my life, so seeing how things are done elsewhere is a valuable perspective.

4. Your feelings & thoughts

This whole experience has been super fun and fulfilling. I’ve made new friends from Switzerland, Turkey, Mexico, Slovenia, Luxembourg, Brazil, Denmark, and many more. I am genuinely excited learning about a whole new healthcare system and observing how patient care and workflow are handled here. It is refreshing and motivating.

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

No halal meat. I eat a lot (though you probably cannot tell by looking at me), so this was tough. I coped by enjoying seafood and stocking up on eggs from the supermarket.

Language barrier was another concern, but most Portuguese people speak English. I also learned some basic Portuguese phrases, people really appreciate the effort, even if my pronunciation is terrible (which it is).

6. Two words to describe elective posting progress so far

Refreshing. It has been really nice seeing how healthcare works in a totally different, more relaxed setting. The environment is calm, respectful, and well-organized which is very different from what I’m used to, in a good way.

Exciting. Every day feels new, whether it’s learning in the hospital or just exploring Portugal. Between cool surgeries, surfing, and meeting people from all over, it’s been such a fun and memorable start.

7. Your plan for next week (Week 2)

Observe and assist more actively in surgery, especially orthopaedic procedures.

Continue learning simple Portuguese phrases to help with communication.

Explore more of Coimbra and I am planning a weekend trip to Porto.

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Name: Wong Meng Seng

Matric number: A196449

2. What have you done?

I reached Warsaw Chopin Airport on the 29th of June where my contact person (Julia) met me. She facilitated my transfer to the dorm and provided essential guidance on navigating the local bus transport system, including directions to the hospital. I have one free day on the 30th which i spent most of my time getting to know my housemates (Carlos and Victoria from Mexico) and also did some grocery shopping at Lidl.

My days at the University Hospital of Olsztyn located at Aleja Warszawska 30, were packed with diverse surgeries observations. I was introduced to the general surgery department and my supervisor, Dr. Lukasz Dysko. Based on my notes, here’s a summary of the procedures I observed:

1. July 1st (Tuesday): Stood 6 hours to observe a right hemicolectomy with anastomosis (abscess with fistula) and an endometrial tumour removal with abdominal mesh repair (endometriosis).

2. July 2nd (Wednesday): Two OGDs (one with normal images, checking for H. pylori, and another with normal images related to anaemia), and two colonoscopies (one where 8 polyps (Kudo I / II) were seen and polypectomy performed, and another incomplete examination due to long sigmoid colon which causes pain by tension).

3. July 3rd (Thursday): Observed a herniorraphy (herniotomy and mesh repair) for a direct inguinal hernia.

4. July 4th (Friday): Observed a laparoscopic cholecystectomy, wound dressing for a diabetic foot post-amputation, and a thyroidectomy.

Beyond hospital duties, I enjoyed some leisurely time with friends, going paddle boating at Lake Ukiel and taking a city walk through Olsztyn Old Town on Thursday. I also spent the Saturday evening with some new friends, enjoying drinks. To round off my week, on Sunday, I went kayaking, presumably enjoying the beautiful natural surroundings of Olsztyn.

3. Points to remember from Week 1

Reflecting on Week 1, several key takeaways stand out. I think I had improved in adaptation skills for example using local public transport in Olsztyn and became familiar with the operational environment and daily routines of the University Hospital in a different language. Most importantly, I gained invaluable exposure to a wide spectrum of surgical procedures and patient care scenarios, from intricate abdominal surgeries to endoscopic examinations. Furthermore, the balance of demanding clinical hours with a vibrant social life is a life I am looking forward in my future doctor life. Lastly, I think having a strong support system such as friends or supervisors in a foreign country can make a foreign place feels a little more like home.

4. Your feelings and thoughts

It was a blend of excitement and anticipation, coupled with a natural degree of nervousness that often accompanies new environments especially in a new hospital at a foreign country. I felt happy to make new friends from different countries and share this wonderful memories with them. Besides, I also felt a hint of loneliness as I am the only incoming student that is posted at this hospital, but the surgeons and students here are very friendly to me which makes me felt better and welcomed.

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

I would say the biggest difficulty I faced is a new language environment, but thanks to my Polish friends that translated to me in the hospital for me to understand and learn. I also learnt some Polish phrases with my friends to be used in a daily basis. Besides, the weather is also something I didn’t expect as I think it would be hot in summer but lately Poland has been windy. Therefore, I bought a jacket in the nearby mall. Finally, I would say there is a minor cultural shock with the food, customs, and social norms. However, I have coped it with actively seeking out and participating in social activities with friends as it is an excellent way to alleviate stress, build connections, and experience the local culture.

6. 2 words to describe elective posting so far

In conclusion, this week was largely successful as I learnt some new things and made some friends. Poland life is definitely relaxing and I am really enjoying the exchange so far!

7. Your plan for week 2

Hopefully get more hands on opportunities and observe different interesting surgeries. Make more new friends if possible and discover Poland more.