University of Crete Internal Medicine Global Health Rotation

 Today was my last day at the hospital, and wow just what an experience. I had an amazing time during my rotation and on my time off. I learned about the Greek healthcare system, how medical education works, and got to practice on my clinical thinking and skills. It really was a time of discovery and joy.  This experience will shape how I approach medicine in the future. I really feel like it was incredibly beneficial for me to be in a place where I was uncomfortable and had to ask for help. It gave me a greater appreciation for how challenging navigating medicine can be if you are not intimately familiar with the setting. I feel so comfortable in US hospitals since I have been in them for years at this point. But that is not the case for patients. Keeping this in mind will help me be more empathetic and understanding. I also want to take the good-naturedness of the residents and medical students with me. Everyone was so helpful and willing to teach. Even though I struggled at...

 I was running this morning with the sun rising over the water and it just hit me how incredible this experience is. I am nearly done with this rotation and medical school as well. It is crazy how fast the time has gone and just how much my life has changed over the course of 4 years. I'm incredibly lucky that I was able to participate in global health. 

I really didn't know what to expect from this rotation before I came over. I knew the basics of the Greek healthcare system and had experienced the private aspect of it myself. However, I had not had any interaction with the public sector.  When I first got to the hospital, I was surprised by the lack of security. In the US, you have to badge in and there are metal detectors and guards, but this hospital didn't have any of that which was a nice change. I loved how all of the hospital rooms had balconies and the doors were often open allowing fresh air to blow throughout the room. The rooms were bright and well kept.  I really think that I have grown on this rotation. I love to travel and have been on several trips, but this was a great time to really push myself. It was different coming to a country and having responsibilities. I needed to fit into the culture and be in less of a vacation mindset. I had moments where I had no idea what I was doing, but really its good for me t...

 Obviously there are going to be differences in the Greek healthcare system compared to the US. I have been working at a public hospital so I can only remark on my experiences there and not at the private hospitals.  The internal medicine department are actually referred to pathologists while what we call pathologists in the US are known as anatomical pathologists. A little confusing for me at first, but I digress. The hospital is set up so that there are different wards and you essentially stay in your area. So if a patient is admitted for a GI issue, they go to the GI floor and they manage all of their care. Patients were admitted to our service if we didn't quite know what was going on yet, they had many co-morbidities, or just had a general issue. As I mentioned in another post, the conditions we treated were very similar to conditions I have dealt with in the US. The diagnosis process and the plans we came up with were things that I was familiar with.  One thing that...

I have a basic grasp of the Greek language and luckily lots of medical words have a greek origin. Many medications are just called by their English brand names and bacteria and viruses are also in English. However, it is difficult to communicate at times. Many of our patients are older, so I cannot directly communicate with them. I have to rely on the residents or other medical students to translate for me. It is frustrating at times and I feel like a burden. I came here and am in their environment and I am not fluent in the language. I try to make sure I am prepared to talk about the patients, but without being able to immediately know how they are answering the doctors questions, I find myself struggling.  In the US, I was always on my toes and felt like I was part of the care team. I was able to pre-round on patients, ask questions, and formulate my own thoughts, plans, and diagnoses. My apprehension was tied to looking good and not making mistakes in front of the attendings. No...

 I've spent about a week and a half on my rotation now and it has been a great experience so far. I have been one of two hospitals in Heraklion. It is a main hospital for Crete and covers many of the islands as well. On internal medicine, our patients are very similar to patients I encountered during my rotations in the US. We have been managing anemia, fever of unknown origin, sepsis, heart failure, upper respiratory infections, and AKIs to name a few. Most of the patients are older, we even had a 98 year old patient who was quite spry. There are lots of co-morbidities like hypertension, hypercholesterolemia, and diabetes. We look at ABGs a lot and it has been great to refresh on acidosis vs alkalosis, metabolic vs respiratory, and anion gap vs normal.  I have been working on improving my physical exam, especially stethoscope skills. I feel like I am getting better at picking up the differences in sounds. The residents are all very confident with their physical exams and lear...