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Richard Sim Jian Cheng, A179778, 21/08/2023 (Mon) - 29/08/2023 (Sun)

1. Were the objectives of the projects fulfilled?

Yes, the objectives of this project was successfully achieved.

One of my objectives was to observe the differences in healthcare in Japan compared to Malaysia. Through my attachment in Juntendo University, I have learnt several differences in the healthcare system between Malaysia and Japan. Some of the similarities I saw is that doctors usually carry out ward rounds to ensure that the patient is well and doing alright before and after a procedure is done. Another similarity is in terms of consultation as both doctors in Malaysia and Japan will patiently explain the procedures to the patients. Among the differences I observed  is that every doctor in Japan is provided with a work smartphone which is useful to separate their work messages from personal messages. Another difference is that doctors in Japan use less paper than in  Malaysia as most of the things are digital which helps to decrease clutter and risk of losing patient information. I later learnt that this is different for each department as some department still uses a lot of paper.

Another objective is to learn about some of the cases found in Juntendo University Hospital. From my attachment, I learnt that Japan has relatively high cases of gastric cancers. In fact, their number of gastric ca cases surpasses the number of colorectal cancer cases. A doctor speculated that it may be due to the high salt diet in Japanese foods but due to a lack of research, he cannot say for certain. Besides that, I also managed to observe Da Vinci surgery during my time here. It is fascinating to see how far technology has evolved to the point of aiding doctors in surgery which was was thought to be impossible in the past. It was also interesting to observe the removal of cancerous lesions using Endoscopic Submucosal Dissection (ESD).

The last objective of my elective posting is to learn more about the Japanese cultures. Through my stay in Japan, I learnt a lot about the Japanese culture. Among the things I learnt is that we are not supposed to talk loudly or take phone calls while we are on the train. Besides that, I also learnt that Japanese people are very kind and will do their best to help you despite the language barrier. I learnt more about Japan's history via my visit to places such as Tokyo Natural Museum, Yushukan War Memorial Museum and Imperial Palace East Garden. I was also able to enjoy Japanese culture by attending summer festivals such as the Sumidagawa Hanabi, Toro Nagashi at Asakusa and Bon Odori festival at Roppongi Hills. Other than that, my visits to places such as Hakone, Mount Fuji, Kamakura and Enoshima helped me to appreciate the beauty of Japan. Overall, my trip to Japan not only help me gain more insight towards their culture but also helped me appreciate the beauty of Japan more.

2. What have you enjoyed or liked the most about the project?

What I enjoyed the most about the project is the networking opportunities that I obtained during the course of this project. I was able to meet people from other countries such as Japan, Germany, Singapore, Ireland, China and USA. Through my interactions with them,  we were able to exchange cultures and also experiences in medical school. This helped to broaden my perspective of the health care system in other countries and also form relations with people from various countries. These cross-cultural learning experiences is very precious to me.

Another part of the project I enjoyed is the opportunity to explore various different places in Japan. During my project, I was able to places such as Hakone, Nikko and Enoshima which was not only beautiful but also relaxing. There I was able to wind down after a tiring week and be refreshed for the next week. Through these trips, I was able to appreciate the beauty of Japan more.

3. What have you found challenging about this project (any part of the project you found hard to do)

The only challenging part of this project was the language barrier. I found it tough to communicate with the Japanese as their English proficiency is limited and I only understood a bit of Japanese. Through time, I learnt a few key Japanese phrases which helped immensely while I am in Japan. Other than that, translating apps such as google translate and Deep L translator proved to be an invaluable part of my trip in Japan as without them, I would have a way harder time communication with the locals.

4. What has really worked? (any part in the project that you thought worked well)

Some of the things that worked well includes the learning sessions. I was able to observe many different cases and subsequently learnt a lot during my time at Juntendo University Hospital. The explanations given by my supervisors were very informative and I believe the notes I wrote while I was there will prove useful for the future.

Another thing that worked well is my time management. As my time in Japan is limited, I made a list of places to go while I am there and compile them according to place and distance. I integrated the list I made into the schedule the university provides to maximize the time I have in Japan. As such, I was able to visit most of the places I plan to visit without missing my clinical observership.

5. What can be improved in this project?

One of the things that could be improved is gaining a deeper understanding of Malaysia's healthcare system. During discussions with my supervisor and fellow program participants, there were times when I struggled answering some questions posed by them. As such, I was not able to give a satisfactory answer.  Thus, I wanted to know deepen my understanding of Malaysia's healthcare system and also the life as a doctor as it is quite important for cross-cultural learning.

Another thing that could be improved is being more proactive. Though I was already asking questions, sometimes I wished that I had asked to help out in certain procedures. This would have further improved my learning experience and increased my knowledge.

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1. Were the objectives of the project fulfilled?

Yes, I do think the objectives were all fulfilled and gained even more unexpected experience through this posting.

2. What have you enjoyed or liked the most about the project?

I love the way how they treat all elective students extraordinary nice (nicer than their own medical students) and for surgery department, we always have the opportunity to assist in surgery. Another thing that I like about this project is able to meet and get to know new friends. I got to know on how Singapore healthcare system works and prioritise through a small chat with my NUS posting friend. This is how unexpected friendship form as well.

3. What have you found challenging about this project? (any part of the project you found hard to do)

I found the financial aspect is quite challenging for me because the cost for electives in Singapore is not cheap. It cost me about RM 3000 for 2 weeks of posting in the surgery department. It might be even challenging for those who have to pay for their own accommodation as rental in Singapore is very expensive.

4. What has really worked? (any part in the project that you thought worked well)

Overall the electives went really well and smooth. I considered quite fortunate to have a very supportive admin who provided me assistance most of them when I need it, grateful to local medical students who are friendly enough to bring me around whenever they go and Doctors that are nice and kind to offer to teach me.

5. What can be improved in this project?

Although the clinical experience Khoo Teck Puat Hospital is considered very fruitful and interesting, if I am given another chance,  I would like to choose to do my electives in Singapore General Hospital or National University Hospital. Different hospital has different style of working and in big hospitals such as NUH and SGH, I believe they have much more nicer or special cases. I would really like to explore and find it out one day.

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Chapter 4: Adventures with Friends and Say Bye to Korea

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Chapter 4: Adventures with Friends and Say Bye to Korea

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Tan Zi Yee (A181429)
21.08.2023 - 28.08.2023

1. Were the objectives of the project fulfilled?

Definitely yes. During my elective posting in Korea, I successfully achieved my objectives of exploring patient management techniques and different medical practices in a different country. I actively participated in surgeries, engaged with healthcare professionals, attended conferences, and conducted research on colorectal cancer screening systems. These experiences provided valuable insights into Korean healthcare practices and enhanced my understanding of patient management strategies.

Throughout my elective posting in Korea, I effectively fulfilled my objective of stepping out of my comfort zone and immersing myself in a setting with a different language and cultural background. Initially, the language barrier was a significant challenge, but I embraced the opportunity to learn basic medical terminology and communicate with medical staff through language apps and gestures. This not only improved my communication skills but also fostered a sense of cultural awareness and adaptability. Engaging with patients, colleagues, and medical professionals in a foreign environment allowed me to broaden my horizons and gain a deeper understanding of cross-cultural interactions, ultimately helping me grow both personally and professionally.

2. What have you enjoyed or liked the most about the project?
During my elective posting in Korea, I cherished the blend of
hands-on experience, exceptional learning opportunities, cultural immersion,
and the profound personal growth that accompanied them. The hands-on
experience, particularly in the operating room, allowed me to actively engage
in surgeries and gain practical insights into my field of study, contributing
significantly to my professional development. Simultaneously, the learning
opportunities were invaluable. Attending conferences, conducting research, and
interacting with esteemed healthcare professionals expanded my knowledge base and provided a broader perspective on healthcare practices, contributing to
both my professional expertise and personal growth.

Moreover, immersing myself in Korean culture was an incredible experience that broadened my horizons and nurtured cultural awareness. From exploring historical landmarks like Gyeongbukgung palace to donning traditional Hanbok attire, I embraced every opportunity to delve into the cultural tapestry of Korea, further enriching my personal growth. These diverse experiences collectively made my elective posting a multifaceted journey that fostered both professional and personal growth, making it an enriching and unforgettable chapter in my life.

3. What have you found challenging about this project? (any part of the project you found hard to do)

Absolutely, the application process itself presented a significant challenge. It required months of meticulous planning and preparation to secure this valuable opportunity. Coordinating the application alongside my already busy academic schedule was no small feat. Gathering the necessary documents, completing paperwork, and ensuring that all deadlines were met demanded a considerable amount of time and effort. This process added an extra layer of complexity to an already demanding journey.

Moreover, the language barrier proved to be one of the most prominent challenges. Given that the medical environment primarily operated in Korean, I had to rely on translation apps and non-verbal communication methods to effectively interact with the doctors and understand medical procedures. This language barrier introduced complexity to tasks such as

patients interaction and comprehending intricate medical procedures. Nevertheless, it was a valuable learning experience that pushed me to adapt and enhance my communication skills in a cross-cultural setting.

4. What has really worked? (any part in the project that you thought worked well)

There were quite a few things that worked perfectly in this project. First of all, deciding to go with Seoul National University Hospital (SNUH) for my elective was an absolute game-changer. It opened doors to so many opportunities, and I can't stress enough how much I learned and grew during my time there. It was a real turning point in my medical journey.

When it came to accommodations in Korea, I lucked out. The places I stayed in were super convenient. Easy access to transportation, awesome food options, amazing location, the hosts were incredibly friendly, and the whole stay was comfy. Having a cozy and well-located home base made a huge difference in how smoothly things went.

Our plan of exploring not just Seoul, but also Busan and Jeju, was a brilliant move. It was more than just an elective; it was an adventure. I got to soak up Korean culture, traditions, and broaden my horizons big time. Our meticulous planning and executing it well added to the project's success.

However, what truly made this project a resounding success was having amazing companions along for the ride. My buddies Wen Jia, Yi Hui, and Kai Xin were a blast to be with. We shared incredible moments, laughed a ton, and had each other's backs throughout. Exploring Korea with friends who were just as eager to dive into the culture as I was made every part of this journey a winner.

5. What can be improved in this project?

There are a couple of aspects where this project could see improvements. Firstly, the planning phase should ideally commence as early as possible. In my experience, initiating the application process around late February 2023 led to some challenges. It took more than two months for SNUH to confirm our application, and this coincided with the final exam period. Consequently, we had to juggle preparations for flights, accommodations, medical reports, paperwork, and final exams simultaneously, which was quite hectic.

Additionally, I could have better prepared for the trip by learning some basic Korean. This would have significantly improved communication with locals and medical staff, making interactions smoother and more efficient. In a medical environment, where effective communication is paramount, even a basic understanding of the language would have been advantageous.

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Reflecting on a Transformative Journey: The Final Week of Volunteering in Nepal

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Reflecting on a Transformative Journey: The Final Week of Volunteering in Nepal

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Sarvisuwaran Ravi, A181777, 6/8/23- 22/8/23

1.     Were the objectives of the project fulfilled

Yes, all my objectives were fulfilled

-        Gained insight on healthcare system in a third world country

Nepal is far behind in terms of medical facilities. During my EP, I get to see how patient is treated at a hospital with limited facilities. Healthcare system in Nepal is far behind and needed a lot of time, funds and energy for improvement. They are improving slowly but for them to have a healthcare system as good as our country is going to consume a lot of time. Its sounds impossible but with proper governance , it can be made possible

-        Improve my skills and knowledge in medical field

During my EP, I get to improve my soft skills in terms of communication skills and other soft skills as well. My interactions with patients and doctors has improved a lot during these 2 weeks. Not to mention, I gained a lot of knowledge especially on how things can b done with limited equipments. I believe these knowledge will definitely be useful for me in the future

2.     What have you enjoyed or liked the most about the project.

I loved my surgery posting the most as it was something that really caught my attention during my time there. I get to witness multiple operations including 2 c-section and it felt so nice to be there when a baby is born. Definitely a loving experience.

Besides that, I loved all the adventure activities we did there. My favourite was the bungee jumping as it really did test my courage to jump of a platform from a height of 225 metres.

3.     What have you found challenging about this project?

Language barrier. Being in a foreign country becomes a hassle when you don’t know how to communicate with them. Local patients could only understand single language making it harder for me to communicate with them. Thus, I couldn’t approach all the patients as it was hard for me to communicate and get information from them.

Secondly, the climate. As it was monsoon season, it rains heavily almost everyday. This makes it harder ask we had to walk to the hospital and sometimes we do get soaked. Besided that, this uncertain climate also disrupts our preplanned activities as most of our preplanned activities could not be carried out in rain

4.     What has really worked?

The experience and memories I made. I felt volunteering in Nepal is something I might not do anytime in future as I had made enough memories in Nepal. I came here to experience their healthcare system and I get to do it. I learned a a lot during my EP here. Their hospitality is something to be proud of as most of them are very welcoming. They are more than willing to accept and teach us everyday.

5.     What can be improved in this project?

The only thing that could be improved is the duration. I felt the duration was short and it shoul be longer. If I had more time, I would had explored other departments such as O&G and Ortho especially. More weekends also allows me to explore more local attractions and this trip would had been more complete.

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Nahgeshwarie Ratha Manaalan

A182267
6/08/2023 - 22/08/2023

1. Were the objectives of the project fulfilled?

YES all my objectives are achieved!!

During my medical elective posting in Nepal, I was able to successfully complete my objectives. My primary aim is to fully immerse myself in the medical system and improving my hands-on skills. I am amazed on how many hands-on procedure I have practiced throughout my medical elective posting Nepal where it truly gave me a chance to not only practice my skills but also build some self confidence in my self to approach patient in hospitals. The experience offered was an invaluable knowledge it revolves around healthcare environment that involves resource limitations and various clinical issues. Under the direction of experienced doctors, I actively engaged with a wide range of activities in the hospitals like joining the ward round, observing some mind blowing surgical procedure such as inguinal hernia repair, modified electroenchephalogram and newborn screening and learn more emergency treatments.

My elective in Nepal turned out to be an extensive immersion in Nepali culture that went well beyond the scope of medicine. I discovered the variety and complexity of Nepali food through my gastronomic journey of trying local delicacies. Every meal turned into a sensory experience that offered a sense of local customs, culture, and nuances. A moving highlight was taking part in the time-honored custom of applying tikka. A strong sense of community and belonging was conferred by this symbolic act of blessing and welcome. It created relationships that were independent of language and emphasized how commonplace human connection is. Cultural events provide an overview of Nepal's culture. I witnessed the ongoing tradition of a vibrant culture, from energetic festivals bursting with energy to complicated rituals steeped in meaning. These encounters provided unique insights into the moral principles and religious convictions that guide Nepalese society. This cross-cultural journey not only enhanced my elective but also shed light on the crucial relationship between healthcare and cultural sensitivity. It created a lasting impression and strengthened my resolve to offer compassionate and culturally competent treatment. The journey confirmed that the healing process involves an array of human experiences and goes beyond medical interventions.

2. What have you enjoyed or liked the most about the project?

First and foremost, I would like to thank my friends whom asked me to join the medical elective in Nepal. If it was not for them I would not have joined the medical elective in Nepal. I truly believe that a good companion matters when we are travelling. In this case its a big yes. Eventhough Nepal was a splendid experience which includes the welcoming people, cultural diversity and breathtaking landscapes I personally feel if my friends were not there in Nepal, the trip would have been not that special to me.

Another thing I enjoyed in my elective posting was the hospital we were assigned to. Gandaki medical college is the place where I learned cultural diversity and enhanced my medical knowledge. The Drs and nurses were so kind and nice to us and did not hesitate to answer our questions. I learned a lot of valuable knowledge that I would cherish throughout my medical career.

3. What have you found challenging about this project? (any part of the project you found hard to do)

During my elective posting in Nepal, several challenges tested my adaptability and perseverance. The foremost obstacle was the language barrier. The local population predominantly conversed in Nepali and Hindi, languages I wasn't proficient in. This linguistic divide hindered my ability to communicate effectively, making it difficult to engage with both patients and locals. Socializing, a crucial aspect of my personal and professional growth, proved challenging due to this language barrier. It often left me feeling isolated and restricted in my interactions.

Additionally, the entire experience took me far beyond my comfort zone. The unfamiliar healthcare environment, cultural differences, and daily uncertainties pushed me to confront my fears and insecurities. However, it was precisely these challenges that fostered personal growth and resilience, ultimately strengthening my character.

Another noteworthy challenge was adapting to the local cuisine. The flavors and ingredients were distinct from what I was accustomed to, and at times, my taste buds struggled to acclimate. Nevertheless, this challenge offered a unique opportunity to embrace new culinary experiences and broaden my cultural understanding.

In retrospect, while these challenges tested my limits, they also became invaluable learning experiences. They compelled me to develop innovative communication strategies, enhance my adaptability, and cultivate a deeper appreciation for diverse cultures and cuisines. These challenges, while formidable, ultimately enriched my elective posting experience in Nepal and contributed to my growth as a future healthcare provider.

4. What has really worked? (any part in the project that you thought worked well)

In the midst of the challenges and uncertainties of my elective posting in Nepal, several aspects of the experience truly stood out as exceptionally rewarding and effective. One notable success was the opportunity to engage in hands-on medical procedures. During my time in the hospital, I had the privilege of practicing various procedures such as ECG, branula insertion, blood collection, and catheterization under the guidance of experienced medical professionals. These practical experiences allowed me to sharpen my clinical skills and gain a deeper understanding of medical procedures, which I believe will be invaluable in my future medical practice.

Moreover, the adventure activities that I had the chance to partake in were an absolute highlight of my Nepal journey. Experiencing adrenaline-pumping adventures like ATV rides through the rugged terrain and soaring high above the picturesque landscapes during paragliding was a dream come true. These activities not only allowed me to check off items from my bucket list but also pushed me to conquer my fears and embrace new challenges with enthusiasm. The sense of accomplishment and the breathtaking views I encountered during these adventures will forever be etched in my memory, reminding me of the immense personal growth and resilience that this elective posting facilitated.
Thereby, the hands-on medical experiences and thrilling adventures were the cornerstones of what worked exceptionally well during my elective posting in Nepal. These elements not only enriched my medical knowledge and skills but also contributed to a deeper sense of self-discovery and empowerment. They encapsulate the essence of the transformative journey I embarked upon and will serve as enduring reminders of the valuable lessons and experiences gained during this remarkable chapter of my medical education.

5. What can be improved in this project?

Reflecting on my elective posting in Nepal, one area that stands out for potential improvement is the project's timeline. While the experience was undeniably enriching, lasting just two weeks felt somewhat limited in the scope of what could be accomplished and absorbed. A longer duration would have allowed for a more comprehensive immersion into the healthcare system, culture, and community. It would have provided a greater opportunity to deepen relationships with both patients and local professionals, fostering a deeper understanding of their needs and challenges. Additionally, a more extended timeframe would have offered the chance to undertake more extensive medical projects or research initiatives, contributing to a more significant impact on the local healthcare landscape. In hindsight, an extended duration would have transformed what was already a valuable experience into an even more profound and eye-opening journey, further enhancing both personal growth and professional development. Therefore, in the future, considering an extended timeline for similar elective postings could be a valuable enhancement to maximize the benefits for both the participants and the host communities.

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Ng Wen Jia, A180860, 21/8/2023 - 28/8/2023

1. Were the objectives of the project fulfilled?
Absolutely! All the objectives were successfully achieved.

To explore the difference of healthcare systems in Malaysia and South Korea

During my visiting clerkship at SNUH, I had the opportunity to work alongside top professors in this prestigious South Korean institution. This experience provided valuable insights into the distinctions between healthcare in South Korea and Malaysia. South Korea's healthcare system stood out for its efficiency and cutting-edge technology. Hospitals in South Korea were exceptionally well-organized, offering centralized services to patients. In contrast, Malaysia's healthcare system seemed more constrained in terms of resources and infrastructure. Nevertheless, both countries share similarities in terms of accessibility and affordability of healthcare services. Additionally, conversations with South Korean medical students offered valuable insights into medical education in the country.

To experience the culture and society of South Korea

I found the Korean people to be exceptionally polite, often greeting each other and demonstrating respect through bowing, reflecting their strong emphasis on social etiquette. Immersing myself in Korean culture, exploring historical sites, and savoring authentic Korean cuisine was a highlight of the trip. I was struck by the emphasis on physical appearance in South Korea, with people dressed neatly and stylishly. The cleanliness of the streets, despite limited public trash bins, and the commitment to recycling and waste sorting were impressive. The sense of safety in South Korea, where residents left valuable belongings on tables without fear of theft, was another noteworthy aspect.

To observe the common diseases and technology in South Korea

he epidemiology of breast and endocrine diseases in South Korea was similar to that in Malaysia. Most breast disease patients were middle-aged to elderly females, while thyroid issues primarily affected young females. Witnessing robotic-assisted surgeries was an eye-opening experience, as this technology was widely used in clinical practice. Robotic-assisted procedures yielded outcomes comparable to conventional surgeries but with superior cosmetic results. Surgeons regarded robotic surgeries as easier to perform due to their versatility and precise control. While this technology might not be as widespread in Malaysia due to cost considerations, it was a valuable trend to observe early in my medical journey.

2. What have you enjoyed or liked the most about the project?
The most enjoyable aspect of the project was the people I encountered. Initially, I was apprehensive about my trip to South Korea due to various online perceptions about Koreans. Fortunately, my experience turned out to be quite the opposite. Every Korean I met was warm, friendly, welcoming, and incredibly helpful. This was especially evident in Busan, where locals went out of their way to assist us with navigation, often driving us to our destination without expecting anything in return. Their kindness left a lasting impression. I also deeply appreciated the guidance and care provided by the doctors and staff at SNUH. Their support was instrumental in making the project a success.

3. What have you found challenging about this project? (any part of the project you found hard to do)
The most significant challenge I encountered throughout the project was the language barrier. Communication among doctors and patients primarily took place in Korean, including medical records and histories. Understanding conversations and discussions during surgeries, clinics, and conferences was difficult, and while I could grasp some content, it often required guessing the meaning. This language barrier reduced my ability to participate fully and share my thoughts and questions. I occasionally resorted to using a translator to understand patients' histories, which was time-consuming and required extra effort. At times, I used gestures and guesswork to communicate with locals, but my limited Korean language skills often made interactions humorous. Improving my Korean language proficiency would have enhanced the overall experience.

4. What has really worked? (any part in the project that you thought worked well)
One of my primary goals for this visiting clerkship was to participate and assist in surgeries. While I had limited exposure to surgeries in my home university due to time constraints and my status as a clinical newbie, my experience at SNUH allowed me to actively assist in surgeries. This hands-on experience added depth and excitement to my medical journey, providing a unique opportunity.

Additionally, the extended duration of my stay in South Korea was a highlight. It allowed me to immerse myself in the local culture and explore the country more extensively than a typical tourist. Over time, I began to feel like a local rather than a tourist, which enriched my experience. I had the freedom to explore different places, savor various foods, and enjoy the views that often appear in Korean dramas.

Meeting people from diverse backgrounds was another rewarding aspect. Despite initial reservations about social interactions, I found that engaging with strangers energized me. These encounters broadened my cultural horizons and provided insights into medical education in their respective countries. While these encounters might have been brief, they left a lasting impact, making each day special.

5. What can be improved in this project?
Budget planning and financial management are crucial aspects that could be improved. South Korea's attractions can be quite enticing, and it's easy to overspend. Given the relatively higher living costs compared to Malaysia, implementing a more disciplined budget and price comparison strategy would help avoid overspending.

Another area for improvement could be the schedule planning during the visiting clerkship. Expanding opportunities to join ward rounds and observe various medical procedures, such as mammograms, ultrasounds, and fine-needle aspiration cytology (FNAC), would provide a more comprehensive understanding of healthcare management in South Korea. While I observed surgeries extensively, these additional experiences could offer a broader perspective on healthcare practices in the country.

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1. Were the objectives of the project fulfilled?

Did the Project Objectives Get Achieved? Yes, indeed, the project objectives were successfully fulfilled. One of my primary objectives was to observe and actively participate in the activities conducted at JDC (Japan Dawah Centre). During my one-month stay, I actively engaged in discussions and had the opportunity to meet new people. One of the most memorable experiences was during my first week when I witnessed a Shahadah event (reversion to Islam). This, coupled with making new Japanese friends, contributed to the accomplishment of my objectives.

Another key objective was to immerse myself in Japanese culture. Throughout my stay, the majority of my meals consisted of Japanese cuisine. Additionally, my daily commute to work involved taking the train to the city centre. This routine allowed me to closely observe the activities and behaviours of the Japanese people, providing me with an authentic experience of their culture.

2. What have you enjoyed or liked the most about the project?

One of the most enjoyable aspects of my project was undoubtedly my time spent in Japan. Staying in this beautiful and culturally rich country allowed me to fully immerse myself in its traditions and lifestyle. Exploring the vibrant streets of Osaka, the Kyoto, and the natural wonders of places like Nara park was an unforgettable experience that left a lasting impression. Equally rewarding was the opportunity to meet new people, both locals and fellow interns, from diverse backgrounds. These interactions enriched my understanding of Japanese culture and offered insights into the lives of people from all corners of the world. Organizing cultural events, especially during my second week was exciting and I, was a particularly fulfilling endeavour. It allowed me to bridge cultures, foster meaningful connections, and create memories that will stay with me for a lifetime. My time in Japan was a captivating journey of exploration, connection, and cultural celebration, making it a truly cherished part of the project.

3. What have you found challenging about this project? (any part of the project you found hard to do)

One of the most significant challenges I encountered during my elective in Japan was effective communication with the locals. While Japan is a globalized country and English is taught in schools, I quickly realized that the level of English proficiency varied greatly among individuals. In rural areas and smaller towns, it was not uncommon to find people with limited or no English skills. This language barrier made everyday interactions, such as asking for directions or ordering food, quite challenging. What I did to overcome this was I would use google translate to talk with the locals as it is the best and easiest way to communicate with them. Another challenge I encountered at the outset of my elective was the difficulty in using the public transport system, which was predominantly labelled in the Japanese language. However, with the assistance of helpful local officials and some of my friends, I successfully grasped its workings, and the train became my preferred mode of daily transportation during my time in Osaka.

4. What has really worked? (any part in the project that you thought worked well)

1. Experience Organizing an Event

One of the most successful and rewarding aspects of my elective project was the opportunity to organize a cultural exchange event. This event aimed to foster cross-cultural understanding and bring together individuals from diverse backgrounds, including local Japanese residents and fellow international students.

What worked exceptionally well in this endeavour was the collaborative effort involved. I found that teamwork, effective communication, and clear delegation of responsibilities were key to the success of the event. By working closely with a dedicated team of volunteers and leveraging our combined skills and strengths, we were able to plan and execute the event seamlessly.

2. Gaining Insight into Japanese Culture

My objective of gaining insight into Japanese culture was met with great success during my elective. What worked particularly well in this regard was the immersive nature of the experience. Instead of merely observing Japanese culture from a distance, I actively sought opportunities to participate in cultural activities, ceremonies, and traditions. Learning the Japanese language, even at a basic level, greatly enhanced my ability to connect with locals and gain a deeper understanding of their culture. It allowed me to engage in conversations beyond surface-level interactions, which was pivotal in building authentic relationships and gaining cultural insights. Additionally, keeping an open mind and being adaptable were crucial in my cultural exploration. Japan's culture is a dynamic blend of tradition and modernity, and by remaining receptive to new experiences, I was able to appreciate both the ancient rituals and contemporary trends that make up Japanese society.

3.     What can be improved in this project?

·      To plan and research on the transportation system prior to flying in Japan

·      I was informed that if I had planned an event before coming to Japan, it could have been organized within my one-month stay. This would have been a lot of fun and exciting, allowing me to orchestrate my own event. However, I ended up participating in events organized by others, which ultimately made my experience in Japan all the more memorable.

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Tan Xin Yee A182195
1. Were the objectives of the project fulfilled?

·         To understand and experience the healthcare system of Japan.

Throughout my clinical elective program at Juntendo University Hospital, I gained a comprehensive understanding of the Japanese healthcare system. It stands apart from Malaysia in several aspects, such as work ethics, privacy standards, and the integration of technology. As a medical student in Juntendo University, they had the unique opportunity to engage with the DaVinci simulation, providing a solid foundation for understanding robotic surgery. In Japan, surgeons maintain a strict focus during procedures and do not engage in casual conversations, emphasizing the importance of professionalism. Communication within the hospital is facilitated through hospital-provided phones, and personal phones are not used during working hours. The hospital's ward design prioritizes the safety of elderly patients, effectively reducing the risk of falls. Patients and healthcare workers have separate entrances to the hospital, minimizing disruption to patients and their families. The operation rooms are exceptionally clean, well-lit, and equipped with modern technology. Automatic doors are conveniently placed throughout the hospital, and scrubbing areas are located outside the operation rooms.

·         To develop cross-cultural communication skills and patient care.

Initially, I was concerned about the language barrier, given that Japanese is the primary language in Japan. However, the doctors in the hepatobiliary pancreatic department were incredibly accommodating and went out of their way to explain procedures to us in English and through illustrations. I actively engaged in cross-cultural communication, relying on both verbal and non-verbal forms of communication, such as body language. I believe that I have made significant progress in developing cross-cultural communication skills. Furthermore, I had the privilege of observing and experiencing patient care in Japan during surgical observations and ward rounds. While I couldn't directly interact with patients due to Japanese law, I gained valuable insights into the doctor-patient relationship and the importance of providing optimal patient care.

·         To improve history taking and physical examination skills

Unfortunately, I was unable to fulfill this objective during my clinical elective program at Juntendo University Hospital. Japanese law prohibits students from directly interacting with patients. However, I thoroughly enjoyed my time at the hospital and had the opportunity to observe doctors' interactions and patient care during ward rounds.

·         To help students gain a deeper understanding of their chosen specialty and solidify their career goals.

My time at Juntendo University Hospital provided me with a wealth of knowledge and a deeper understanding of hepatobiliary pancreatic surgery. I had the unique opportunity to observe real-life cases and witness disease management firsthand. This experience highlighted the importance of anatomical knowledge, which I recognize as foundation in medicine. Inspired by the dedication of the doctors at Juntendo University Hospital, I am motivated to become a better future physician who takes each patient's case seriously. My aspiration is to provide the best possible patient care and management in the future, despite the challenges that lie ahead. This journey won't be easy, but I am determined to make it happen.

2. What have you enjoyed or liked the most about the project?

What I enjoyed the most about this project is the personal growth it has facilitated. Studying abroad was a long-held wish of mine, dating back to my high school years. I could hardly believe that my dream was coming true. This journey has been a tremendous learning experience on multiple fronts, including knowledge acquisition, gaining courage, and developing independence. It marked my first  trip to Japan and, more significantly, my first venture to a foreign country without the presence of my parents. Naturally, I was initially anxious, but I believed that this unique and transformative experience would help me evolve into a more capable adult. My family was a source of encouragement, pushing me to step out of my comfort zone. I took on the responsibility of booking flight tickets, arranging accommodations, and planning transportation, meticulously preparing for my journey in Japan. Successfully completing my clinical elective posting with flying colors and returning with a certificate of completion, along with cherished memories from Japan, felt like the medals of personal growth that I had earned.

3. What have you found challenging about this project? (any part of the project you found hard to do)

The most challenging aspect of this project was communication. Despite having learned some basic Japanese, I still faced significant difficulties in communicating with Japanese doctors. Dr. Mise Yoshihiro explained that English is not widely spoken in Japan, as it only began to gain prominence a few years ago. To overcome this challenge, I relied on a combination of English, body language, and Google Translate to communicate with individuals at Juntendo University Hospital and during my travels in Japan. Fortunately, the Japanese people I encountered were exceptionally kind, warm, and always willing to lend a helping hand when needed.

4. What has really worked? (any part in the project that you thought worked well)

I am truly appreciative of the guidance and explanations provided by the doctors and nursing staff during my clinical elective posting. Their support significantly improved my time management, decision-making, and clinical skills, all of which I was able to apply effectively throughout the program. Most of the objectives I had set for my clinical elective posting were successfully achieved, and I gained valuable insights into both the Japanese healthcare system and the Malaysian healthcare system. This experience has given me the confidence that I can adapt to diverse environments and healthcare systems in the future. It has also reinforced my determination to face challenges with courage.

5. What can be improved in this project?

I am highly satisfied with my clinical elective program in Japan. Everything worked seamlessly, and I gained valuable insights into the Japanese healthcare system and its comparison with the Malaysian healthcare system. I genuinely enjoyed every aspect of this experience and hope for the opportunity to have similar experiences in other countries in the future.

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Phase 4: Bid a satisfied farewell to my travels in Taiwan

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Phase 4: Bid a satisfied farewell to my travels in Taiwan

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Wong Yi Lyn, A179360

Last part of  journey

- At Kaohsiung, I visited several fascinating spots as well together with Zhi Xuan. For example, the first place we went was Qi Jin,  which is a beautiful little island located just off the shore of Kaohsiung, hence to get there we have to take a ferry ride from Kaohsiung’s harbour.

We had a great day touring Cijin's greatest sights, including TianHou Temple, Cijin Beach, Rainbow Church, Star Tunnel, Seashell Museum, Koahsiung lighthouse, and also Windmill Park.

The second spot we went together to was Ciaotou Sugar Refinery.  It was the first modern sugar refinery in Taiwan which was established during the Japanese Colonial period and is now more than a century old. Its well-preserved wooden buildings in the Japanese style as well as other historical features greatly amazed us. In and around the museum, there are other displays of old trains, railway equipment, and other works of art.

- The following places that we visited include the National Science and Technology Museum, Love 2 pier, Caoya SKM park.

- There were instances when I also travelled alone as Zhi Xuan and I were given different schedules at the hospital.  For example, I had travelled by train to Sizihwan, a place known for its beautiful sunset. Before that, I had passed by a popular spot, Pier 2 Art Center. It is a unique open art space and I have always liked the feeling of this literary and artistic environment. It is also accompanied by the natural landscape, which includes bridges, rivers, and railroads. When it was near to sunset, I only walked to Xiongzhen NorthGate to enjoy the sea view.

- Besides, I also travelled alone to Taichung, which is  a vibrant city in Taiwan known for its cultural attractions, beautiful parks, and a mix of modern and traditional experiences. Tsutaya bookstore, Painted Animation Lane, Natural Science Museum, Tunghai University, Gao Mei wetland, Lukang old street, Sun Moon Lake, and Caowu plaza were among the locations I visited.

1. Were the objectives of the project fulfilled?

Yes, all the objectives of the project were fulfilled.

To deepen my understanding of the unique challenges that family medicine presents

In the hospice ward, there were a number of issues faced, including those related to end-of-life care and communication skills. However, I was able to gain knowledge through observing how family doctors handle hospice care and conversations with patients.  The integration of palliative care principles in hospice care also enables me to build a foundation in pain management, symptom control, and improving the quality of life for patients with life-limiting illnesses. Moreover, I get insight into how family doctors handle difficult conversations with patients and their families while addressing concerns, providing information, and upholding patients' wishes.

Gain hands-on experience, to develop primary skills and hone my skills to deliver patient-centred care, which involves considering not only the medical aspects of a patient's health but also their social, psychological, and cultural needs.

I have developed practical skills well by engaging actively in clinical activities and patient care. For example, I always volunteered  for procedures, examinations, and tasks whenever appropriate. Additionally, I was always proactive and eager to learn, so I frequently received guidance from medical professionals and seniors who were willing to share their experience and expertise with me.

Gain a deeper grasp of the best ways to support patients’ overall health and wellbeing by using a variety of interventions,

Through the lectures offered by Dr, I have learnt about some of the alternative therapies that can be used in hospice wards, such as massage therapy, aromatherapy, music therapy, guided meditation, and art therapy, to help the patient feel at ease.

Besides, I also gained insight about the type and dosage of medication administered to the patients in accordance with their needs.

Exchanging insights and experiences with new friends

Through the medicine elective and trip to Taiwan, I have met some new friends despite their ages. I enjoyed spending time with them, especially in the ward where I developed close relationships with a few seniors. We shared the experiences we had along the medical career route, and I was delighted to discover that the healthcare systems in Taiwan and Malaysia are very different.

The kindest thing that ever happened to me was when Dr. Hsiao occasionally brought Zhi Xuan and I desserts during ward time. He also treated us to dinner before we left and purchased us two boxes of pineapple cakes and sun biscuits, respectively, as souvenirs.

2.  What have you enjoyed or liked the most about the project?

The fascinating experience of clinical practice in the hospice ward is what I find to be most enjoyable. Since I had never been approached about receiving hospice care in such a hospital before, everything was new to me. However, after attending lectures given by physician residents and seniors, I am nevertheless passionate about understanding the theoretical aspects of hospice care since I find them to be interesting.

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Phase 4: Bid a satisfied farewell to my travels in Taiwan

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Phase 4: Bid a satisfied farewell to my travels in Taiwan

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3. What have you found challenging about this project? (Any part of the project you found hard to do)

The application procedure for this project has been difficult for me. I initially applied to numerous hospitals using the links I found on a website. I only received two to three letter responses, which was bad news because it indicated that their hospital did not allow foreign students to take elective medical courses.

Before this, another hospital I applied to was Taipei Medical University, and I had uploaded all the necessary documents. However, after realising the hospital's approval date would be delayed, I only decided to look into other options for hospitals in Kaohsiung. As I previously mentioned, due to time constraints,  I had to hustle to finish all of the paperwork and make travel plans.

4. What has really worked? (Any part in the project that you thought worked well)

I actually felt proud of myself for being able to adapt to an unfamiliar situation, whether it was in the hospital or when travelling.

At first, I thought everyone in the ward was preoccupied with their work, so I was hesitant to approach and engage in conversation. However, when the senior doctors noticed I didn't understand the circumstances, they were prepared to help. As I was the kind of student who was eager about questioning, they were still willing to clarify my doubts. I especially enjoyed getting to know Dr. Yang, one of the senior doctors, because she constantly gave me the chance to learn something new.

Besides, when I occasionally travelled alone to popular tourist destinations, I felt like I was stepping out of my comfort zone. This is because I've gotten better at navigating by utilising signboards and Google Maps, though sometimes I still get lost. Fortunately, I've met passersby who have been able to point me in the right direction, particularly grandmothers who were extremely helpful. I clearly recall the time I neglected to carry my umbrella, and it was a hot bright day. The grandmother provided me with her umbrella and gave me travel safety tips. I was touched by this since I could sense Taiwanese people's friendliness.

5. What can be improved in this project?

In my opinion, one of the things that can be improved is the duration we spent on electives. This is because learning medical things in a foreign nation is a worthwhile experience. In addition, I believe that a longer stay would allow me to learn more about Taiwan's customs and traditions and examine the history of many of the popular tourist attractions.

In addition, because we were the first group of students to participate in the hospital's medical electives, the procedures were confusing for us. For example, we only received notice that it was time to make payments before we left, and even on the final day, we received no information about how to check out.

Therefore, I believed that the situation could be improved if both sides could clearly understand what was happening through efficient communication.

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1. Were the objectives of the project fulfilled?

Yes indeed all the objectives were fulfilled and accomplished.

Gaining new information and exposure to various diseases and surgery techniques along with getting exposure of new environments to work in.

I learnt a lot of new information regarding medical diseases and surgery techniques which were indeed overwhelming but gave me the enthusiasm to further explore what medicine looks like in the far future and give me an insight about it.A few diseases that I clearly remember were the myocardial infarction emergency cases, asthmatic attacks, sepsis,dengue fever,bronchiectasis and various types of cancer.When questioned further regarding their cause of the disease, there were a lot of reasons that we managed to gather which were their lifestyle, the weather along with their air conditions, food intake and occupational exposure.Apart from the diseases I've learnt,I was able to watch surgeries for a lot of gastrointestinal diseases such as laparoscopic cholecystectomy,knee and hip replacement surgery along with laparoscopic hysterectomy.

Learning a new language as part of the elective programme

Never did I know that my elective posting would make me learn an extra Lagrange which was Hindi and it was an amazing experience indeed.The doctors in Nepal either use English,Nepalese or Hindi to communicate with one another but mostly Hindi was the main language used.My friends and I used google translator and learnt many new words which made us realise it isn't the hard to learn a new language as long as we make the effort.One of my friend already knew Hindi and she was guiding us along the way and especially after booking an uber,the drivers would call us to confirm our location in Hindi and learning the language was the best decision we made as it made a lot of things easier and smoother.We even managed to watch a movie in the cinema which was in Hindi and understood the storyline as we had the basics of Hindi.It was really a challenge to learn the language but by doing so it helped in many ways.

Participated actively in patient care

I got the chance to participate in a variety of patient care activities while I was in Nepal, including history taking, physical examinations, and diagnostic tests, all under the supervision of local healthcare professionals. Due to the fact that many patients had trouble speaking and understanding English, obtaining a patient's history presented a unique problem.However,we never gave up but instead we looked up the files to get all the necessary information.

2. What have you enjoyed or liked the most about the project?

I personally loved the whole planned elective posting done by IVHQ Team and their never ending effort to make sure we were always comfortable,got adequate food and drinks along with an amazing experience in the hospital.I truly enjoyed every moment I was there as it was a new experience which I knew even if I paid million I would never be able to get the experience of staying in a local's house travelling back and forth to the hospital and learning the culture of the family together.The people there are also very welcoming and never lets you feel like an outsider instead it makes u feel at home.

Our organisers went above and above to make sure we were comfortable from the moment we stepped foot in Nepal. Our host family gave us a warm welcome when we got to their homestay and gave us their traditional scarves and tikkas. This was a fascinating experience for me because I had never had it in Malaysia. Our host family always made sure we had enough food, and they even had a flask of their special masala tea on hand in case we got thirsty. Their kindness really warmed my heart.

Apart from the learning process that we had gone for, we also enjoyed all the sightseeing in Pokhara,Nepal.We tried not only ATV rides but also paragliding, bungee jumping from the Cliff which is about 228m and the swing which is the world highest swing.The natural scenery in Pokhara is so spectacular and beautiful .It's difficult to find tranquilly elsewhere, but visiting places like Phewa Lake, with its calm waters surrounded by gorgeous mountains, gave it. My buddies and I went on a boat ride on the lake to take in the splendour of the lake and the high mountains. Additionally, we had the honour of viewing the majestic snow-capped Annapurna mountains from the house where we slept.

Lastly,I would like to personally thank my friends for sticking through with me and making sure I did all the procedures and encouraged me to keep working harder.Without a doubt, I'll miss going on this amazing trip with them. Together, we made a ton of memories that I will always treasure.The whole trip was such a relief as everything went slowly with no hiccups.

3. What have you found challenging about this project? (any part of the project you found hard to do).

The hardest part was definitely the language barrier which we were not prepared for.Doctors and nurses communicated with their native language,Nepalese and also Hindi which made the whole process difficult and very few doctors used English as their mode of communication.We had no choice but to put in a little extra effort and learn an extra language as it would definitely be beneficial for us and it was indeed.Whenever we ordered a taxi, the drivers spoke in Nepali or Hindi. Their  English was not very good. We had a hard time communicating with them and  had to find a local to  talk to the taxi drivers.

Another challenging part was to stay away from snatch thefts along the way who do it in broad daylight..We had to be extra careful every time we go out by holding our bags tightly and making sure everything is safe.There were also scammers who took advantage of us because we were unfamiliar with the local money. It's important to get opinions about prices for items and transportation from individuals you trust or from locals. When we told our host family that a taxi driver had overcharged us, they said that Nepalese people frequently barter for prices.Wer slowly learnt our lesson and improvised from there.

Next was the weather which was really unpredictable and we all had to get our raincoats and umbrella each.We got soaked once as we were not prepared and this taught us a lesson to be more prepared next time.We also witnessed landslides because of the heavy downpour which was continuous and that delayed our journey up to Pokhara.The usual journey would take about 10 hours but ours was a total of 14 hours.

4. What has really worked? (any part in the project that you thought worked well)

I had thought that our main responsibility would be to observe the patients and their cases. I was pleasantly surprised to see that we were able to take part in practical operations like venipuncture, ECG, and continuous bladder draining.This made really contented as I didn't expect to be doing any hands on activities but when I was able to it really made me very enthusiastic and made me want to continuously carry out more procedures with the guidance of the doctors and nurses there who were always willing to help.

The doctors and nurses went all out in teaching us the methods and also helping us learn in depth the diseases that were common and helped us interpret chest X rays which were the most hated by most students.That made us learn easy methods to interpret different X rays and have a better understanding of the reason the films are taken for interpretation.They exhorted us to keep trying. I have to be honest that doing these procedures on actual patients for the first time made me extremely anxious and nervous. But I was able to complete all of these treatments successfully under the direction and watchful eye of the doctors and nurses.

I am forever grateful for the knowledge and experience I've gained throughout my elective posting and will definitely use it in the future.It also gave me some motivation to work harder in order to achieve what I want to specialise in and be passionate about what I wish to do.

5. What can be improved in this project?

It was unfortunately the monsoon season when we went to Nepal coincidentally so we should have enquired better regarding that and chosen a different timing to visit Nepal but overall it wasn't as bad as we expected it to be.

Our stay was very comfortable but we had encountered a lot of cockroaches which kept disturbing our nights which we hoped could have been improved by our hosts.The host food was also rather little and had less variety which could also have been improved but we managed to get food from outside as well which made things better.

Despite these difficulties, I had a good time in Nepal and wished I could have stayed longer. I'm really happy that this elective assignment gave me the chance to see how healthcare is delivered in a different environment, often provided thorough experience in a particular area, and provided a fantastic opportunity to travel to a new nation.

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Farewell India - With a Heart Full of Gratitude and a Suitcase Full of Memoriess :)

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Farewell India - With a Heart Full of Gratitude and a Suitcase Full of Memoriess :)

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Noor Halinah Binti Mohamed Ali Jinnah, A181430

1. Were the objectives of the project fulfilled?

Definitely a YES!

- To gain a better understanding of the healthcare system in Tamil Nādu, India.

I observed and learned how things work there. The atmosphere was unfamiliar to me with an overcrowded population but the doctors still managed to attend to all their needs which was very commendable. Not only did I get to know the healthcare system, but I also learned about their medical education.

-To expand my clinical knowledge and to be familiar with the international medical field.

Many cases on a vast variety of topics were discussed and seen throughout my postings. I also got the opportunity to do physical examinations and elicit findings. Privileged to see rare cases such as Hirschsprung disease where I witness clinical manifestation in real life patients; (a 21 y/o adolescent with the growth of a 12 y/o due to poor nutrient absorption).

-To be more confident and resourceful.

I realize that as time passes by, I become more confident to approach doctors to ask questions and clear doubts. Used to be less proactive in classes, understood that we can only learn by asking questions and active participation. Just observing will not be a problem initially but it will hinder your knowledge.

2. What have you enjoyed or liked the most about the project?

The people and culture - 2 weeks in India indeed gave me a new outlook on their way of life. The country offers astounding variety in every aspect of social life such as ethnic, linguistic, regional and many more. There are 28 states and 8 union territories with people of each one of them having a different language, eating different food, wearing different clothes and practicing different religions. And hospitals become the place where all of these meets as the patients come from all over India in search of good health.

3. What have you found challenging about this project? (any part of the project you found hard to do)

- Blending in was quite challenging as a foreign student. I often feel being scrutinized by people whenever I go around the hospital owing to me wearing a scarf. But I managed to overcome it soon.

- I was wrong to assume that only Tamil will be mostly spoken in Tamil Nadu. As I mentioned before, people come from all over India and they speak different languages. Even the doctors here speak more than 4 languages to attend to patients which was really impressive. So, in order to understand the consultation sessions, I usually need to ask my fellow medical students to translate it for me. It can be quite a hassle because by the time they finish translating one part, the consultation will be over.

4. What has really worked? (any part in the project that you thought worked well)

Building personal and professional connections - Throughout my journey I got acquainted and communicated with many people including professors, staff, local medical students and even  street vendors. As an introvert who rarely starts a conversation, I become the first one to approach and get to know people. And that was how I got to know a Dr. Sabiya, a lovely professor from Yenepoya Medical College when we were just waiting at the bus stop.

The clinical knowledge and experience - I learned a lot of things during my posting. It was very useful and interesting although some part of it was quite overwhelming. The medical staff’s enthusiasm to teach me and share their experience have taught me something more than what I could learn from the textbook and helped me in becoming a revitalized version of myself.

5. What can be improved in this project?

- Duration of posting could be longer. I only had 1 week in the surgery department and another week in the medicine department. These 2 weeks went by so fast that I didn't get the chance to explore more on the procedures and surgeries. That's not all, a longer posting time will also be advantageous in improving teamwork and building rapport.

- Practice becoming more proactive and challenge myself to do procedures or to scrub in and assist surgery. I didn't get to scrub in as I was doubting whether I would be allowed or not. I should be more assertive and try to delve into the possibilities.

Nevertheless, my experience at CMC is one that I will never forget and it will remain as one of the most important milestones in my medical journey.

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Phase 4: Farewell to Taiwan: Reflecting on My Elective Posting

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Phase 4: Farewell to Taiwan: Reflecting on My Elective Posting

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Ng Zhi Xuan, A182906

1. Were the objectives of the project fulfilled?

Yes.

1) To improve personal professional skills in the aspects of making decision, interpersonal communication, time management and critical thinking

Before deciding to do my elective posting abroad, I carefully considered various factors: language proficiency, affordability, interest, and recommendations from others. It was a bit tricky, but I assessed different options, thought about the pros and cons, and finally selected an elective posting that matched my preferences. My careful decision-making played a role because my elective experience in Family Medicine not only enhanced my understanding but sparked a genuine interest in this field.

Time spent in the hospice ward also provided me with invaluable insights into informed decision-making and shared decision-making in a clinical context, which will be crucial in my future medical practice.

In the hospice ward, most of the patients were terminally ill and approaching death, I was not encouraged or expected to clerk them. Knowing that my chance of interacting with patients was limited, I tried to seek opportunity to interact with doctors, interns, caregivers and other staffs in ward to learn something from them. These were the times when I put my interpersonal communication skills into practice.

Through joining home care, ward rounds, and family discussions within the hospice ward, I had the chance to witness and appreciate the significance of effective and compassionate communication in healthcare. This experience indirectly contributed to the improvement of my interpersonal communication skills. I managed my time well throughout the elective posting period, as I always tried to be punctual and confirm my schedule a day before.

As an observer in hospice ward, I witnessed various discussions among healthcare providers and families regarding patient care, including the patients' treatment goals, options for symptom management, potential side effects, decisions to withdraw life support and so on. Critical thinking came into play as I challenged myself to analyze the ethical, medical, and emotional aspects of these decisions.

2) To observe and learn about doctor-patient relationships and patient-centred approaches.

My observations during ward rounds and family discussions, have allowed me to witness how doctors in the hospice ward interact with patients and their families. The emotional moments and conversations about patients' wishes and family concerns deepened my understanding of doctor-patient relationships in a palliative setting.

I learnt that these relationships are built on trust, empathy, and a shared commitment. Only with these qualities can the doctor understand patients' emotional and psychological needs and provide comfort and support that aligns with the patient's needs.

3) To gain a general understanding of the healthcare system in Taiwan.

In Taiwan, through National Health Insurance (NHI), comprehensive healthcare services with good accessibility are provided for everyone. The services includes inpatient and outpatient care, dental care, Traditional Chinese medicine, maternity care, home care, preventive care, and more with low out-of-pocket costs.

The healthcare market in Taiwan is dominated by private providers contracted with government. Under NHI, the government supports the private sector by reimbursing them based on a predetermined fee schedule for different medical procedures, consultations, and treatments.

Through NHI, patients are free to select their healthcare providers. They can consult specialists directly without any referral from a primary care physician. Furthermore, their healthcare system is highly responsive, with minimal waiting times for appointments and patients can normally see any specialist they wish to during regular working hours.

Besides, every Taiwanese citizen possesses an NHI IC card, a smart card that serves multiple functions. It not only serves as personal identification but also stores a concise medical history and facilitates billing through the national insurer. Patients are required to present their NHI IC card each time they access medical services, with hospitals subsequently submitting related charges to the government for reimbursement.

Taiwan also has well-developed electronic health records system, which greatly enhances patient care by streamlining processes, reducing errors, and improving overall healthcare coordination.

4) To identify differences between healthcare system in Malaysia and Taiwan

Accessibility and Coverage

Malaysia has a hybrid healthcare system with both single-payer and private insurance components, while Taiwan boasts a single-payer healthcare system where the government covers basic healthcare needs.

Malaysia's primary healthcare system consists of public clinics governed by Ministry of Health of Malaysia (MOH) and private clinics owned by general practitioners. Public healthcare clinics or "Klinik Kesihatan," offer low-cost and subsidized primary care services for Malaysians.  Government employees, their dependents, government pensioners, and the disabled are eligible to receive free public healthcare. This includes maternal and child health services and treatment for certain infectious diseases such as tuberculosis, all provided without cost. However, Malaysia doesn't have a unified system of universal access to healthcare for every citizen. Access to primary care services in urban areas is generally good, but there may be disparities in rural and remote regions.

Taiwan's primary healthcare system is highly accessible, with a vast network of primary care clinics and community health centers spread throughout the country. The NHI program in Taiwan ensure universal healthcare coverage, providing primary care services for nearly the entire population, with low out-of-pocket fees.

Gatekeeper System

In Malaysia, government clinics serve as gatekeepers, requiring referrals before patients can see government specialists. This minimizes unnecessary costs, enhances healthcare equity, and shortens waiting times for specialist care. However, the private system lacks gatekeeping, enabling direct access to private specialists even when unnecessary. This contributes to its higher cost compared to public healthcare.

In Taiwan, under NHI, patients are free to bypass primary care and seek secondary care through self-referral, even for minor illnesses. However, this crowds out resources for patients in need of high-level care. Due to small out-of-pocket expenses, medical resources tend to be overutilized. For instance, there is a high demand for hospital outpatient services every day, as I observed in Chang Gung Memorial Hospital in Taiwan.

Health Information Systems

Malaysia has been working on improving its health information systems, including electronic medical records, to enhance healthcare delivery and coordination, but some hospitals and clinics still rely on a combination of paper-based and electronic records.

Taiwan has a well-developed, comprehensive electronic health record system that is extensively adopted, allows for efficient sharing of patient information among healthcare providers. Based on my observation in clinics and hospice ward in Chang Gung Memorial Hospital, patient health records are entirely paperless.

5) To build cross-cultural relationships and foster cultural appreciation.

During my time in Taiwan, I tried lots of Taiwanese food and talked to locals about our favorite dishes from our countries.

Besides, me and Yi Lyn gave presentations on introducing Malaysian medical education system and the tourist attractions in our hometowns. Our Taiwanese friends in the Family Medicine Department at CGMH liked our presentations and even wanted to visit Malaysia as a group. Our efforts of cultural sharing and exchanging were not only successful but also appreciated.

I also had some really nice experiences talking to locals.  These interactions were heartwarming. From helping a retired nurse with directions to receiving a kind gift from an elderly woman at a hypermarket, I felt touched by the warmth and friendliness of the Taiwanese.

Even though I sometimes had trouble with the language, especially with Minnan dialects and medical words, I asked for help, learned from my colleagues, and studied to understand. This helped me to better connect with patients and my colleagues.

Overall, the elective posting helped me learn important life skills like being independent and adaptable by immersing myself in the culture of unfamiliar environment.

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Phase 4: Farewell to Taiwan: Reflecting on My Elective Posting

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Phase 4: Farewell to Taiwan: Reflecting on My Elective Posting

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Ng Zhi Xuan, A182906

2. What have you enjoyed or liked the most about the project?

What I liked most about this elective posting is the exposure to and understanding of palliative care in Family Medicine.

I remember back in my third-year surgery OSCE when a simulated patient asked me to explain what palliative care is. At that time, the only thing that came to my mind was reducing pain and discomfort, not curing the disease or prolonging life expectancy. I mainly discussed the management of symptoms and physical discomfort while completely ignoring the emotional, psychological, and spiritual aspects of palliative care.

During my elective placement at CGMH, I had the opportunity to step into a hospice ward for the first time in my life. Participating in ward rounds, joining family discussions, and listening to conversations in the hospice ward made me feel like I was watching a real-life PPA OSCE series, which was interesting and gave me much to reflect on.

Now, my understanding of palliative care is that its aim is to alleviate suffering in all its forms to improve the overall quality of life of a patient when a medical cure is not possible. Physical pain is one of the sufferings faced by terminally ill patients. Emotional, psychological, and spiritual distress are also forms of suffering faced by the patients themselves, as well as their family members. Therefore, addressing these aspects is important and should never be overlooked by healthcare professionals when dealing with those facing the end of life.

3. What have you found challenging about this project?

Initially, I thought I could practice my history-taking and physical examination skills throughout the elective posting at CGMH. However, my experience of joining the outpatient clinic at CGMH did not provide me with much hands-on training in history taking and physical examination.
Despite the numerous patients in each clinic session, they were mostly there for medication renewals and follow-ups on chronic diseases. For most patients, their consultation times were brief, some even less than 5 minutes, and as an undergraduate, I was neither given the opportunity nor expected to clerk patients during these sessions.

One doctor informed me that the high outpatient volume is one of the undesired consequences of National Health Insurance (NHI). I also noticed that every patient who came to the clinic held an NHI card. Realizing that I might not have the chance to sharpen my hands-on clinical skills during these sessions, I decided to shift my focus towards learning about the NHI system and the functions of the NHI card.

Before entering the hospice ward, I had initially planned to clerk patients, but I soon realized that many of them were extremely weak and not fully conscious. Therefore, throughout the elective posting, there was little hands-on learning, so I decided to put more emphasis on listening, asking questions, observing, and reflecting.

Although I was not naturally proactive in initiating conversations, I kept reminding myself that I must learn something from this elective posting. Therefore, I challenged myself to be creative in my learning approach and attempted to talk with anyone in the ward from whom I believed I could learn, including the doctors, postgraduate-year interns, and even the chaplain. Initially, I found this difficult and unnatural for me, but I slowly adopted this approach and managed to learn a lot.

4. What has really worked?

From this project, I think what has really worked is that I have grown to be a more empathetic and tolerant person.

In the hospice ward, I witnessed the physical and emotional struggles that patients went through, along with the emotional impact on their families and the healthcare providers. Understanding their pain and suffering has taught me to be more compassionate and empathetic toward patients as well as people in general. Now, I have learned to consider things from various perspectives before drawing any conclusions and try to take into account the emotional needs of all parties involved in my decision-making process.

This elective posting also has taught me the importance of empathy, compassion, and holistic approach in providing the best possible care to patients and their families. These experiences will stay with me as I continue my journey in the medical field.

5. What can be improved in this project?

I should have applied for elective placements in multiple departments within the hospital at once to gain a broader exposure, considering that my stay in Taiwan was quite long, lasting about one month plus they provide free accommodation.

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Creating Lasting Memories: Adventures in Hong Kong's Culture

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Creating Lasting Memories: Adventures in Hong Kong's Culture

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Oon Men Joo, A179804, 21/08/23 (Mon) - 28/08/23 (Mon)
1. Were the objectives of the project fulfilled?

Yes, the objectives of this project have been successfully achieved.

Through my elective clinical attachment at Queen Mary Hospital, I've observed improvements in my communication skills. It was because the demanding working environment forced me to express my thoughts clearly and precisely to avoid wasting anyone's time, and it enhanced my ability to communicate effectively in a medical setting. Doctors' feedback on the importance of speaking clearly and loudly contributed to this skill development. My Cantonese language skills also saw significant enhancement, progressing from 1 percent to approximately 40 percent proficiency. Although I didn't have the opportunity for direct patient history-taking in Cantonese, I learned many Cantonese medical terms during consultations. This knowledge will be valuable for communicating with Cantonese-speaking elderly patients in Malaysia.

This project also provided invaluable insights into the healthcare system and medical culture in Hong Kong. The similarities with Malaysia, including medical knowledge being taught in English and the use of consistent medical terminology, made it easier for me to understand when accessing the patient records. The efficiency and punctuality of the Hong Kong healthcare system left a strong impression. The integrated health information system, accessible by doctors across different hospitals, encompassing both public and private hospitals, impressed me. Moreover, I found Hong Kong's research system to be well-established.

This clinical attachment significantly enhanced my clinical knowledge. In contrast to my previous surgery posting at HUKM, where my involvement in operating theatres and procedure observations was limited, this elective posting provided the opportunities to closely witness various operations and medical procedures. This kind of exposure significantly improved my clinical knowledge, particularly in areas that I found challenging to memorise from textbooks. I also gained insights into medical practices like liver transplantation, which are less common in Malaysia but prevalent in Hong Kong.

While the objective to network with medical students in the School of Clinical Medicine, HKU, was partially achieved due to differing schedules, I still managed to connect with some HKU students and had lunch together. Furthermore, I had the opportunity to meet students from various countries, including the UK, Australia, Germany, and Japan, fostering a broader network.

2. What have you enjoyed or liked the most about the project?

The part I enjoyed the most was the networking opportunities and cultural exposure. Despite some scheduling challenges, I had the chance to network with medical students from Hong Kong, the UK, Australia, Germany, and Japan. These interactions expanded my global perspective and provided opportunities for cross-cultural learning. Besides, exploring Hong Kong's culture and attractions during my free time was a delightful experience. It not only provided a break from the clinical setting but also allowed me to appreciate the cultural diversity and uniqueness of the city.

Additionally, I felt fortunate and deeply appreciated the opportunity to witness both DDLT (Deceased Donor Liver Transplantation) and LLLT (Living Donor Liver Transplantation) operation. The LLLT, in particular, was a remarkable experience as it involved simultaneous surgeries for both donors and recipients, with the active participation of numerous liver transplantation consultants. The operating theatre was filled with doctors, medical students, and secondary school students observing the procedures, and I made sure to be considerate and not to block their way. Witnessing the process of removing a portion of the liver from a living donor and successfully transplanting it into the recipient was inspiring. It demonstrated the importance of seamless teamwork and coordination among all hospital staff involved in this life-saving procedure.

Lastly, I experienced a strong sense of accomplishment throughout this project. I could see significant growth in both my hard and soft skills, making the entire journey incredibly rewarding and enjoyable.

3. What have you found challenging about this project? (Any part of the project you found hard to do)

The challenging part of the project includes the observational role. As an observer, there were moments when I wanted for a more active involvement in patient care, such as clerking, performing physical examinations, or assisting in surgeries. Unfortunately, due to the strict rules and regulations governing the elective posting, these opportunities were often limited.

Besides, while I had the opportunity to network with medical students from the University of Hong Kong (HKU), coordinating schedules and finding common topics for interactions was challenging as well. It was because the HKU medical students were divided into small groups and I only had the chance to meet one small group of students 1-2 times per week. They often have packed schedules filled with lectures, teaching session, research activities and clinical rotation at other hospitals which is different from my schedule. Therefore, it was challenging to find overlapping free time that would allow us to meet and interact.

Lastly, language barrier was also a challenge. Medical jargon spoken rapidly in Cantonese sometimes made it hard for me to grasp the details of the discussions and procedures, making my experience more complex.

4. What has really worked? (Any part in the project that you thought worked well)

There were several aspects of the project that worked well.

The teaching sessions were a success. They were not only informative but also well-structured. I was able to compile the knowledge I gained into a PDF file for my reference in the future. These sessions provided an invaluable platform for learning and enabled meaningful interactions with medical professionals.

Despite the initial language barrier, the immersion in a Cantonese-speaking environment was highly effective in enhancing my Cantonese listening and speaking skills. It was a great experience that not only improved my language proficiency but also boosted my confidence in asking questions and expressing myself.

Lastly, careful planning allowed me to strike a balance between clinical learning and leisure activities. I have explored the tourist attractions of Hong Kong, immerse myself in its vibrant culture, and appreciate the stunning scenery and the warmth of its people.

5. What can be improved in this project?

I think I should be requesting more opportunities for active participation rather than just observation such as following the HKU students to clerk patients, perform physical examinations, assist in minor procedure or engage in hands-on learning where appropriate. This was a more a proactive approach that can enhance my understanding and skills.

Besides, I should gain a deeper understanding of the Malaysian healthcare system and the life of doctors in Malaysia so that I can provide more detailed and insightful responses when I was asked about my home country's healthcare system. This knowledge can be valuable during cross-cultural interactions.

Additionally, there was an instance where my supervisor offered for me to assist with research initiatives. Regrettably, there was no subsequent follow-up on their part. At that time, I chose to remind my supervisor once, mindful not to disrupt their busy schedule with frequent inquiries. In hindsight, I should recognise the importance of taking a more proactive approach and persistently engaging with my supervisor to seize the opportunity for additional learning experiences.

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Week 4 - Sayonara, Land of the Rising Sun 🇯🇵

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Week 4 - Sayonara, Land of the Rising Sun 🇯🇵

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FARAH ALYSHA BINTI MOHD FARID RIDZWAN LEE, A181270, 22/7/23-10/8/23
1. Were the objectives of the project fulfilled?

Most definitely. My first objective was to learn the foundation and basic concepts of medical research and I think I’ve achieved beyond that. Through the articles that were assigned to me, I was able to grasp the approach to conducting a research and writing up an article.

My next objective was expanding my knowledge and understanding in the field of neuroanatomy. I had the opportunity to observe so many experiments that were essential in contributing to the research findings. If it wasn’t for this project, I wouldn’t have known how important SBNO1 gene is and how it contributes to the pathogenesis of many neurological diseases. I also learned that it plays a protective role in neurons when it’s not mutated.

In terms of personal development, I achieved my goal in adapting well to an unfamiliar environment and demonstrate the capability to gain new knowledge even with a language barrier. It didn’t take me long to get along with the students and professors there. We used different means to communicate, from hand gestures to google translate.

Lastly, my critical thinking skills were definitely elevated throughout my 3 weeks there. Travelling to unfamiliar places and navigating various situations gave me a boost in obtaining strong critical thinking skills. Although I had everything planned from A to Z, unexpected circumstances are unavoidable. For instance, I had to cancel my plan on one of the days due to a typhoon. Thankfully, I was able to find places that I can visit without worrying about the extreme weather. That was one of the experiences where I put my critical thinking skill to good use and ensured that I made the most out of my three weeks there. Traveling allowed me to step out of my comfort zone and gain new perspectives, which in return enhanced my problem-solving skills and creativity.

2. What have you enjoyed or liked the most about the project?

Personally, what I loved the most about this project was the sense of discipline and independence that I got to experience. The joy of being completely in charge of my own life was like nothing I’ve ever felt before. From this project, I learned how impactful my decisions can be. Everyday, we make decisions subconsciously. I believe no matter big or small, all decisions are capable of changing the trajectory of our lives. Hence, I’m eternally grateful for having the opportunity to embark on this journey that has enhanced my decision making skill.

I also enjoyed how my 3 weeks experience has changed how I view things. I used to hate trying new things and adapting to new environments but i have a new perspective now. I’m also no longer afraid to step out of my comfort zone because I believe only by doing so, I’ll be able to grow as an individual.

I absolutely loved the fact that I was able to study and travel at the same time. I was not only gaining new knowledge, I was also seeing and experiencing new things. This was not an easy opportunity to come by, so I’m very grateful for the experience. This journey has definitely broaden my horizons and made a huge positive impact in my life.

3. What have you found challenging about this project? (Any part of the project you found hard to do)

The hardest part of this project was definitely the preparation part. There were so many documents to prepare and so many forms to submit. I’d be lying if I said I didn’t have second thoughts about moving forward with this project. However, I told myself repeatedly to push through and that it’ll all be worth it. I’m immensely proud of myself for not giving up because this project was life changing and definitely worth all the hard work.

As I’ve mentioned prior, the articles that were assigned to me were so difficult to understand and I was stuck reading the same paragraph for days. I felt a little frustrated but I reminded myself that there’s always a first time for everything and first times are always hard. In addition, I had a sense of comfort knowing that the articles were meant for the PHD students, who were way more advanced than me. With continuous support and guidance from my superiors, I finally understood the context of the article better.

4. What has really worked? (Any part in the project that you thought worked well)

I think my time management worked really well. I was getting things done efficiently and I felt incredibly productive everyday. For the very first time, I saw my potential and the things I’m capable of achieving and in return, I’ve become more motivated to reach for the stars.

I also feel that my financial management was pretty good. I wrote down my expenses everyday for 3 weeks to keep track of my money usage. I also planned my budget carefully, putting aside money for meals, groceries, transportation, shopping and so on. I’m proud to say that I’ve become wiser in managing my finance.

I’m also proud of me and Adliana’s planning strategies. Our well planned itineraries made all our weekend trips possible, enabling us to have the best time of our lives.

5. What can be improved in this project?

I should’ve planned my project way earlier, perhaps at the beginning of year 3. I had a bumpy start as I missed the deadline to submit the application forms for many universities. I was sending multiple emails, submitting multiple forms but unfortunately, I didn’t receive any good news. I was lucky enough to be accepted by Shiga University of Medical Science, and I owe it all to Professor Suzana for lending a helping hand.

Apart from that, I feel that everything else went pretty well, just some minor inconveniences here and there. For example, I could’ve signed up for Japanese classes prior to the project to help me communicate better with the Japanese people. I’m not saying that learning independently is impossible, but given the time frame, taking classes would’ve been the better and wiser option.

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LIM YEE XIN, A179999, 21/8/2023-28/8/2023
1. Were the objectives of the project fulfilled?

Definitely YES! All the objectives fulfilled.

·        To get exposure and understanding different healthcare system and patient population in foreign country
The healthcare system in Hong Kong shares some similarities with Malaysia, offering two main options: Public and Private healthcare. In terms of the private system, it closely resembles Malaysia, with individuals having to bear high expenses for medical care. However, Malaysians are fortunate in that the fees within the public healthcare system are significantly more affordable compared to Hong Kong. For instance, when it comes to accident and emergency attendance, Hong Kong citizens are required to pay 180HKD (equivalent to RM106), whereas in Malaysia, we only need to pay RM1. In regard to the overall healthcare system, I would say Malaysia has a more comprehensive and systematic primary healthcare system. Hong Kong lacks the extensive coverage provided by Malaysia's Klinik Kesihatan (health clinics), which is why many Hong Kong citizens are unsure of where to seek medical attention when ill and often head straight to the emergency department. In the realm of obstetrics, pregnant mothers in Hong Kong can receive antenatal care at tertiary hospitals without any underlying complicated conditions. Nevertheless, I believe Malaysia has a more structured approach to antenatal care especially our primary healthcare system Klinik Kesihatan. While waiting lists can be quite long in Hong Kong, it doesn't seem to be as crowded as Malaysia in terms of healthcare services.

·        To broaden my prospective of medical work and international health issues
I had the opportunity to engage in discussions with the house officers in Hong Kong. These housemen typically have a work duration of 12 months during which they can choose to rotate through two medical postings and two surgical postings. Interestingly, the housemen in Hong Kong receive higher salaries, approximately 30,000HKD (equivalent to RM17,000) per month, although their working hours are similar to those in Malaysia, and they don't engage in tagging. Specifically in the field of obstetrics, while issues like gestational diabetes and obesity are prevalent in Hong Kong, Malaysia experiences an even higher prevalence. Obese individuals are rarely seen in Hong Kong compared to Malaysia. The most common cancers among women in Hong Kong, such as breast, colorectal, and lung cancer, are similar to those in Malaysia. However, Hong Kong reports a higher incidence of uterine corpus cancer compared to cervical cancer, which is more common in Malaysia.

In my opinion, this difference may be attributed to the higher health awareness in Hong Kong. Doctors in Hong Kong readily recommend pap smears for sexually active patients and consistently advise them to undergo regular screenings. Generally, Hong Kong citizens are well-informed about the purpose of pap smears and keep track of their latest results. I was also impressed to see that many of them use their smartphones to record their menstrual cycle dates, reflecting their strong commitment to maintaining good health.

·        To build cross-cultural relationship through different learning environment
I had the pleasure of attending classes alongside local HKU students, participating in clinic sessions, grand rounds, teaching rounds, and obstetric and gynecology case discussions. Some of these students were exceptionally friendly and took the initiative to learn about my background, allowing us to exchange insights on the differences between Malaysia and Hong Kong in terms of learning methods, exam syllabi, and the healthcare system. Even though they didn't have individual supervisors as we do in UKM, they displayed impressive independent learning abilities and possessed a strong knowledge base. Some of them went above and beyond by recommending notable places in Hong Kong for me to visit. During my elective period, there was another elective student studying at the University of Liverpool in the UK, but she was originally from Hong Kong. I was grateful to have her as a guide on occasion, and she proved to be a valuable resource. The medical officers here also contributed to making me feel comfortable, engaging with me in conversations that felt like chatting with friends. I learned from one medical officer who had graduated from the UK that contraception in the UK is provided free of charge. Another medical officer inquired about my specialty interests, and I mentioned my interest in emergency medicine, while she expressed her passion for obstetrics and gynecology. She shared that the emergency department at Queen Mary Hospital isn't typically busy and often receives individuals with mild ailments like the flu or fever. She believed this was because the primary care system in Hong Kong was not as well-established, and people were unsure where to seek medical attention, opting for the emergency department instead. The cross-cultural relationships I developed at Queen Mary Hospital brought me a sense of happiness and enjoyment during my elective.

•           To increase cultural and linguistic competences
As I embark on this enriching journey, my primary objective is to fully immerse myself in the local culture and language. While I already have some knowledge of Cantonese in Malaysia, I primarily hear this language spoken in my hometown, so my proficiency level is only average. I aimed to actively engage with the community, patients, and healthcare professionals in their native language, Cantonese, in order to overcome communication barriers and gain a deeper understanding of their perspectives. For instance, I was able to assist patients at Queen Mary Hospital when they sought my help. Moreover, Queen Mary Hospital had not only Cantonese-speaking individuals but also people from overseas with whom I needed to communicate in English. I recall one instance where I had to seek consent from an expectant mother for observation during delivery, and her husband was from North America. Through this experience, I learned that North American culture often involves a preference for female medical practitioners and a hesitance to allow male individuals, including medical students, during childbirth for their wife. This exposure not only enabled me to provide more effective patient care but also encouraged me to develop cultural sensitivity and respect. This applied not only to my interactions with patients but also with the nurses at the hospital. Since I frequently needed their assistance, I gradually familiarized myself with their communication style. I noticed that they tended to have a quick temper, so when approaching them with requests, I learned to introduce myself and get straight to the point. By actively listening, learning, and embracing the diverse cultural backgrounds encountered during my elective, I am dedicated to broadening my horizons and evolving into a healthcare practitioner who is culturally competent and empathetic.

2. What have you enjoyed or liked the most about the project?

The adventurous clinical experience in hospital! I really glad and appreciate that even I know nothing but I get to palpate the fetus, measure SFH, use the speculum and do PV examination, this would definitely help and ease my journey of year 4 in O&G posting!

3. What have you found challenging about this project? (any part of the project you found hard to do)

Definitely the application process! I had been prepared the elective since the beginning of year 3 and prepared the documents since last year December. Although the application process is clear for The University of Hong Kong, the details of documents are hard to prepare, such as infection control training certification, medical malpractice insurance for medical student. For example, the medical malpractice insurance generally only offered for those with APC certified licensed doctors but not the medical student, that is why I have to keep asking different people, waiting for the reply in order to get the ways to apply malpractice insurance. Fortunately, the AMSA UKM did recommend the medical protection society that offered the insurance for medical student for FREE. There is a lot of uncertainties. Initially, I didn’t get any offer from my preferences which are Emergency medicine, General medicine and Surgery. The application admin is kind enough and ask me any other choices of department I would like to choose and eventually the Obstetric and Gynaecology department accepted me. From the application until receive the offer letter, there is a lot of feelings, I scared, I disappointed, growing sense of anxiety while waiting…I am glad that eventually it worked out fine with the help of my friend, Menjoo.

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LIM YEE XIN, A179999, 21/8/2023-28/8/2023
4. What has really worked? (any part in the project that you thought worked well)

During the elective period! I am proud of myself that I did survive one month alone in Airbnb in Hong Kong. Initially, I really scared of the safety in Hong Kong as I living alone bit far from the hospital without knowing the housemates. When I reached Hong Kong, the host of Airbnb is hard to contact when I wanted to check in. I am fortunate enough to meet an old man that willing to help me to find the unit.  Moreover, there was an underlying sense of insecurity, knowing that all my housemates were male while I was the only female. I was even apprehensive when taking a shower, fearing the possibility of sexual harassment. Thankfully, after conversing with my housemates, I realized they had no complex or troubling backgrounds. Additionally, a Chinese mother and her son moved in after a few days. The Chinese mother would often prepare dinner for me, which brought a sense of warmth to my evenings after returning from the hospital.

Thanks to Hong Kong's excellent public transportation system, I was able to efficiently travel throughout the city and plan my trips with ease. The presence of police patrolling in my living area also contributed to my sense of security while staying in Hong Kong.

5. What can be improved in this project?

I should apply more universities in the early stage to provide myself variety of choices. Even though most of the universities they stated that the requirement need to be 4th or final year, I still can give a try to apply. Perhaps it would be better if the faculty of medicine UKM can put the elective posting in end of year 4 as on that time we already go through many posting that would be provide us wide of range of universities to apply.

My humble opinion is that we can collect all the seniors name/contact/ elective abroad information for various batch to help our juniors in application as doing elective abroad is really help ourselves to step out from the comfort zone and learn a lot !

Furthermore, I really appreciate and give highest gratitude to our faculty of medicine UKM for supporting us and even funding us to do elective abroad and hopefully our juniors will benefit for the following years.

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EP Wrocław Edition; A Blessing In Disguise

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EP Wrocław Edition; A Blessing In Disguise

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Anis Nazira binti Razali, A180856, 14/8/23-20/8/23

1. Were the objectives of the project fulfilled?

Yes, all of the objectives of the projects were fulfilled with great understanding and application of each.

To increase the mobility and to widen the horizon of medical students worldwide

I had the privilege of gaining exposure to a diverse range of medical subspecialties. Besides having the experience of being in the operation theatre in Poland, I also had the chance to attend rotations in various departments, including nephrology and transportation (transplantation), internal medicine, and oncology which allowed me to broaden my clinical skills and experience of being the medical field in another country.

To provide equal chances to medical students to participate in a professional exchange, regardless of subjective, geographical, political, financial, sexual, cultural or religious backgrounds

There were many of my colleagues who attended the exchange which came from different countries such as my roommate from Spain, my general surgery colleagues from Morocco and Kazakhstan and even the rest were from diverse demographical background; Iraq, Taiwan, Romania and Italy.

To provide medical students with the possibility to experience healthcare in another culture with different health and education systems, and to learn how differences in culture and believes are of influence;

The exchange program facilitated meaningful connections with fellow medical students from around the world that provided collaborative learning and cultural exchange to being fostered, building up a sense of unity and understanding among us despite differences in culture and beliefs hence, promoting global perspectives in medicine.

To create possibilities for medical students to learn about global health issues, primary health concerns and basic epidemiology of the host country, and how it differs from their home country;

Since this exchange required us to stay in Wroclaw, Poland for an extended period, this immersion allowed me to observe and participate in local healthcare practices, thereby gaining insights into the cultural and societal determinants of health. I was able to witness how healthcare is delivered in the Poland, including differences in local health issues, healthcare infrastructure, patient-doctor relationships, and healthcare access.

To contribute to the education of future health professionals with a global vision and to contribute to medical students’ personal development, self-reliance, and openness in becoming future health professionals;

This programme encouraged me to engage in community outreach and service learning projects which enables direct beneficial impact for local communities while being able to learn and addressing primary health concerns. I was able to learn about the challenges faced by underserved populations and how healthcare providers in the host country work to address these issues. One notably observed thing in Wroclaw was that the prevalence of locals which were wheel-chair bound, handicapped people, have restricted mobility or uses walking aid were quite high. In fact, I encountered almost everyday a local with cerebral palsy in public areas from different severity and verified by my supervisor. The city itself was an inclusive accessible city whereas they provided complete facilities for restricted mobility users as mentioned as simple as from public toilets to mall accesses.

2. What have you enjoyed or liked the most about the project?
Cultural immersion and the experience of bonding with medical students from all over the globe into becoming a close-knitted team. Besides hospital attachments, the programmes organised by Wroclaw Local Committee which was the National Food and Drink Party was the most remarkable one for me. It was the last gathering that we all had together. Besides us exchanging delicacies, dances and knowledge, it gotten emotional for us too as it was our last time bonding with each other before parting ways in our own paths back in our home country.

3. What have you found challenging about this project? (any part of the project you found hard to do)

Language barrier with the locals

In Poland, they speak Polish The duration between my post-finals and departure to Poland was quite short hence I was only able to grasps basic Polish which were useful but I felt that it would be a better experience with ample time of preparation. It was easy to converse with the younger generations in Poland and shopkeepers since they know English and Google Translate were easily accessible.

Coping with slight racial discrimination faced

There was a moment where my supervisor turned down my request of assisting in surgery when both other of my colleagues had the opportunity to do so because I was wearing a hijab which made me very disappointed after getting excited to assist in the OT. However, we managed to talk it out and came to a consensus however, due to certain circumstances towards the end I still was not able to assist. But that didn’t discourage me from continue grasping as much knowledge and skills observing in the OT, other events were as eventful to experience.

4. What has really worked? (any part in the project that you thought worked well)

Attending all the programmes organised by the local committee 😊 Living in a foreign country together students from various countries and cultural backgrounds whom initially were total stranger eventually create strong bonds. Activities as simple as sight-seeing, hiking, playing board games, having dinner and picnic together enables us to share experiences which builds a solid foundation of deep and meaningful connections of profound cross-cultural friendships. We were able to share challenges and triumphs of adapting to a new environment.
I would personally say being roommates with my Spanish friend, Pilar was the thing that worked well the most. We got along very well which made my exchange experience extra adventurous as we explored and did a lot of things in different places together. We were able to do many things together such as exploring the city's historic architecture, vibrant festivals and delicious Polish cuisine.

5. What can be improved in this project?

Since this project I attended is under Society of MMA Medical Students (SMMAMS) & International Federation of Medical Students Association, I may say improving more on the technical side by their teams. In Poland, during my Upon Arrival Training (UAT) whereby there was an orientation and bonding activities organised for the incomings in the first week, all of the other students there were all members of IFMSA with high positions in the committee and to my surprise, I was just a normal participant. I had no idea about the existence of merit points in their system where they collect, the higher the point, the more chances they get to attend exchange in first-class countries. Incomings from other countries were well informed of this exchange system and brought souvenirs such as keychains, childhood snacks/food since they brought from their country as a kind gesture but I only bought local snacks like kerepek pisang and childhood snacks which were initially for my survival that I then gave it to them as a token from Malaysia. Maybe if I prepared more it could've improved the experience as a whole.

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Name : Kaviyarasi A/P Manoharan
Matric Number: A182834
Date : 6/8/2023-22/8/2023

1. Were the objectives of the project fulfilled?

Yes, all the objectives of the project were fulfilled.

-Expand clinical knowledge and skill set
This posting has helped me a lot with improving my skills. Before this, I was so used to performing procedures on mannequins and I have always wondered when I dare to perform it on real patients. I am glad that I have started it already. I hope in the future I will have more patients to gain more confidence and be a good doctor.

-Gain experience that will be of potential value in the future
EP has helped me to envision the approach in the working environment and workflow Nepal has, in contrast to the Western countries. The medical experience here has prepared me for tougher cases and different way approaches when lack of resources. There were a lot of things in my life I took for granted and I felt very lucky in the end to be able to help the people around me and also learnt to be more grateful.

-Immerse in Nepali culture
The people of Nepal are so welcoming and kind. The best part was that I was allowed to completely take on the Nepali culture and was fully immersed by my host family. When we arrived in Pokhara, our host family welcomed us with a tika on our forehead. Every day they served us a Nepali dish, which is 'dal bhat' and masala chai. Mr Dharma took care of us well. They checked on us from time to time. There are some days I would wake up to the sound of the prayer bell in the neighbor houses and it just showed how they are so cultured. It summed up the Nepalese culture and way of life perfectly.

2. What have you enjoyed or liked the most about the project?

As a medical student, even though most of the time would be observing, I could still learn a lot from talking to nurses and doctors. I enjoyed the atmosphere there because everyone was so nice to us. I think being a volunteer is the best method for us to know about a country because it helps you to get involved with the residents there, and makes you feel that you are part of them and I learned a lot about myself also. I think I have grown to be a more adaptable, optimistic person and I will never forget such a wonderful experience.

3. What have you found challenging about this project?

Elective posting during monsoon weather was challenging. Most of the days we had to travel by car due to rain although it is just walking distance. We kept changing our plans every day as the weather was uncertain but luckily few days were fine with good weather and we were able to make use of it well.

Besides, we had a few experiences of being scammed in Nepal. Some days we would go to Pokhara Lakeside to have dinner and the drivers tried to scam us by charging more than the price we booked. Even when we went shopping, some sellers sold the souvenirs for a high price thinking that we would not find out. Shopping in Nepal has been quite challenging for us.

4. What has worked?

Volunteering in a big group was fun. All of them are very cooperative and sporting. Although we had so many immediate changes, we were able to make it work as everyone was so supportive. I am so glad that I was able to establish good bonds through it.

5. What can be improved in this project?

The period we went for elective can be improved. Although we were there for two weeks and got the chance to learn a lot, I feel like doing it for one month would have been better as we explored their medical approach and would have gotten the chance to be in a few more departments. The Obstetrics and Gynaecology department seem interesting but unfortunately, we were not able to attach there due to time constraint.

Besides, the hygiene in the hospital and host house can be better. Usually, the nurses in the hospital do not wear gloves when doing a procedure and place the syringes they need to use on the bed itself. It was quite hard to find rubbish bins and sanitizers there. In the host house, we faced a cockroach crisis multiple times. It was probably due to the cleanliness not well-maintained.

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Prissha Siveraj, A184223, 6/8/2023-22/8/2023

1. Were the objectives of the project fulfilled?

Yes, all the objectives of the project were fulfilled.

Gained exposure to a diverse range of medical conditions and diseases commonly seen in Nepal

During my time in Nepal, I encountered a significant number of cases related to respiratory diseases, including pneumonia, chronic obstructive pulmonary disease (COPD), bronchiectasis, and lung cancer which was due to tobacco smoke, household and ambient air pollution, as well as occupational exposure. In addition to respiratory cases, I also had the opportunity to various systemic conditions.

Actively participate in patient care

During my time in Nepal, I had the opportunity to engage in various aspects of patient care, including history-taking, physical examinations, and diagnostic procedures. History-taking posed a particular challenge since many patients had difficulty speaking and understanding English.

In terms of physical examinations, we were not permitted to conduct them without the direct supervision of doctors. However, I am grateful that the doctors allowed us to appreciate positive findings and provided us with explanations of the cases we were observing. It was a truly enriching experience to perform procedures under the supervision of doctors and nurses. This was my first time carrying out procedures on real patients, and I had concerns that the patients might become annoyed or reject our attempts. To my relief, they were all cooperative and understanding, recognizing that we were students striving to enhance our skills through practice.

Gain insights into global health challenges, healthcare disparities, and resource limitations by working in a resource-constrained healthcare environment.

When I initially made the decision to pursue my medical elective in Nepal, I had the expectation that the healthcare system in Nepal would be significantly different from what I was accustomed to in Malaysia. And indeed, my expectations were met. My motivation was to gain firsthand experience in a resource-limited healthcare setting to better understand the global health challenges and disparities that exist.

2. What have you enjoyed or liked the most about the project?

I would like to express my heartfelt gratitude to IVHQ for providing me with this incredible opportunity to volunteer for a Medical Elective in Nepal. Never did I imagine that I would enjoy my time in Nepal as much as I did. What stood out the most during my volunteering experience was the remarkable hospitality of the people there.

From the moment we set foot in Nepal, our organisers went above and beyond to ensure our comfort. Upon arriving at our homestay, our host family extended a warm welcome, presenting us with their traditional scarves and tikka—a novel experience for me, and one that I had never encountered in Malaysia. Our host family consistently made sure we had enough to eat and even kept their signature masala tea ready in a flask in case we felt thirsty. Their thoughtfulness truly touched my heart.

I genuinely enjoyed the natural beauty of Pokhara. It's hard to put into words just how stunning and breathtaking the natural landscapes in Pokhara truly are. Visiting places like Phewa Lake, which was surrounded by majestic mountains, provided a sense of tranquillity that's hard to find elsewhere. My friends and I took a boat ride on the lake, allowing us to immerse ourselves in the beauty of the lake. Moreover, from the house where we stayed, we had the privilege of seeing the magnificent snow-capped Annapurna mountains. My host family was truly fortunate to have such an incredible view from their rooftop, and I couldn't help but feel grateful for having the opportunity to witness such an amazing view.

Last but not least, I am truly grateful for my group of friends. Every moment spent with them was filled with excitement and laughter. I will undoubtedly miss this incredible journey with them. We created countless memories together that I will cherish forever.

3. What have you found challenging about this project? (any part of the project you found hard to do).

The most challenging part of this project was the language barrier. As a tourist, we had to travel mostly through InDrive. Every time we booked a cab, the drivers would speak in Nepal or Hindi. Their Proficiency in English was not really good. It was hard for us to communicate with them and we had to find a local to make them talk to the cab drivers. The same problem we faced at the hospital where it was hard to communicate with the patients.

As tourists, encountering scams from sellers was quite common. Since we were not familiar with the local currency, some individuals tried to take advantage of us. It's crucial to seek advice from locals or people you trust regarding the prices of goods and transportation. When we informed our host family about an incident where we were overcharged by taxi drivers, they explained that bargaining is a common practice in Nepal, whether it's for shopping or negotiating taxi fares. This was a new concept for us, as it's not a common practice in our country.

Another significant challenge during this project was the weather. We travelled to Nepal during the monsoon season, which meant that it was raining most of the time. On our journey from Kathmandu to Pokhara, we even witnessed a landslide, but fortunately, we arrived safely in Pokhara. Travelling during the rainy season posed some inconveniences, as we had to constantly carry umbrellas with us, as rain showers could occur suddenly. However, we were fortunate to have some clear days when the skies allowed us to explore and enjoy sightseeing to the fullest.

4. What has really worked? (any part in the project that you thought worked well)

This project has offered me a wonderful opportunity to learn and expand my knowledge in ways I hadn't expected. Prior to volunteering, I had assumed that our role would primarily involve observing patients and their cases. However, I was pleasantly surprised to discover that we were given the chance to participate in hands-on procedures like venipuncture, ECG, and continuous bladder drainage.

The doctors and nurses went to great lengths to ensure that we learned the proper techniques, and they provided valuable insights into the causes and potential complications of these procedures. They were also incredibly supportive, especially when many of us struggled with inserting a branula for the first time.

I will be forever grateful to these dedicated healthcare professionals, as the experience has equipped me with valuable skills that I can now apply in my own practice. My time in the Emergency Department was particularly enjoyable.

5. What can be improved in this project?

The timing of our trip to Nepal could have been better since we visited during the monsoon season, resulting in frequent rain. It would have been more enjoyable if we had travelled when the weather was sunnier and more pleasant.

Furthermore, there were some cleanliness and hygiene issues at the hospital that could have been improved. In the hospital, I observed that healthcare workers rarely used gloves when examining patients or performing procedures, and there seemed to be a shortage of normal gloves. Additionally, proper hand sanitisers were not readily available.

Despite these challenges, I personally enjoyed my time in Nepal and wished I could have had more time there.

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Nepal : The Journey is over , but the memories will last Forever

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Nepal : The Journey is over , but the memories will last Forever

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Parvin A/P Thirumurugananthajiva
A180823
6/8/2023 - 22/8/2023

1. Were the objectives of the project fulfilled?

Yes, all the objectives of the project were fulfilled.

-actively participated in patient care
During my time in Nepal, I actively participated in patient care, embracing various opportunities for hands-on experience. I had the privilege to observe doctors taking patient histories and conducting physical examinations. Additionally, I actively engaged during ward rounds by seeking clarification through thoughtful questions. In the company of a doctor's guidance, I even had the chance to perform a respiratory examination on a patient with pleural effusion. In the emergency department, I was given the opportunity to conduct ECGs and witness procedures such as catheterization and venipuncture.

-gained exposure to diverse range of medical conditions and diseases

My experience in Nepal exposed me to a diverse range of medical conditions and diseases, some of which were distinct from what I had encountered before. Most cases were diagnosed in advanced stages, particularly pulmonary conditions like COPD, bronchiectasis, and pleural effusion, along with common heart failure cases. I learned about the typical medications prescribed in Nepal and the insertion of IV fluids.

-improved my soft skills , notably critical thinking , independence, teamwork and communication

This journey also contributed to the improvement of my soft skills, notably critical thinking, independence, teamwork, and communication. Each day presented challenges that required me to think critically, adapting to a new environment and interacting with unfamiliar people. I made independent decisions concerning patient care and handled tasks like toiletry shopping on my own. Notably, I arrived during the monsoon season and promptly purchased an umbrella. While we moved as a group during our journey in Nepal, teamwork was evident both in the hospital and our foster houses. For instance, my friend and I shared the responsibility of doing laundry due to the manually operated washing machine. My communication skills flourished as I met new people and immersed myself in their culture, fostering an open-minded approach. I welcomed suggestions and consistently engaged in discussions with my friends to review our experiences and cases at the end of each day.

2. What have you enjoyed or liked the most about the project?

I thoroughly enjoyed the quality time I spent with my friends both within and outside the hospital. While working in the hospital, we were organized into groups, and this camaraderie was invaluable. We had each other's backs, which made navigating our daily duties much smoother. We diligently learned from each case, engaging in discussions about symptoms and signs we might have overlooked in patients. When it came to procedures, we provided support to one another, offering guidance and reassurance.

The doctors and nurses deserve a special mention for their patience and dedication in teaching us about cases and procedures. Despite their demanding schedules, they consistently made time to assist us. Every day was undeniably hectic, but their support made it manageable.

Leaving Nepal also means bidding farewell to my foster family, who demonstrated incredible care and ensured our comfort daily. I have a deep fondness for their traditional dishes, such as "dhall bhatt," and the delightful "masala tea," which I will greatly miss. The entire community embraced us, and their friendliness and kindness were heartwarming. Even the corner shop offered us discounts, treating us like family, thanks to the warm introduction from our foster family.

3. What have you found challenging about this project? (any part of the project you found hard to do)

One of the notable challenges I encountered during my time in Nepal was the persistent rainy weather, with rainfalls nearly every day. This meant that I had to carry an umbrella with me daily, and our shoes often got soaked, taking days to fully dry. Drying my clothes also proved to be an issue, with the laundry piling up due to the damp conditions.

Additionally, I faced some allergies while staying at the homestay, which proved to be quite discomforting. I had to rely on medication daily to manage these allergies, making it one of the more frustrating aspects of my daily routine.

4. What has really worked? (any part in the project that you thought worked well)

Undoubtedly, the experiences I garnered during my time at the hospital stand out as some of the most unforgettable moments. It was a treasure trove of hands-on learning, where I not only observed numerous surgeries in a single day but also gained insight into the intricacies of how ward rounds are conducted in that unique hospital setting. The guidance and teachings generously imparted by the doctors and nurses remain etched as a highlight.

The friendships I forged both within the hospital and among my foster housemates hold a special place in my heart. They were not only wonderful companions but also looked after us with care and consideration. It was heartwarming to witness their efforts, even going so far as to communicate with our Grab drivers on our behalf when language barriers arose.

Another skill I developed during my time in Nepal was the art of bargaining. Initially, I found myself paying overpriced amounts for various items. However, as time went on, and with the support of my friends, I gradually honed my bargaining skills. This aspect of my experience was particularly enjoyable as it presented a new and rewarding challenge.

5. What can be improved in this project?

There are a couple of areas where improvements could be made in this project:

1. Homestay Hygiene: Enhancing the cleanliness and hygiene standards at the homestay is essential, as I experienced an allergic reaction due to bedding issues. It's reassuring to note that this concern has been conveyed to IVHQ, and it's crucial that they take steps to ensure a more hygienic and comfortable environment for future volunteers to enjoy a peaceful stay.

2. Timing of the Elective Project to Nepal: Consider the possibility of adjusting the timing of the elective project to the summer season. This change would enable volunteers to fully partake in all planned activities, as the weather conditions would likely be more favorable for outdoor experiences. This adjustment could enhance the overall experience for participants.

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Farah Dina Khansa
A177347

1. Were the objectives of the project fulfilled?

Yes. Through this elective programme that I chose to do at FKUGM, broaden my perspective on how the healthcare system in Indonesia actually works. I have always gone to private hospitals before this therefore I am never really sure how the dynamic in general hospitals would likely be.

2. What have you enjoyed or liked the most about the project?

I found out that my last attachment at the hemato-onco clinic was the most enjoyable. I got the opportunity to form a meaningful relationship with the patients and their parents and also the doctors and nurses. The environment at this clinic was also more conducive compared to ICU and Klinik Tumbuh Kembang. I was exposed to many cases, observed many invasive procedures, and was able to directly engage with patients. It was really fun and I didn’t know until then that I was actually really interested in learning topics regarding hemato-oncology. The other thing that I really liked was the location itself. Yogyakarta is always famous for its traditional arts and cultural heritage. On the weekends, I used my free time to explore the city and it was very relaxing and fun.

3. What have you found challenging about this project? (any part of the project you found hard to do)

My attachment at both pediatric and neonatal ICU was the toughest for me. The circumstances overall just made me sad. It was very hectic and the doctors were also very busy. Everyday I witnessed parents crying in front of the ward or besides their baby or children's bed. A very heartbreaking scene to see their parents trying to say something reassuring to their kids while their eyes slowly turned red and teary but they got no response. Sound of patients crying was also heard everyday for hours.

4. What has really worked? (any part in the project that you thought worked well)

Through this opportunity, I learnt countless lessons and gained lots of new experiences. Being directly engaged with patients at the clinic as well as the ICU helps me improve my communication skills and professionalism when working with other people. This also helps me be more confident in approaching the patients and improves my adaptability skills when working in a new environment with new people since I needed to attach with multiple departments. I also got the opportunity to observe a few invasive procedure and learnt multiple common cases that are commonly found.

5. What can be improved in this project?

The only thing that I would change was the time I started my EP. If only I was able to start earlier I would extend my 2 weeks clinical attachment to a month. But overall all the ups and downs that I experienced throughout the 2 weeks programme InshaAllah will shape me to be a better person.

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1. Name, matric number, date
Adliana binti Abdul Samad, A181052, 10th August 2023 to 14th August 2023

2. Were the objectives of the project fulfilled?
Yes, all of the objectives of the project were fulfilled successfully.
·      To observe and conduct a proper ways of handling cell such as neurons.
- Throughout the three weeks, each week involved daily planning of experiments including, cell passage, cell transfusion, cell counting using a hemacytometer, and many more. The main objective has been obtained with even more knowledges not just limiting to proper ways of handling neurons, but I also get to see it multiples, grows and differentiates into neurons with long axons and various dendrites.

·      To learn the correlation of common neurological disease in Japan, brain aging and relate it to the molecular and cellular mechanisms of neurons.
- This objective has also been attained during my stay at SUMS, the neurological disease that I studied in the research is based on a specific gene of interest that has been found to be absent in autism patient which is a neurodevelopmental disorder. The gene of interest is called Sbno1. As for the correlation of Sbno1 gene to the molecular and cellular mechanisms of neurons, I have learnt that the experiment is to prove that mice with Sbno1 gene which has no anatomical functionality defect (includes neurite growth) is able to provide protective mechanism against DNA damages such as physical source like X-ray.

·      To identify differences between technique used and technology of biochemistry laboratory in Japan and Malaysia
- Since I have limited exposure to the techniques utilized in biochemistry laboratories in Malaysia, I find myself uncertain about the differences. However, the technology of biochemistry laboratory in Shiga University of Medical Science (SUMS) is well-equipped with hi-tech machines. One of the example is DMi8 S Live cell microscope which is used for immunocytochemistry and immunohistochemistry.

3. What have you liked the most about the project?
- I like the little interaction that I had with people in Japan. Short, yet meaningful. One aspect that stood up to me was meeting the second-year Japanese medical students who shared the same study room. Their kindness and willingness to learn, despite of having a degree in other fields has truly humbled me. It reminds me of the saying, ‘One is never too old to learn’. Witnessing their commitment and passion on learning new things has been fascinating. It emphasizes the value of lifelong learning and growth that result from seizing new opportunities. Besides, it is amazing how seemingly little conversation may be open doors to opportunities. The fact that my stay in SUMS for three weeks has also included the talk on potentially joining Professor in the future as a researcher in the department is truly incredible. This project does not only teach me various experiments, but also opened up the possibility of a career in neuroanatomy research in the future.

4. What have you found challenging about this project?
- From the beginning until the end, the vast different in knowledge of a researcher and an undergraduate medical student is huge. It took a significant amount of time to familiarize with the different mediums used in experiments. Reading research papers can be challenging, as they often contain advanced terminology. I spent most of my free time to search for meanings of unfamiliar words in order to fully understand the content of the paper. However, with the explanation and guidance of the professor, everything was much easier to be understood as he simplify the concept.

5. What has really worked? (any part in the project that you thought worked well)
I would say the adaptation in laboratory as a medical student. Although it is different than the typical going to ward to clerk patients, it is nonetheless enjoyable and intriguing in that it provides an excellent overview of what a researcher's day is like. Working in a lab fosters critical thinking abilities by allowing one to practise these skills while carrying out research. I've learned a lot from my observations, I appreciate the opportunity to learn from others and I look forward to taking on a more hands-on role in the future

6. What can be improved in this project?

By dedicating time and effort to plan weekend trips earlier, I could potentially save a lot on transportation. Utilizing app like Klook to purchase subway passes depending to specific regions would be able to provide unlimited train and bus rides which ensuring the convenience and cost-effectiveness.

I would also like to read more on the biochemistry module in year 1 as most of the experiment involves in gene level, instead on revising on central nervous system as the anatomy of a mice is different than a human.

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1. Were the objectives of the project fulfilled?

Yes.

To experience difference in healthcare system between Malaysia and Japan

—  During my elective posting in Juntendo university, I have had the chance to engage with some of top professionals in hepatobiliary surgical field. I have gained insights into the difference between healthcare in Japan and Malaysia. Japan’s system impressed me with its efficiency and advanced technology. The emphasis on prevention and early intervention was evident. In contrast, Malaysia’s healthcare system appeared more resource-constrained, with challenges related to infrastructure.

To improve history taking and physical examination skills

—  I had faced a significant obstacle to fulfil this objective during my elective posting in Juntendo university. As a foreign student, I wasn’t permitted direct contact with patients. This restriction posed a challenge to my initial goal. Nonetheless, despite the limitation, I believe I have gained valuable insights during my time at Juntendo university. I observed the discussions between medical staff and patients during ward rounds, even though with the language barrier and I could only understood 50% of the conversations, this indirect exposure allowed me to absorb crucial aspects of the process.

To produce well competence medical student

—  this elective posting has been transformative, equipping me with skills and knowledge to become a competent medical student. My time in Juntendo university had broadened my clinical exposure, introducing me to diverse hepatobiliary cases, some of which I had never seen in Malaysia. This elective has instilled in me a sense of self-confidence and a commitment to a lifelong learning.

2. What have you enjoyed or liked the most about the project?

The most fulfilling aspect of this journey was the independence I was given. This elective posting project was entirely my responsibility, from arranging accommodations to managing transportation. These challenges had made me stepped out of my comfort zone. Furthermore, the opportunity to be in a foreign country’s hospital was a transformative experience. It exposed me to a more diverse culture and medical practices. This exposure had expanded my understanding of global healthcare systems.

3. What have you found challenging about this project? (any part of the project you found hard to do)

The language barrier in Japan was a huge challenge to cope. As a foreign student in a Japanese hospital, where English proficiency was limited among patients and some healthcare staff, effective communication often requires a lot of effort with help of google translate or hand language. In the clinical setting, the language barrier affected my ability to collaborate with medical professionals. for example, I couldn’t understood completely the morning conference.

4. What has really worked? (any part in the project that you thought worked well)

The elective posting journey not only deepened my medical knowledge, all the challenges that I faced in this project had forced me to develop as a medical student. I had developed problem-solving skills, problem-solving skills and a stronger non-verbal communication skills. This project definitely strengthen my ability to adapt in a foreign healthcare setting.

5. What can be improved in this project?

I think everything in this project is perfect.

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Haritha Subba Rau
A181806
6/8/2023-22/8/2023

1. Were the objectives of the project fulfilled?
Yes all the objectives were fulfilled.

1)  Master hands-on clinical skills

Initially I spent time observing the doctors and nurses performing branula insertion on patients and how they approach and interact with patients. Once I felt confident enough I tried to do the procedure while the nurse was guiding me.

2)  Able to compare the difference between own country’s healthcare system and Nepal’s healthcare system.

Throughout my medical elective in Gandaki Medical College which is a private hospital in Kathmandu,Nepal, I was able to see many differences between healthcare in Nepal and in my own country.There were many differences in terms of infrastructure and resources available in the hospital which is very limited,access to healthcare which is basic,insurance and financing where many patients experience finance barrier to accessing care and the healthcare quality where there are so few doctors expected to attend many patients at once.

3)  Able to adapt into new environment.

I was able to adapt with my new environment in the course of 2 weeks and in fact since I had made new friends at the hospital it made things way easier for me. They made me feel welcomed and were always there to guide me.

4)  Improved my soft skills like critical thinking, independent, teamwork, and communication skills.

I have applied all these skills throughout  my medical elective. Critical thinking skill is something I have been practicing everyday in the hospital when seeing patients with complex cases and even in our homestay. I have also learnt to be more independent such as when we want to buy essentials from the market we would bargain to get the best price. We also learnt to work things out together especially in our homestay whenever we had a crisis. My communication skills have improved especially when interacting with patients in the hospital, bargaining with the locals and bonding with my host family.

2. What have you enjoyed or liked the most about the project?

I really enjoyed being able to connect with people from different culture and they made us feel welcomed. I was able to make so many new friends in our homestay as there were many other volunteers who are here not just for medical but also for childcare program, special needs program and many more. I also met a student from India in the hospital and we bonded really well. We would also hangout with all the other volunteers during the weekend and it made things much more special.

3. What have you found challenging about this project? (any part of the project you found hard to do)

I found it challenging to get used to their staple dish which was Dhal Bhat and it was served in our homestay for dinner almost everyday. Dhal Bhat is a dish consisting of rice, lentil soup and sometimes served with vegetables or pickles along with meat or fish. The food served in our homestay was mostly basic and it was a bit of a struggle to make sure we had a proper nutritious meal. The cleanliness of the homestay that we stayed for the 2 weeks was also questionable and I even got sick during one of those days. The room that I got also had some problems with the shower, so I had to use my friends room to borrow her shower. The weather in Pokhara was also gloomy and was raining almost everyday. It was challenging as we had to walk to some places while it was raining cats and dogs.

4. What has really worked? (any part in the project that you thought worked well)

I am so grateful to my university and IVQH for giving an opportunity to do my medical elective abroad in Nepal.I have definitely broadened my horizons in terms of gaining a deeper understanding of Nepal’s customs, traditions,way of life and the global issues faced there.I was also able to push myself out of my comfort zone by experiencing what a traditional Nepali family goes through everyday. I was also able to make a direct impact by volunteering in the hospital. I performed ECGs on several patients as well as branula insertions.

5. What can be improved in this project?

One of the things that can be improved is the condition of the homestay. It could have been cleaner although everything we needed was there and we felt comfortable during our stay. This issue has been raised up to IVHQ by one of the volunteers and hopefully they take action to make sure future volunteers wont have to face this. Besides that, everything in this project went smoothly and it was an invaluable experience that I will truly cherish.

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Goh Xin Qi, A184017

1. Were the objectives of the project fulfilled?

Yes.

I have broadened my outlook on healthcare delivery systems in China. I observed the integration of traditional Chinese medicine, the structure of medical departments and the different approaches to mobile payment systems.

I applied the theoretical knowledge that I gained and improved my clinical skills in obtaining focused history and performing physical examinations on patients. I participated in procedures like electrocardiogram, bronchoscopic procedures, and pleural fluid drainage which shows my practical application of medical knowledge.

I acquired and expanded the knowledge that will benefit my personal development and patient-centered care. Exposure to various medical conditions, patient interactions, and cultural nuances have undoubtedly enriched my knowledge.

I developed self-reliance and strong cross-cultural communication skills with patients. I immersed myself in a Mandarin-speaking environment, interactions with patients and teammates, and adaptability to cultural differences which contribute to my development of strong cross-cultural communication skills.

I met and connected with medical students from different countries by exchanging personal experiences and ideas, as well as establishing a long-lasting friendship. In the cardiology department, I met Yuxin. In the respiratory department, I met Shi Chenyang, Jin Hanwei, Guo Chunyi, Mu Yali, and Wang Shuyang.

I acknowledged my personal strengths and challenges that may be revealed in the execution of electives. I demonstrated a strong ability to adapt to new environments, cultures, and medical practices, which allowed me to fully immerse myself in a Mandarin-speaking environment, embrace different healthcare delivery systems, and face unfamiliar situations with ease. My cross-cultural communication skills stood out as I engaged with doctors, patients, and friends from various backgrounds.

2. What have you enjoyed or liked the most about the project?

I found my time during my clinical elective at the First Affiliated Hospital of Zhejiang University of Medicine to be most enjoyable, especially within the respiratory department. I am grateful to have a professional and diligent physician, Dr. Bao Zhang as my supervisor. In this department, I could sense a strong and dynamic harmony that exists within the group under the guidance of Dr. Bao Zhang. This dynamic contributes to an effective teamwork and a supportive work environment. Such an atmosphere greatly contributes to both personal and professional growth, as well as job satisfaction. The close relationships among team members not only enhance collaboration but also create a sense of camaraderie that makes the workplace more enjoyable. Additionally, I had the opportunity to establish many new friendships, including individuals such as Shi Chenyang, Jin Hanwei, Guo Chunyi, Mu Yali, and Wang Shuyang. All of them are incredibly welcoming, friendly, and ready to provide guidance and support. Their assistance has greatly aided my adaptation to a new environment, enabling me to fully embrace and make the most of my clinical electives.

3. What have you found challenging about this project? (Any part of the project you found hard to do)

The challenge I encountered in this project was the restricted scope of involvement in patient care tasks. In China, medical students typically emphasize observation rather than actively clerking patients, which becomes more significant in their final year of study. Consequently, my participation in clerking patients was understandably limited during the clinical electives. My contributions were focused on more specific tasks, including performing electrocardiograms, assisting with pleural fluid sample collection, and participating in pleural fluid drainage procedures. Despite the restriction imposed on my role, I embraced these opportunities to contribute and learn from them.

4. What has really worked? (Any part in the project that you thought worked well)

I proved my ability to adapt to living alone in a foreign country, despite not knowing anyone prior to my arrival. This experience challenged me to step out of my comfort zone and navigate a new environment independently. Throughout the entire month, I successfully managed various aspects of daily life, including accommodation, transportation, and exploring the local culture. I efficiently managed my time, balancing clinical duties with personal exploration, and I made decisions about weekend trips to neighbouring cities, executing solo journeys. From choosing to travel alone to managing various aspects of daily life in a foreign country, my self-reliance has not only enhanced my personal growth but has also reinforced my confidence in my ability to handle challenges and adapt to diverse environments.

5. What can be improved in this project?

Overall, I am satisfied with the outcomes of the project, as it has provided me with valuable insights into both the clinical environment and the local culture. However, I acknowledge that there is room for improvement in terms of diversification. While my focus solely on Internal Medicine, I believe it would be beneficial for me to broaden my experience by exploring alternative departments, such as Surgery. This approach would offer me a more comprehensive understanding of China’s healthcare delivery system, leading to a well-rounded perspective.

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Azizah Zafira (A179285), 10th August - 24th August 2023

1. Were the objectives of the project fulfilled?
- To learn the basics of orthopaedic
in preparation for year 4 posting
This objective was definitely achieved as I now have a clearer view of what orthopaedics will be in my upcoming posting, I now understand which cases are the must know and nice to know in real life situation. I have a clearer guide in what to study and pay more of my attention to so that I can study smarter and not just blindly read everything.

- To identify the difference in
technology used, especially in
radiology (MRI)
The MRI machine they used is completely different from what I know and I see in the HUKM, however the procedures remained the same. With the help of the kind MRI operator, I was able to fulfill this objectives as I have managed to at least see 5 MRI cases each day while I was there. Even in my opinion, this objective was overly fulfilled as I was not just able to witness the MRI cases, but the common plain radiograph, to identify fractures in both upper and lower limbs or even the pelvic area.

- To learn the basics of hospital
management system in different
country
With the help of the nurses and the emergency doctors as well as all the surgeons I attached to, I had a clearer pictures on the differences between Malaysian healthcare system and Indonesian healthcare system. The main difference was in Malaysia it is more to time-pay, but in my county it is more to pay per service. I believe that there will be more differences, which I wished I could be more observant.

Therefore, with these three objectives I had in the beginning of my EP posting, I would say yes, all objectives were fulfilled

2. What have you enjoyed or liked the most about the project?
The most enjoyable experience I had was definitely to be able to communicate with the hospital staffs with such ease as well as able to observe the two most common operative prpcedure in orthopaedics

3. What have you found challenging about the project? (any part of the project you found hard to do)
My project was a month delayed due to the issue with iStar application. It was on my side, since I miscalculated the date of the program application. Other than that, everything went well, better than my expectations

4. What has really worked?
Understanding the difference in working culture of the hospital in Indonesia and Malaysia had opened my eyes together with the improvement of my communication skills helped me to gain more learning opportunity

5. What can be improved in this project?
In my opinion, all instructions given by all doctors were clear enough and they were very helpful when we had issues we encountered. One improvement is maybe to have another EP in year 4

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Chia Xin Yi, A181188, 26/6/23-1/7/23

1. Were the objectives of the project fulfilled?

To observe and study common cases found in Mater Dei Hospital with regards to general surgery

Mater Dei Hospital handles a variety of common cases within the realm of general surgery. Surgeons at the hospital routinely perform procedures such as appendectomies for appendicitis, hernia repairs, gallbladder removals, and surgeries related to colorectal, thyroid, and breast conditions. Additionally, excision of soft tissue masses, skin lesions, and emergency trauma surgeries are common occurrences. The hospital also employs minimally invasive techniques when appropriate to enhance patient recovery. Speaking of this, I had the opportunity to closely observe surgeries in my supervisor's operating theater, including laparoscopic cholecystectomy, the removal of a sebaceous cyst on the right breast, and several hernia repairs.

To learn the disease management and procedures done through adequate exposure in visiting hospital

During my time here, I've gained valuable insights, emphasizing the paramount importance of patient-centered care for optimal patient outcomes. While I've noticed that disease management and medical procedures here are similar to those in Malaysia, I found one particularly intriguing aspect: the FAST scan utilized in the emergency department not only performs rapid evaluations for tension pneumothorax and free fluid collections around the liver, spleen, and pelvis but can also provide a swift echo. Additionally, it's worth noting that direct sun exposure can adversely affect scar appearance.

To identify differences between the healthcare system in Malta and Malaysia

Malta and Malaysia have distinct healthcare systems. Malta's system is predominantly publicly funded and characterized by accessibility and high-quality care. The government plays a central role in financing and managing healthcare, ensuring that citizens and residents have easy access to services. The main hospital include Mater Dei Hospital and Gozo General Hospital. In contrast, Malaysia has a mixed system with both public and private sectors. While public healthcare is more affordable and accessible, the private sector offers advanced treatments but at a higher cost. Both countries report favorable healthcare outcomes, but Malta's smaller population allows for a well-developed infrastructure, while Malaysia's larger population results in a more extensive healthcare network.

2. What have you enjoyed or liked the most about the project?

The first thing that comes into my mind is the remarkable friendliness and helpfulness of the people in Malta. It's a place where you can strike up casual conversations with strangers while waiting for the lift or the bus, and warm greetings are a constant part of daily life. This stands in stark contrast to some other countries where such interactions might be considered unusual. I found the experience of conversing with Dr. Undji, the houseman working under my supervisor, to be particularly uplifting and inspiring. She offered unwavering support and optimism, encouraging me to gain hands-on experience with various medical procedures, starting from basic tasks like blood sampling and cannula insertion. Furthermore, I cherished the cultural exchange with my two German colleagues, Lisa and Clara, as we shared insights about Malaysia and they reciprocated with information about Germany's healthcare system. Given my initially low expectations for my elective posting, I am immensely grateful for the wonderful people I have encountered during my time here.

3. What have you found challenging about this project? (any part of the project you found hard to do)

The only challenge that I have encountered during this project was the language barrier, particularly during ward rounds and patient handovers. As most of the patients speak Maltese, I find it difficult to fully understand the case. Even speaking English can be variations in accents and colloquial expressions. However, I viewed this challenge as an opportunity for personal growth and improvement in my language skills, and over time, I adapted and became more proficient in navigating these linguistic differences. The doctors on the team were also incredibly gracious to translate for us and patiently addressing our questions after each patient encounter. It was a valuable learning experience that enhanced my communication skills in a multicultural healthcare setting.

4. What has really worked? (any part in the project that you thought worked well)

What has proven to be effective in this project is the proactive approach I took to maximize my learning opportunities. Since many of the attachment sessions with doctors relied on the students' own initiative, I consistently pushed myself out of my comfort zone to reach out to doctors and immerse myself in diverse experiences. While I acknowledge and share my German colleagues' appreciation for the relaxed pace of life in Malta, which is also endorsed by most of the doctors, I was equally determined to absorb as much knowledge as possible. After adapting to the new environment during the first week, I proactively began requesting to assist and offering help to the housemen, often staying back after ward rounds. This allowed me to gain valuable insights into the working style of housemen in Malta, observe how pre-operative consultations were conducted, and develop a deeper appreciation for the work culture in Malta, where the work-life balance is notably better than what I've experienced in Malaysia. Overall, this proactive approach enabled me to acquire extensive knowledge and broaden my perspective of the healthcare system, clarifying my career aspirations and goals.

5. What can be improved in this project?

I've truly made the most of my time in Malta, enjoying the company of wonderful people and savoring the crystal-clear seawater that surrounds the island. As far as I can see, there is nothing needs to be improved in this project. In fact, I'm now considering the possibility of extending my elective posting to three weeks to further enhance my exposure to the hospital environment.

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Name: Chee Jun Kai

Matric number: A181855

Date: 14/08/2023 - 18/08/2023

1. Were the objectives of the project fulfilled?

Yes all the objectives of the project were fulfilled

Learn new clinical skills and techniques that may not be commonly used in my home country. During the attachment at the respiratory department, I learned how to take blood from the femoral artery which I had never seen before in my medical life. Doctors were super nice and patient when they guided me to do this hands-on. Besides the doctor, the patient also gave his full commitment to us.  In addition, the method they took the blood pressure of the patient was different by using a small special device that can pump the pressure cuff itself and record the readings every 30 minutes. Fortunately, my supervisor gave me a chance and assigned me to do this hands-on on the patient.

Joined all the ward rounds and clinics even the medical conferences to expand my medical knowledge. Although I didn’t have a chance to join the clinic session, I managed to attend all the ward rounds and medical conferences. All the rounds were knowledgeable and the title for the conferences was attractive, which was about DKA. I will apply all the knowledge I learned there to the rest of my medical life.

Experience the healthcare system in China. The system in China was an eye-opener. All the documents were digitized, and can access every information with one click of the mouse button and is very convenient and time-saving. In addition, all the doctors practice and build a good doctor-patient relationship. Last but not least, patients treated me as a doctor even though they knew that I was just a year 3 exchange medical student from overseas.

2. What have you enjoyed or liked the most about the project?

I like the working vibe in the hospital the most. Although every day is hectic and stressful, every medical staff in the ward will always bring a smile to their face. They are not selfish and will help each other when facing problems.

3. What have you found challenging about this project? (any part of the project you found hard to do)

The most challenging in this project is during the application process and the language barrier. For the application process, there are a lot of documents needed to prepare and submit, but the most frustrating was getting rejected by the universities that I applied to. Luckily, Zhejiang University accepted my application and gave me a warm welcome.

Apart from that, another challenge in this project is the language barrier. In China, the main language they use is Chinese. Although I am Chinese and can understand well the language, but for medical abbreviation is really over my head. Every time I communicate with medical staff or even patients I must rely on Google Translate to continue the conversation. I am grateful they didn’t show impatient when communicating with me.

4. What has really worked? (any part in the project that you thought worked well)

Understand the culture and healthcare system in China was working very well in this program. In addition, all the doctors guided me patiently and tried to explain things in a way I could understand easily was really appreciated too.

5. What can be improved in this project?

In my opinion, everything actually worked fine in this program. Maybe doctor can have a face-to-face session with the junior batch to give clearer instructions on how to apply this program to make the application process more smoothly

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"Momos" (first row at the most right),me and my friends in GMC, "Dal bhat" (below Momos), touring with friends, buying souvenirs for family, with my host family

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Name: Shuithadevi Ganaraj (A184032)
Date: 06.08.23 - 22.08.23

1. Were the objectives of the project fulfilled?

Yes, I feel that every objective that I had in my mind before this project started has been fulfilled.

- Experiencing the healthcare system in a lesser developed country and gaining hands-on activity in the hospital.

I went to Nepal with minimal expectations but I'm grateful for all that I learnt in the hospital. I saw multiple interesting surgeries in the OT and got to see how surgeons work together in getting an operation done while making sure no harm gets upon the patient. Although I was not allowed to have direct hands-on in the OT by assisting any surgeons but I got to be close to them and some would even explain to me what and how is the procedure being done on the patient. I also got to practise some hands-on like taking blood and doing ECG when I was posted in ED. The doctors there would always encourage us to try even if we didn't do it properly during the first try. They were very supportive towards us and that always made me want to learn more from them. It is true that there is definitely a difference in the healthcare system between Nepal and Malaysia. For example, patients who arrive in the ED are required to buy their own branula and all the items first before the doctor does the procedure on them. Only when they have paid for it, then they would be looked onto. Nevertheless, one thing I have realised is that it is best not to compare between healthcare systems from different countries because at the end of the day, everyone serves the same purpose which is to care for the needs of the patients.

- Adapting into the culture and diversity of Nepal

I managed to see Nepal at a greater depth by staying in the homestay and living among the local people in the same building. Mr Dharma and Mrs Shanthi (his wife) took care of us well and made sure we always felt at home. They always gave us good breakfast/brunch and dinner would normally be 'dal bhat' which is Nepal's local dish. Mrs Shanthi cooks well and I enjoyed her cooking. Other than that, walking everywhere in the streets of Nepal. One thing I realised was it was definitely faster to get to places on foot rather than taking a taxi due to the heavy traffic everyday. I became braver to walk on the streets and I can say I have mastered crossing the busy roads in Nepal. The trick is to just walk and the cars would stop for you! I also learnt more nepali words each day over there and would try to use them towards the patients in the hospital.

- Became more proactive and better at making decisions

Being in a foreign country, would mean at times I have to change the way I think and feel based on how the situation is. For example, in order to get things done like asking for directions to get to a place, I cannot just give up if the locals there do not understand me. I have to either change the way I speak or use actions/pictures to get my answers. I definitely improved on my critical thinking skills when it came to finding a solution and realised that we shouldn't keep depending on others to always work things out for ourselves.

2. What have you enjoyed or liked the most about the project?

First and foremost, I am really glad and thankful that I got the opportunity to be chosen as a medical volunteer in Nepal under IVHQ. I definitely do not regret volunteering over there because the experience that I received is priceless and would always be in my bag of memories.

What I enjoyed the most in this project would definitely be how welcoming the people in Nepal are regardless if they were from the healthcare setting or they weren't. Right from the time we landed, we were well taken care off and they always manage to include a little bit of their culture here and there and made sure we could at least immerse slightly into it. They took care of our placement, food, transport and accommodation for the 2 weeks that we were there and I enjoyed every bit of it. Next, would of course be the company of my great friends. Going for a project like this in a big group consisting of 10 of us was indeed a challenge but they made it worth every challenge and it was never a dull moment with them. All of us took care of each other during this whole project and always looked out for one another.

Furthermore the beauty of the scenery in Pokhara. Pokhara was extremely green and  surrounded by mountains everywhere. Yes,  the sad part was due to the monsoon season, most of the time the mountains were hidden by the clouds but the days that we could actually see it, was just something so magical and calming. There was a day where we even woke up as early as 4:00am to see the sunrise before going for our posting after that. If the weather is good, we could see the Himalayan mountains from our homestay and imagine waking up to view like that everyday!

3. What have you found challenging about this project? (any part of the project you found hard to do)

First things first was the weather in Pokhara. The monsoons season was really bad and there wasn't much we could do because even if we planned ahead, somehow plans would still change because it would start raining in the morning. The rain isn't heavy but it just goes on for the whole day. It was hard for us to do any outdoor activities after hospital posting ended for the day. One thing that we were waiting to do was paragliding and we were afraid if we could have the chance to go for it with the weather condition like this but luckily we had one sunny day and took that opportunity to go for paragliding. It was also difficult to walk to the hospital during rainy days and we would end up taking the taxi and get caught in the traffic. The weather was quite unpredictable and it took time for our clothes and especially shoes to dry. Every time once we are back, somehow or rather , we would still be wet.

Other than that hygiene. Hygiene is not well practised in Nepal even in the hospital setting. People tend to do things fast without considering the hygiene behind it and honestly this isn't something we should practise. Even the homestay that we stayed in wasn't very clean but somehow we had to manage over there. Hygiene should be made as a prority and I do hope people over there would start taking it seriously.

4. What has really worked? (any part of the project that you thought worked well)

Honestly, before going I thought I wouldn't be able to do any hands on over there and probably would end up just observing the surgeries and procedures. However, this is something that worked so well because I got the opportunity to actually perform stuffs and watch many operations in a short period of time. Opportunities like these definitely don't come always and I'm glad I grabbed it when I had the chance. I wished my posting period was longer but I am still grateful for all that I got to do in the past 2 weeks. Other than that, I am happy that we worked well in a group of 10 to get our itinerary settled and we got to visit many tourist spots, eat good local food outside especially trying "momos"(Nepal's dumplings) in nearly all the restaurants that we went too and even had time for some adventurous activities. Everyone was so sporting and I couldn't ask for a better group of people to go on this project with.

5. What can be improved in this project?

This would definitely be the period the programmed was conducted. Honestly, many things could have been better if this project was conducted not during the monsoon season. We had limitations to what we wanted to see and do due to the rainy days and that was quite frustrating. It could have been planned during the summer season because Pokhara is even more beautiful during sunny days. Also, maybe the project duration could be longer than 2 weeks so we can learn more and not rush to switch between departments. Another thing as mentioned earlier would be cleanliness and hygiene in both the hospitals and homestays. It was quite depressing to live in a house with bugs and cockroaches crawling here and there. I do sincerely hope, that hygiene is something that no one should compromise on because that reflects how you are as an individual and people would trust what they see.

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Name: Keshrina Subramaniam
Matrics number: A182868
Date: 6.8.2023- 22.8.2023

1. Were the objectives of the project fulfilled?

Immersing in cultural diversity

We managed to be part of the Nepali lifestyle thanks to our host, Mr Dharma and his family. Right from having breakfast and brunch immediately after that to the Dal-Bhat served to us for dinner. Not only that, walking around in the streets of Nepal whilst having a lot to see was also a great experience! In some places, it is faster to get on foot than on the road due to the heavy traffic there.

Explore healthcare system abroad

Being able to learn in a different setting has broadened my clinical judgment. I have observed and learned various Drs and nurses how to perform procedures, surgeries and even as simple as communication with the patient. I have also gained new information and have noted the difference between the healthcare system in Malaysia and in Nepal. For example, in Nepal, patients are required to buy equipment prior to receiving healthcare as compared to Malaysia where patients pay for the healthcare received upon discharge. This is due to the limited resources in the hospital and thus, every piece of equipment used for the patient (syringes, branula, even gloves!) have to be used sparingly.

Fostering personal and professional well-being

Travelling all the way more than 2,000 miles away from my homeland meant that there would definitely be a lot of challenges, critical thinking and decision-making that would be required in the journey. This decision-making started even way before flying. For example, as simple as deciding when to go to the Ministry of Foreign Affairs to claim our Certificate of Good Conduct required a decision to be made. Not only that, since part of our sightseeing also required transportation, due to the weather conditions, we still had to predict the weather beforehand (with the help of the weather forecast) to inform the driver beforehand. At the end of the day, no matter how big or how small of a challenge we go through, it will surely have a positive impact on our personal well-being

2. What have you enjoyed or liked the most about the project?

Looking back at the whole medical elective abroad experience, it was definitely a great opportunity given to me. First and foremost, I would like to extend my gratitude to the organiser, International Volunteer Headquarters for the whole experience. From the beginning, they welcomed us and provided us with Nepali cultural exposure by visiting one of the UNESCO World Heritage, Swayambhunath Temple (also known as Monkey Temple) and providing us with delicious, mouth-watering Dal-Bhat (which is one of my top favourite Nepali foods). Being under their supervision has definitely eased our stay in terms of accommodation and breakfast every day.

Apart from that, I will also treasure the quality time spent with my friends. Since we were going in a big group of 10 people in total, there was never a dull moment. From our time in the hospital, although we have never been in the same group or posting, everyone was really proactive and helpful with one another. It really felt like a healthy learning environment. Not only that, but with the support and aid from the doctors, nurses and other volunteers there, the experience in Gandaki Medical College has secured a special place in my heart.

Other than that, how could I miss the beauty of nature in Pokhara? A country with stunning landscapes of the Himalayan Mountains. Never have I imagined being in a country where I could wake up in the morning and be blessed by the admirable sight of snow-capped mountains and pristine air while being accompanied by the sound of ringing prayer bells in the neighbourhood. In contrary to the life in Pokhara, it is very much city life in Kathmandu. Here too, walking in the busy streets of Thamels trying to bargain on almost everything that we purchased whilst being greeted by a bigger species of dogs every 100 metres is also definitely something that I will never forget. It was really fun and looking back at this experience now, I really feel more confident in crossing streets in Malaysia now.

3. What have you found challenging about this project? (any part of the project you found hard to do)

One of the things that was challenging was the weather conditions. Since we went during the monsoon season, it was hard for us to pre-plan our agenda beforehand. We only could wait for the day to come to decide if our outdoor activities could be held. Not only that, although it might seem like it will be all about Sun and shine for the day, but surprisingly, it could rain in the evening. The rain period in Nepal will last for a long time too. There was once, it lasted for about 4 days, which made us to postpone our paragliding plans and leave our clothes and shoes soaking wet. This was definitely one of the biggest struggles there. Ever since then, I have really appreciated the equatorial climate in Malaysia even more!

4. What has really worked? (any part in the project that you thought worked well)

Something that I am really proud of is our itinerary planning. Although all of us have never been to Nepal before, but based on our own research, we were able to cover most of the popular tourist spots. There is a long list of the places we have visited in a span of two weeks. Although our daily schedule was packed, it was never tiring.

Not only that, I was also glad to be given the opportunity to perform so many procedures and observe so many surgeries in a short period of time. Opportunities like this are certainly hard to come by in Malaysia. This was exactly how I pictured my medical elective in Nepal to be, with lots of hands-on opportunities.

5. What can be improved in this project?

One of the things that certainly could be improved is the period and duration of our medical elective. Unknowingly, we chose the two weeks of the monsoon season. Thus, we were left with most rainy days which decreased the quality of our sightseeing. So, in the future, if I or anyone else would like to visit Nepal, the best time is around October to December. This is when the skies are clear blue and the views are spectacular (as suggested by locals). Also, regarding the duration of our time in the hospital, I would love to have a longer time in the hospital as I feel like I learn something new each day.

Another thing that could be improved is hygiene both in the hospital and in my homestay. In the hospital, as mentioned, gloves should be used at all times especially if we are dealing with a patient’s body fluids. It only takes less than a minute to take the necessary precautions. In our homestay, we had quite a few issues with bugs and cockroaches for a few nights in our room and in the kitchen. It is normal to have bugs around once in a while but should never be in the kitchen. It is where food is being made and with the bugs around, reflects the poor quality of maintaining hygiene at home.

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Salinee A/P R Arasu (A184222) >> 06/08/2023 - 22/08/2023

1.     Were the objectives of the project fulfilled?

Gain hands-on experience and exposure to different aspects of healthcare in Nepal.

We were able to watch so many surgeries up close and help nurses in the ED. We’ve also learned so many cases that are prevalent in Nepal. I’ve noticed how the healthcare system in Nepal is different from Malaysia. In Nepal, you are required to buy the equipment such as branula by yourself for the treatments to be initiated. Payments are to be made before the treatments are done. I’ve also noticed how many of the patients do not rely on insurance. This has caused them to refuse medical treatments as they couldn’t afford to pay. Fortunately, there are some kind of doctors who are willing to pay the treatment fee for their patient’s wellbeing.

Develop new clinical skills and broaden my perspective on Nepal’s healthcare system.

I’ve practised so many procedures that aren’t usually allowed to be done by year 3 medical students in Malaysia. I’ve managed to assist nurses in giving medicines intravenously, performing ECGs every day on patients and inserting cannula.

Learn about a new culture and way of life

Staying in a family who grew up in Nepal can teach you so many different things about the way they’ve lived their life. We learned so many new things about Nepalese. They believe that Nepal is ruled by 5 elements in life which are the sky, earth, fire, air and water. They believe that their life should start and end with the 5 elements. We also learned that Nepalese love to walk. Apart from that, Nepalese have beautiful genes.

2.     What have you enjoyed or liked the most about the project?

What I liked the most about this project are the bonds and relationships I’ve created with everyone over the past few weeks. I formed so many new bonds with the hospital staff, my friends, other volunteers, my host family and even patients. Building relationships and connections with people from diverse backgrounds can be one of the most enjoyable aspects of volunteering.

3.     What have you found challenging about this project?

One of the most challenging things is the weather. It was an overcrowded hospital with little to no air-conditioner or proper ventilation. On some days, it would be scorching hot in the hospital. On other days, it would be pouring really heavily. We usually walk to the hospital or to places nearby, so the rainy days were a hassle to walk.

4.      What has really worked?

I believe I was able to sharpen my clinical skills such as performing basic procedures and getting a good history. My ability to clerk a patient has improved despite the language barrier that we faced. I’m very grateful to my doctors and nurses who have helped me overcome this challenge.

5.      What can be improved in this project?

Personally, I don’t think there’s anything that I would change about this project. I believe everything was explained clearly about the project. I’ve had my ups and downs but I believe they'll shape me to be a better person. Nevertheless, I thoroughly enjoyed my elective posting.

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Row 1 & 2: NICE Project with incomings all over Poland | Row 3 & 4: Last few days in the hospital and baked cookies for my dr! | Row 5 & 6: Last trip to Krakow 

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Dziękuje i do widzenia Polska! (Thank you and goodbye Poland!)

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Dziękuje i do widzenia Polska! (Thank you and goodbye Poland!)

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Name: Yasmein binti Yuhaimi
Matric Number: A181933
Date: 18/8/2023 - 25/8/2023

1. Were the objectives of the project fulfilled?
Yes, I strongly feel that every objective I have set for my project has been fulfilled.

To promote understanding and cooperation amongst medical students and all health professionals, through the facilitation of international student exchanges by IFMSA - Throughout the whole exchange I had lived in the student dorm for 4 weeks closely with the other exchange students from all across the world - namely Romania, Italy, Greece, Oman, Jordan, Lebanon, Kenya and Equador. Between us, we were in Poland for an exchange in different fields namely obstetric and gynaecology, nephrology, cardiology, general surgery and opthalmology. There were also who were there for a research exchange where they had been closely involved in the lab works of their desired topics. Upon the first meeting, we were breaking the ice and getting to know each other as well as the professions chosen by each of us. We were able to discuss the importance and significance of each health profession as a collaborative effort in an effective healthcare system. An understanding of each profession was also met when we would casually meet and discuss what we have done in the wards or the labs under close supervision from our supervising doctors. I was also able to commit to a professional attitude throughout when dealing with certain cultural differences and opinions I could not agree to in the situations of social and political circumstances.

To experience the healthcare system in Poland with the possibility of different health management approaches in the aspects of technological advancements, culture and political influence - I was posted in the Nephrology department of the University Clinical Center of the Medical University of Warsaw. Here, I had been working closely with dedicated internal medicine doctors, nurses and hospital staffs who patiently guided me through the wards for the last 4 weeks of my exchange in Poland's pubic health care. I was very fortunate to have a one-to-one session on patient management, following the ward rounds and having them being translated to English and closely observe the in and outs of the health information management system used. I was able to identify some significant disparities in comparison to the Malaysian healthcare system especially those surrounding such economical, poltical and cultural influences. For example, the rate of kidney tranplantations done in Poland is as though such a common phenomenon. Everyday I would see another patient who just had a kidney transplant or a newly admitted patient in for the required laboratory and clinical clearance before qualifyng for the next available transplant. From an economical point of view, the public Polish healthcare system revolves around a mandatory health insurance policy where the funding of health care in Poland is delivered the National Health Fund (NFZ) - when compared to Malaysia which is funded by general taxation and public health care facilities are heavily subsidised by the government. In terms of technological advancements, personally there were no apparent difference with public hospitals in Malaysia specifically in larger cities like Kuala Lumpur. However, each doctor is provided their own desk and computers to manage their case notes and new admissions whereas in Malaysia - HUKM for instance, doctors and nurses share the same computers at the front counters of the wards. Overall, I am able to identify the difference in healthcare systems and practise in Poland and Malaysia.

To participate in the international student exchange social activities carried out throughout the exchange and learn through culture appreciation amongst medical students from other countries - Throughout the exchange, there were volunteers from the hosting university who would take us out into the city and walked us through historic landmarks, introduce us to National foods as well as exchange different cultural understandings between the other exchange students. I had also attended the National Incomings Care and Excursions (NICE) Project - equivalent for the National Social Program in Poland. Through these activities, I was fortunate enough to learn as well as experience real life historic places of Poland, try authentic and traditional Polish food and share some of my upbringings as a Malaysian. Of course this was also applied to the other exchange students from different countries. We found ourselves in casual conversations exchanging the difference in culture of our respective nations, and also attending the local activities together as a group. International friends were made as well as social media has played a crucial role in ensuring we keep in contact.

Apply skills in managing out-campus learning in the aspects of making decision, interpersonal communication, time management and critical thinking - Apart from taking part in a student exchange and undergoing clinical clerkship in Poland, I was also learning to be independant and survival in a foreign country. To which, skills of decision making, interpersonal communication, time management and critical thinking had tied my whole EP journey together. Decision making is most important since I was living alone and cannot expect other people to make decisions for me. I was deciding what to eat, to spend on and my plans for the upcoming days. Interpersonal communication had its barriers as I was not fluent in the Polish language. Though, I took the initiative to learn basic communicative skills in Polish and where I was not able to apply them, I was able to convey my needs and concerns through body language and other means of communication. This was also important throughout the process of making friends with the other exchange students and crreating a bond with them throughout the exchange. Time management is also crucial especially in maintaining a professional atitude, especially when it comes to punctuality and productivity - such as when I had to commute everwhere via public transport and make use of the free time I had.

2. What have you enjoyed or liked the most about the project?
I enjoyed traveling the most about my project. I have not had the opportunity to travel in my lifetime so I really wanted to use this opportunity during my project to travel. I enjoyed the fact that I was able to attend my clinical clerkship for the minimum amount of hours during the day and I was free to explore the foreign land after. I was excited to see and experience a diffrent part of the world with different people, cultures and history. I am blessed and grateful to have travelled to 5 Polish cities as well as visited 2 countries before I arrived in Poland for my project.

3. What have you found challenging about this project? (any part of the project you found hard to do)
I had found the language barrier and making friends the most challenging during the project. It was not that I was not able to communicate or make friends during the project, but it was energy draining and sometimes filled me with anxiety to do so. Everyday before deciding to take part in a social program or socialising at a large gathering, I would have to brace myself to talk to the other exchange students. Although I found it challenging to do, I realise that talking to them and making new international friends is the biggest part of taking part in a student exchange and it would be a shame to sit in my on bubble for the most of the time. Thus, everyday I found myself improving in creating small conversations and keeping up with a group of students throughout the exchange - to which I feel most satisfied of.

4. What has really worked? (any part in the project that you thought worked well)
To my surprise, I was able to learn so much in the nephrology department during my clerkship. My expectations had been set by realistic reviews of the student-doctor environment in the hospital from existing Polish students. However, my exectation exceeded when I was attached to my supervising doctor who gave her all in making sure I could learn as much as I could eith the limited amount of time I had. I had done history taking in English, done physical examinations, performed an ECG, interpreted labs and x-rays and observe common clinical procedures in the wards. I am very happy as I enjoyed my Internal Posting in Year 3 and this clinical clerkship had filled my interest more to pursue internal medicine.

5. What can be improved in this project?
Personally, I feel the local committee who had handled my the student exchange in Warsaw could have done a better job. We were the only city to have received some important informattion late, we did not have many helpful contact persons facilitate our stay in Warsaw and there were minimal engagement done by the local committee with the other incomings. Fortunately, I had done my research and had settled the required documents for my one-month stay in Warsaw for instance my transportation card, the international student ID and getting spme local currencies. Unfortunately, the other incomings did not receive much help either but we had helped each other with or without the help from their contact persons. However, I was able to adapt well to my life in Warsaw well and had good relationship with my supervising doctor so there were no major issues in communication.

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Name: Ng Yueh Chee
Matric Number: A182958

Were the objectives of the project fulfilled?
Yes!

To gain more hands-on experience in clinical settings.

I manage to perform ECG on real patients multiple times. I also observed effective communication skills as doctors explained diagnoses and treatment plans to patients and addressed their concerns.

Exposure to Different Healthcare Systems

By engaging with patients and healthcare providers from diverse cultural backgrounds, I gained insights into how cultural norms and beliefs impact healthcare decision-making. I observed the unique challenges faced by each healthcare system, such as managing patient flow in busy urban hospitals. I also learned how they digitalized all the healthcare data systematically.

To promote cultural sensitivity and develop interpersonal skills.

By engaging with patients from diverse cultural backgrounds during clinical rotations, I had achieved this objective. I also actively listened to patients' stories, beliefs, and concerns, appreciating the impact of cultural norms on healthcare decisions.When communicating with the doctors, we tend to exchange our life in own country. I found there is a very big difference in the healthcare system in Malaysia and China. In China, there is very minimum amount of private hospital because public hospitals in China are often associated with established reputations, as they have been the main healthcare providers for generations. Trust in private healthcare providers might take time to develop, especially when compared to the long-standing history of public healthcare institutions.

2. What have you enjoyed or liked the most about the project?
I like how the project gave us the opportunity to plan ourself from zero to hundred. I enjoyed the planning process including how to travel around china, how to approach the person in charged in hospital and also the transportation in China. It gave me a golden chance to listen to different story about the healthcare system in other country. I also love that I can travel to other different provinces in China, to see the beautiful building and scenery, to see how the Chinese develop their countries.

What have you found challenging about this project?
To me, I think to adapt myself in this very crowded country is quite challenging. When I wanted to enjoy in the beautiful scenery, the crowd always affect the beauty.
Besides, China's internet is subject to censorship, and many popular Western websites and apps are blocked. This can impact your ability to access certain information, social media, and communication platforms. I must use VPN to browse Google and to use What's app. I must also download Alipay in order to do payment in China.

What had really worked?
I think the biggest advantage for me is that I can speak and understand Chinese. Almost everything in China is written and spoken in Chinese. Although, I still took sometimes to adapt the life, I believe being able to speak in Chinese make me able to adapt the life in a shorter period of time. The doctors and colleagues in SAHZU also very friendly. They shared their experience to me and also bought me coffee !! It was really an unforgettable memories in my medical school life.

What can be improved in this project?
In my opinion, the process of application is unclear. I was lost at the first, did not sure how to do my research and decide where to do my EP. Initially, i planned to go countries like UK or Australia. However, I still did not start to prepare all the document and the deadline of application already reached. This is because I did not know where and how to start to prepare all those documents. So, I think it is important to prepare a detailed guideline and recommended university for the juniors to apply.

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1. Were the objectives of the project fulfilled?

Yes, I think every aspect of the objectives for this project was fulfilled successfully.

1st objective: To explore research on legal and forensic medicine via observation and demonstrations — during our stay in Shiga we have been involved in the autopsies done almost everyday by each of our forensics doctors. Not only have we been observing the autopsies, we also had the opportunity to help assist in the autopsies itself. Our doctors have guided us on every step of the procedure, starting from analysing the police reports, to completing the autopsy procedure by doing urine tests, gram stains and completing the histopathology studies.

2nd objective: To assist ongoing research lead by our supervisor (Professor Masahito Hitosugi, M.D., Ph.D.) from Legal Medicine Department in Shiga University of Medical Sciences — from the three weeks in Shiga University, we have been given forensics related lectures from our doctors and Japanese friends. One of the lectures that were given by Dr Nakamura was regarding the System of Determining Causes of Death in Japan. In this lecture, she explained how forensics was performed in Japan and including statistics and important points relating to this field. Afterwards, we were give a task by Dr Hitosugi which was to give a presentation regarding the System of Determining Causes of Death in Malaysia. In order for us to do so, we had to some research first regarding this topics since we haven't undergone our Forensics posting yet in HUKM. By referring to Malaysia's Ministry of Health (MOH), Malaysian's statistics, Google Scholar and much more, we were able to create a good presentation about this topic. When presenting in front pf our doctors and friends, we were all able to discuss the differences and similarities of the systems between Malaysia and Japan.

3rd objective: To strengthen and apply research methods as preparation for a special study module involving research that will be conducted during my fourth year of medical school — I think this objective was fulfilled during our daily mini lectures conducted on weekdays. Most of the lectures that was given by our fellow Japanese friends on the second week were presentations on their research topic under Dr Histosugi's guidance. We learnt how and why they chose that certain research topic, went through the contents of their paper, understood the methods, results, and discussion of the topic. A lot of them also included animations of the research methods and results for us to have a better understanding. For example our friend, Ayumu, her research topic was the conjoint of engineering and medicine fields, that was to study relation of cardiopulmonary resuscitation (CPR) effects on broken ribs. This is because she had previously taken an engineering course, however decide to pursue medicine halfway. She had used a powered software that showed the mechanics of CPR performed on a few broken ribs, and this one of her research methods. Thanks to this, I have widened my knowledge on choosing research topics, a vast choice of methods can be used, and how the discussion can be made.

4th objective: To understand cultural differences between Malaysia and Japan by observing both healthcare workers and citizens in Japan — this objective was fulfilled not only by spending my time in the Forensics department in SUMS, but also by observing Japan culture outside of the university. From what I gathered in the department and SUMS as a whole, I realised that the system and the work ethics in Japan was respectable. Their planning, punctuality, paying attention to details, documentation and so many more. The list just goes on and on. As for their everyday culture, I admired how respectful they were to one another. Not to mention their publics services was just incredible. Their convenient stores, was just, really, really, convenient. They had ATMs, a coffee machine, a photocopy machine, clothes, stationary, and of course food and beverages. Also Japan's public transport system is famous to be superior and I can one-hundred percent agree on that note.

5th objective: To gain new knowledge that can be implemented in future practice — a lot of knowledge on various areas was mastered during our stay there. Let it be in forensics, studying, or even basic mannerism.

2. What have you enjoyed or liked the most about the project?

First, I basically enjoyed the whole living experience in Japan itself. I loved the food, the weather (despite it being summer season and it was scorching hot), the clean streets, the absence of traffic jams, the skies (Japan skies are on a whole other level, I must say), the short buildings in rural areas, the cute square shaped cars, and so much more. I just loved how the public services served the citizens there. Everything was so convenient.

Secondly, is the hospitality that Japanese people give to us. From most of the experience that I had, is that Japanese people are really kind and respectful of each other. For me, it was quite the culture shock after receiving such kind treatment from their people. They welcomed us with warmth and open arms and made sure our experience in Japan was something we would never forget.

Moreover, I was super grateful that we happened to choose Forensics as our Elective Posting subject. I never knew that we would get this much exposure into the department, not only by autopsies, but also diving into the Pathology department as well. They taught us one by one, and translating everything for us so we would grasp the full understanding of the certain activity. After explaining, they would let us try the procedures on our own and gave us encouragement along the way. With this much exposure, I must say, I am quite excited to enter my Forensics posting in 4th year at HUKM.

3. What have you found challenging about this project? (any part of the project you found hard to do)

What was the most challenging probably was the language barrier among us and the Japanese people. Since most of them was not fluent in Japanese, it was a bit hard to explain a certain situation or procedure done. Sometimes, when we asked questions while performing the autopsy, it was hard to use Google Translate as our hands were covered in blood, so there were a lot of times where the questions were left unanswered. However, when the situation allowed us to use external devices, such as translating applications, the message was easy to get through. However, outside SUMS, there were lots of times where some Japanese people refused to use Google Translate and our words were bouncing back and forth in the air with no answer given or received.

Finding directions to places was also one of the challenges we experienced as a group. However, Google maps is a highly reliable source in Japan as the train schedule and navigator was accurate. We got lost a few times, but we did end up finding our way back home in the end.

4. What has really worked? (any part in the project that you thought worked well)

The autopsy and learning experience, our relationship with everyone in the Forensics department and us adapting to the Japan culture really fit in like a puzzle piece. I wouldn't say it had a bumpy beginning, because everyone made everything felt smooth and easy from the start. So a huge thanks to everyone for that.

5. What can be improved in this project?

I personally think nothing needs to be improved in this project, especially our experience working with SUMS. However, I realised that making a detailed itinerary of your trip is something to take note on.

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Name: Siw Ming Huey

Matric Number: A181220

Were the objectives of the project fulfilled?

Yes

1. Development of professional skills such as decision making, critical thinking, teamwork, and proactivity that are useful for clinical practice.

I had a lot of opportunities to practise these skills especially teamwork and proactivity. As I mentioned in previous weeks, volunteering your help is always a chance to learn. Being proactive also means that I ask and read up about the patient’s history before joining/observing an operation. Every time I have something that I am confused about, I read up about it for a better understanding. When assisting in surgeries, I also learnt that it is important to be a team-player because a surgery is not a one-man-show.

2. Self-enrichment by adapting to and being independent in new experiences and environment.

It was challenging to travel to a foreign country alone and without any prior experience of the local culture there. However, I was glad that I was able to adapt and actually ended up enjoying my whole one-month exchange in Hungary. I tried to ask about a certain culture or practice when I find it new, which quickly helped me to know more about the city and the people. Midway through the exchange, I found myself feeling like a local, knowing my way around the city and not afraid to approach strangers when I need help, all by myself!

3. Enhance communications skills internationally.

In the exchange, there were 21 students coming from 14 countries. It was the best chance to enhance communication skills internationally. Since the first night I was there, I talked to everyone and tried to get to know them as much as possible. We learnt a lot regarding each other’s countries and shared a lot of memories together. We bonded a lot throughout the four-week exchange that it was actually hard to say goodbye.

What have you enjoyed or liked the most about the project?

My favourite part about the project is the chance to meet people from all over the world, including local students in Hungary and also students who came for the exchange. It was a golden opportunity to get a glimpse of those countries through their stories. I heard stories about the healthcare system, the academic system, the lifestyles and the people back at their home-countries. It was like seeing those places for myself even if I have not travelled to those countries. I also made friends that supported me throughout the one month in Hungary.

What have you found challenging about this project? (any part of the project you found hard to do)

To me, language is the most challenging part of the project. Hungarian is one of the hardest languages to learn in the world, even with my prior initiative to learn some basic terms on Duolingo, I had a hard time understanding it. This created a barrier between me and patients because I could not directly converse with them in Hungarian. Besides, this also meant that I always had to trouble my teammates to translate for me and couldn’t talk to patient independently.

What has really worked? (any part in the project that you thought worked well)

I think I feel proudest about my presentation about Malaysia. For the presentation, I talked about our geographical location, our brief history, our multi-racial and multi-religious citizens, our tropical fruits, local food and drinks, our traditional clothes, traditional dances, festivities in Malaysia, and played a tourism video about places in Malaysia. I won a round of applause and compliments that the presentation was fun and interesting. When making the rojak, I was worried that I would not be able to achieve the right taste for the rojak paste. However, to my surprise, all the incomings ended up liking it a lot and they finished the whole bowl of rojak.

What can be improved in this project?

For future projects, I think I should have a more systematic documentation (pictural/graphical/written documentation). I feel that it would be better to record everything down progressively rather than trying to recall everything at the very end.

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Nurul Nabihah, A173349, 14/8/23 - 17/8/23

1. Were the objectives of the project fulfilled?

Yes, the objectives of the project were fulfilled

To explore research on legal and forensic medicine via observation and demonstrations.

During our attachment in the Legal Medicine Department, we were demonstrated a few procedures that were used in research, such as automated tissue slice procedures that were used to micro-slice the tissue of the organs that were taken from the dead body. The tissue slices will be used to study and conduct research regarding the abnormalities that were seen in the tissue slices.

To assist ongoing research led by the supervisor from the Legal Medicine Department in Shiga University of Medical Sciences.

We were not assisting on research, but better than that, we were assisting our supervisors and other lecturers almost every day on autopsies. We succeeded in assisting in 11 autopsy cases of various complexity. We learned a lot of skills—more than we can imagine.

To apply and enhance my research knowledge as a preparation before conducting research in special study module in Year 4

Our research knowledge was enhanced as we were given mini-lectures by the lecturers and students of the Legal Medicine Department regarding their studies related to forensics. We were able to gain ideas on research topics and questions based on the lectures that were given by them.

To enhance relationship and cultural differences between medical students in UKM and Shiga University of Medical Sciences

I am very grateful that we were able to make friends with Japanese students, and they even exposed us to their various beautiful cultures, such as tea ceremonies that were prepared by our own friends, wearing kimonos that were brought by our own lecturer, and various Japanese foods that were fed to us to ensure we enjoyed every single thing Japan can offer.

To promote linkages between UKM medical students and Shiga University of Medical Sciences lecturers.

UKM and SUMS are known to be sister universities and have formed a very good relationship. Apart from us conducting elective postings in SUMS, SUMS was also sending their students to UKM to enjoy being a part of medical students in Malaysia, hence forming a stronger relationship between UKM and SUMS. This is a very good output that was gained through this programme.

2. What have you enjoyed or liked the most about the project?

During my elective posting in the forensic department in Japan, there were likely several aspects that I thoroughly enjoyed. These positive experiences could have contributed to my personal and professional growth. Here are some things I might have enjoyed:

Being in Japan, I likely had the opportunity to immerse myself in a different culture. Exploring Japanese traditions, cuisine, and lifestyle could have been a fascinating and enjoyable experience.

Working in a forensic department allowed me to gain hands-on experience in my field of interest. The opportunity to witness real forensic procedures, investigations, and research would have been both educational and exciting.

Engaging in actual forensic work would have allowed me to develop practical skills that I may not have had the chance to acquire in a classroom setting. This hands-on experience could have been immensely satisfying.

3. What have you found challenging about this project? (any part of the project you found hard to do)

Navigating the language barrier during my elective posting in Japan was a significant challenge. As a foreigner in a specialized field like forensics, effective communication was crucial for understanding procedures and collaborating with colleagues. Initially, I encountered difficulties in comprehending technical terms and conveying complex ideas in Japanese. To overcome this, I dedicated extra time to self-study and also sought guidance from bilingual colleagues and utilized translation tools. Through consistent effort, active listening, and perseverance, I gradually improved my language skills.

4. What has really worked? (any part in the project that you thought worked well)

I think gaining autopsy skills and experience plus learning about research through mini lectures worked really well in this programme.

5. What can be improved in this project?

Nothing can be improved in this programme as everything works so well in this programme. I hope I can be given the chance to go to SUMS again and repeat the same experience.

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Nur Emilia Ellina Binti Mohd Imran, A183604, 14/8/2023- 17/8/2023

1.     Were the objectives of the project fulfilled?

Yes, the first objective was to assist my supervisor from the legal medicine department at Shiga University via observation and demonstration. As a medical student, it was the most amazing experience to participate in the autopsy at Shiga University and practice on actual deceased individuals.  In my third year, I never imagined that I would have the opportunity to handle a dead body, but at Shiga University, I was given the opportunity to remove several organs and assist with the creation of histology slides.

Then, my second objective was to apply and enhance my knowledge as a preparation for the pathology forensic module in Year 4. I sincerely hope that early exposure to the forensic department will improve my interest in forensic studies during my fourth year or give me a better understanding of them. Additionally, I have already given a presentation on the Malaysian system for identifying the cause of death, and I believe that the next lectures on the Malaysian forensic system will help me understand it better.

My third objective was to observe both Japanese individuals and healthcare professionals in order to comprehend the cultural differences between Malaysia and Japan. I had numerous opportunities to learn about and see how the two nations differed. In addition, I had the opportunity to speak with many Japanese medical students at the institution and learn more about their way of life and educational system. When it comes to attending medical school, Japan and Malaysia are actually pretty equivalent. The difference is that in Japan, each student can submit applications to multiple government universities at once and take their own university admission exam. This really increases their chances of getting into medical school.

And my last objective is to gain new knowledge that can be implemented in future practice. There is a lot of knowledge I gain throughout the journey, from the preparation to the end. In order for my juniors to have the same experience as mine, I want to share my experience with them. I believe there are many advantages to acquiring fresh experience at our sister university in Japan because Shiga University is not a stranger to our university.

2.     What have you enjoyed or liked the most about the project?

At the university, I had the opportunity to connect with the people and learn more about their languages and customs, which I really enjoyed. They are also aware of our need for halal food, and they are a big help to me when I'm trying to find it. They respect our religion and are also mindful of our prayer time. We mostly hang out with Japanese medical students who are engaged in research in the forensic department, even though there are other international students at the university but none in our department.
I'm also grateful that I had a wonderful supervisor who looked out for my friend and me. During our last week, he even sent us to Tokyo himself to make sure we arrived there without incident. Surprisingly, I don't have trouble finding a prayer room in Japan outside of Shiga University, practically all major railway stations offer ablution tap and prayer rooms. Knowing that Japan respects various religions and is generous enough to create a space for individuals to pray makes me extremely happy.

3. What have you found challenging about this project? (any part of the project you found hard to do)

The project's biggest challenge, in my opinion, was adjusting to Japanese time. It is now summer, the sun rises at 3 a.m., and practically all malls and convenience stores close at 8 p.m., despite the time zone difference only being 1 hour. Because everything closes at such an early hour, my friend and I need to buy an early dinner. There aren't many restaurants that stay open late. Sometimes, we even sleep after our morning prayers because of the dawn around 3 a.m. I stayed there for about 4 weeks, yet I was still unable to adjust.

4.     What has really worked? (any part in the project that you thought worked well)

My contentment with our final-day presentation is terrific.  We spent nearly two weeks preparing it before presenting it to our supervisor and other physicians. Many people complimented us and asked us about the Malaysian forensic system. I'm honoured to represent Malaysia and enlighten Japanese doctors about our healthcare system. That, in my opinion, is one of my biggest accomplishments while studying abroad as a UKM student. I'm grateful for the opportunity and ability to experience it.

5. What can be improved in this project?

In my opinion, the process of getting ready to apply to university is pretty unclear because I have no idea how to contact them, where to go, or even how to ask for financial support. In order to get information on Shiga University, I had to contact seniors who had already graduated. One of the universities indicated in our guidebook is Shiga University, and I wish I could be an example for the following group to carry out elective posting so they don't have to struggle as much.

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Week 4:

Name: Casey Lau

Matrix number: A181338

Date: 14/6/2023- 1/7/2023

1. Were the objectives fulfilled?

Yes.
a. to enhance clinical skills such as physical examination, history taking and soft skills such as communication skills and critical thinking

My supervisor had assigned my colleague, Leah and I to do a history taking and abdominal physical examination on an English speaking patient. Our supervisor pointed out our mistakes when we did history taking. However, I did not get the chance to really brush up my clinical skills as I only got to do history taking and physical examination once due to the language barrier.

b. to find out the difference in the healthcare system between Malta and Malaysia

I realized that one of the differences is that Malta has a universal healthcare system while Malaysia has a mixed medical healthcare system. Malta has a publicly funded universal health care system, which means that all citizens and legal residents have access to essential healthcare services regardless of their financial status. The majority of healthcare facilities in Malta are government-owned and operated. The main hospitals include Mater Dei Hospital and Gozo General Hospital.Malaysia has a mixed healthcare system consisting of both public and private sectors. The public sector is funded by the government and provides services to citizens at subsidized rates, while the private sector offers healthcare services for those who can afford them.Public hospitals tend to be more affordable but may sometimes face issues related to overcrowding.

c. to observe and study the common cases found in the hospital

According to my observation during ward rounds, I realized that the common cases in the surgical ward in Malta are appendicitis and inguinal hernia.

2. What have you enjoyed or liked the most about the project ?

The part I enjoyed the most in this project is getting to explore more about the places, people and the culture of the country. This is my first time traveling to a European country, the feeling of being at the place is totally different from what I had seen in books or videos. As a buddhist myself, I always wonder what the churches in European countries look like as I have watched a lot of traveling videos on Youtube showing the churches there. To be honest, the moment I really get to visit the churches there such as Mosta Rotunda,  I had goosebumps not because it is scary but the interior and architecture itself is very stunning and the history of this church even made the experience there a lot more memorable. I also got to witness the celebration of the Light Festival at Gozo Island which gave me an opportunity to appreciate and  learn more about their culture.

3. What have you found challenging about this project (any part of the project you found hard to do )

The part I found most challenging in this project is during the application process. To lay bare, waiting for replies from different universities after sending an application form takes a lot of time.  I almost gave up after receiving rejections from some universities, but I am glad I persisted in the end or else I will not get to experience the life of being a medical student overseas and also to immerse myself in a new country and to explore their culture.

Apart from that, another challenging part during this project is the language barrier especially during ward rounds in Mater Dei Hospital. However, I am grateful that the house officers and nurses there are very kind to explain the patient's condition to us in English. Their guidance have been invaluable, offering me insights and knowledge that I will carry with me throughout my career.

4. What has really worked (any part of the project that you worked well)

To be honest, I was very anxious before flying to Malta as I thought I would not be able to adapt to a new learning environment. However the doctors, nurses and staff were very friendly and were ready to guide me whenever I had any questions, especially during ward rounds and I got to learn from them.

5. What can be improved in this project

My humble opinion is that we can have sharing sessions with juniors who are  considering a medical elective abroad so they can gain insights from seniors. Apart from that, I think that a briefing session about ISTAR BANGI can be given to the students of the next batch earlier so that they can have a slight inkling of the preparation process.