Dominic Mears - my elective experience

Undertaking an elective header

The clinical elective is one of the highlights of the MBChB course here at Birmingham Medical School. At the end of the 4th year, you are allocated a month do 'something that means something to you' – and it can be anything you like!

Students often take the opportunity to organise a medical placement abroad followed by the holiday of a lifetime – not bad considering it’s part of your University course. The placement is decided entirely by the students themselves and can be anything from air ambulances in Australia to trauma surgery in Canada.

This diary entry is from Dominic Mears, a current MBChB student at Birmingham Medical School, about his elective at the Shahid Gangalal National Heart Centre in Kathmandu, Nepal. 

For my elective, I spent four weeks at the Shahid Gangalal National Heart Centre in Kathmandu, Nepal. The reason for choosing this hospital was to explore my interest in the field of cardiology and to experience medicine in a developing country.

After the immense relief of finishing 4th year exams, there was no time to lose as I had to pack up my bags and head straight out to the airport for the 14-hour trip to Nepal with a group of friends. Fortunately, the journey went smoothly and we were soon settled into our charming accommodation in Kathmandu. The next day was the first day at placement where I met my supervisor and got a tour around the hospital. Unsurprisingly, the hospital was a stark contrast to the UK – not least the old fashioned white coats and outside patient waiting areas! The hospital grounds were idyllic and certainly a refreshing change of scene.

The next few weeks at the hospital were very enjoyable and offered a unique insight into a totally different healthcare setting. I took part in a daily ward round and saw patients with presentations unlike anything I’d seen in the UK.

This was usually followed by watching procedures in the cardiac catheterisation laboratory, helping out in the non-invasive testing department or seeing patients in clinic with my supervisor. Although the language barrier could be challenging at times, generally I was as involved as possible and it was a hugely positive learning experience. 

Dom elective 2

Furthermore, my experiences in the hospital were very humbling as well as interesting. For example, because Nepal in such a poor country with inadequate transport links, a lot of patients don’t make it to hospital in time and do very badly once admitted. What’s worse is that even if they do make it hospital, often they don’t have the facility to pay for treatment and thus get discharged. Seeing patients go through this served as a poignant reminder of how lucky we are to have free healthcare back home.

By the end of the placement, I had seen a vast array of different patients with weird and wonderful clinical signs, played an active role in a foreign healthcare team and been humbled by the unfortunate consequences of caring for patients in a very poor country. This was a truly special experience that will stay with me for years to come. 

After completing the whole of 4th year and then an action-packed elective, we had well and truly earned the right to travel and relax before 5th year. We started by going paragliding and white water rafting in a local adventure hub before setting out on a trek in the breath-taking Himalayan mountains. Still with time to spare, we managed to check out the jungle safari in the south of the country (elephants, rhinos and crocodiles galore!) and also went on a driving tour of the Tibet region of China. It was absolutely spectacular!

We returned to Birmingham feeling revitalised in advance of the start of year 5 and with plenty of stories to tell. Combining a special placement with a similarly special holiday was an extremely rewarding experience and I would recommend it to anyone!