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Ok. I think that should be us. Um Well, thank you everyone for joining this afternoon. Um We've got a, uh, afternoon full of um, different talks just about people's electives that they've undertaken over the past summer. Um All of our talks are delivered by our final year students. So we've got Roy Matthew Joyce and myself speaking today. Um, Matthew is gonna go ahead with the first talk and he's going to talk about his elective placement in Kenya, followed by Roy who did her elective in Vietnam, then Joyce, who did her elective in North America and then myself finally, who will talk through my electives in the Belfast trust. Um So without further ado, I will hand you over to ma um, if at any point during the talk, you do have any questions, feel free to type into the message box and then Matthew will have a wee look and answer all your questions at the end. Ok, perfect. Thanks time. I'll just present my slides. Now, can you see those? Ok. Ok. So, yeah, hi, I'm Matthew. Um, so I'll just talk about my pediatric medical elective, um, and sort of things. I'll talk through where I did it, um, what I sort of did it in and I'll just kind of talk through a day in the life and, and the sort of things that I did while I was on elective. And then I'll also touch a little bit on kind of the cultural experience as well because I know a lot of people don't want the whole elective to be just medicine based. And then I'll talk about a bit about how you can organize elective specifically if you're interested in maybe doing what I did. Um But that would be towards the end. So yes, where did I do my elective? So I did my elective in Mombasa, Kenya. So I'm originally from Kenya. So this is like home to me. Um But basically as you can sort of see on the map, it's east of Kenya, right by the coast. Um The hospital that I did the elective in is sort of on that um island section in the middle. So if you're interested in sort of an island experience, that's maybe something that might lure you there. Um But very tropical climate, warm and that's sort of something you're looking for, but more about the hospital. So I did my elective in cost general teaching and referral hospital. So this is a level five hospital in the region and basically what that means. There's sort of levels 1 to 6 of um care centers in Kenya, um level 12, I think like three is maybe, is sort of like your primary care clinics, GPS, that kind of thing. And then level four is sort of your um minor hospitals. Level five is your regional hospitals that take in lots of cases. Um They'll serve like huge, huge regions in the country. Um And they tend to have like a lot of specialized um areas and then specialized um units and wards and things. Uh And this being a regional hospital and referral hospital, it got a lot of patients from other surrounding minor hospitals that would be a bit more complicated and that included in pediatrics as well. Um So it's a teaching hospital as well. So it has a lot of connections with, I think primarily the US and there's some organizations that are connected with the hospital to organize for students to go on elective and things. So if you are interested in doing your elective here, you'll find a lot of other students with you, but you'll also find a lot of doctors and medical professionals willing to teach and get you involved, which I think is very good. I tried to include mostly my own photos as well. So these are all photos that I took of the hospital while I was on elective. Um And the photo on the left is just outside the maternity and pediatric unit. So yes, my time in pediatrics. So I spent four weeks on elective in pediatrics. Um three weeks specifically I spent in neonatology and then one week I split between emergency medicine for pediatrics. And then I got an opportunity to attend pediatric surgery as well. Um So my primary interest was neonatology and there were three units in the, in the um area of the hospital. So there was uh two units for sort of slightly less sick, um, newborns and then one like primary ICU as well. And during the time in neonatology, you got to sort of um move between the units. Um you could do per day or even during the day, you could move around. And then that picture in the top right is just outside the pediatric emergency department. Um And it's not a very big department, but it can be very, it would vary from busines or being like a bit less busy. And then the picture sort of bottom left is inside one of the surgeries. So I was able to get permission for um some photos, but this was um there was a sort of like um a project being run to help do more pediatric cardio surgeries. So this surgery I think specifically was a repair of A VSD, I think. Um but in all the areas, there was a lot of very helpful, friendly staff, they were all willing to get me involved in learning and being part of the team. Um And it was very flexible in terms of what to do. Or how long you would want to be in a specific area or who you wanted to shadow or be with. Um, and there was a quite a good opportunity for sort of f one level clinical involvement. And by that, I mean, sort of less you to shadowing, but maybe being given a level of responsibility within the wards. So that could have been from updating notes to requesting bloods or scans. Um, I personally was able to get quite involved and do um things that probably wouldn't be accepted in Queens. They definitely wouldn't allow us to do in the hospitals here. Um But again, because it is so flexible, it's so easy for you to say what you are and are not comfortable in doing and next. Yeah, so kind of day in the life of what I did. So they started around 8 a.m. And if you go to the hospital around 8 a.m. you'd be there in time for pre rounds. Um So you just kind of like go around review the the babies that are there in, in the NICU um and sort of maybe update the notes where appropriate before the consultant would come for ward round. And ward round typically was around 830 but it just sort of depended maybe what um consultant was on for the day if they showed up on time or not. Um It sounds like an early day but uh as you can maybe see from the slide, you're not there for a long time in the day. So it sort of balanced out quite well. Um And there's usually a lot going on so you don't even feel the time passing as much, but the kind of clinical tasks uh that I was involved in and I sort of mentioned them before, but I was um doing things like updating patient files, writing discharge letters, dis uh summaries in the notes. Um, you also gave instructions to mothers that were being discharged on um, like care of the umbilical cord, breastfeeding, um other things like that, uh then you carry out like investigation or you would um, request investigation sometimes. So the way it was done in that hospital is you would fill out forms and then deliver the forms to the relevant departments for investigations to be done and then you signed things like examinations and of course, if any of the babies were crying, you'd have the opportunity to go hold them and soothe them if that's what you feel comfortable doing. And yeah, around 1 p.m. Sundays 12, maybe if they, they were feeling nice and there wasn't really anything going on, but around lunch time you'd be able to go home. So it was quite a nice balance for the early start in the morning as well then in terms of a cultural experience. So, yeah, like I said, this is like my home region in the world and I've lived in Mombasa for a long time as well. Um, so I can tell you with confidence that it's a very friendly and, um, quite engaging place to be. Of course I'm biased. But, um, yeah, it's quite a, it's quite an easy going lifestyle. Um, everyone's quite friendly. There's not a lot of intensity or rush even like in the street or anything. Um, yeah, it's, they've got a like mix of culture influence, um just from history. So there's Arab influence, Portuguese influence and that kind of blends into like the music and the food. Um even just the like, like the culture that you'd see on the street every day. Uh in terms of language barriers, that might be something that might put people off. But in Kenya, a lot of people do speak English, especially the people that work in the hospital. So don't be afraid of not being able to communicate with anyone. Patients, depending where they're from, might not speak as much English, but usually a lot of them are able to get by. But in terms of if you wanted to learn, so we speak Swahili in Kenya, if you wanted to learn a little bit of like how to introduce yourself or how to um ask some questions. So it is not a very difficult language to learn. And I think it's on Duolingo as well. So if this was somewhere you were interested in going, you could get started as soon as you wanted in learning the language as well. Um And I know that some of the um connections in the hospital offered language lessons um outside of placement if that was something you're interested in, um in terms of sort of like religious culture. So majority of people are either Christian or Muslim, I think, like, basically everyone and it's sort of an even split between, but the religion plays a lot into kind of like cultural norm and cultural expectations. So you would consider the area sort of relatively conservative. Um, but don't let that put you off, they're very used to tourists and very welcoming of tourists. Um, so, like, don't be afraid to just get to know someone or speak to anyone. Um, and yeah, it's a very tropical, hot, humid area, I think like, uh, summertime is our winter time. So it's supposed to be colder, but like, colder in Mombasa is around like 30 degrees average every day. Um, but yeah, you're close to the sea and things. So when you're not in placement, it's easy to go take a dip in the ocean if you want to cool down and sort of the activities you can do outside of placement as well. Um Lots of things. So lots of beaches to explore. We have a north coast and a south coast. So either side of that island that you saw on the map at the beginning, um There's south coast is probably a bit bougie and a bit nicer. North coast is very popular and it's kind of where a lot of the hotels are. So, it just depends how far you want to travel. But there's lots of tour guides and, and, and like tour companies that offer like day trips and excursions to different places as well. So if you do enough research, you can definitely organize things. So, yeah, there's different things like boat tours, snorkeling camel rides and food tours as well. You can go and try a lot of the local cuisine. Um And then of course, there's lots of historical sites. Um again, from that kind of like Arab and Portuguese influence. So if history is your thing, you can go and visit different um museums or there's just kind of like different sites like Fort Jesus is almost like our version of a castle. So it's like this big for, with a lot of history and tour guides and things that explain everything. We also got the opportunity to visit local orphanages. And um I think there was a, a place for people with disabilities as well that we got to visit and you just get to speak to them and, and kind of get to know the people and know their stories as well. And yeah, going to local schools and things and of course, um being it would be a shame to miss out on the wildlife. So there's lots of different places you can go within Mombasa. But if you're up for a more of a journey maybe at the weekend or something, you can plan trips to the masai for um like a more of the big wildlife or you can go to Zanzibar and Tanzania as well or is uh it's just less than an hour flight from Mumbai. Um But yeah, and more things you can apply any research on. So in terms of organizing your elective, I was able to organize mine through connections mostly again cause I had some family that worked in the hospital, but I sort of paired up with this company called Elective Africa. And they were very good in terms of organizing a lot of the transport to and from the hospital and also uh any of the day trips or excursions or activities that we did outside of hospital. Um So that QR code at the top, right? Um If you scan that, it takes you to the website page about specifically about an elective in Mombasa, um they mostly cater to American students, but they are looking to branch out to welcome um students from the UK and other countries as well. So they'd be more than happy to accommodate you. But if you want more information, there's some emails as well you can contact them with or just look on their website as well. But I'd recommend getting in contact with them as soon as you can just cause it's easier in terms of planning what dates you want to go and also coordinating flights and things cause the earlier you book flights, the cheaper it will be. Um But yeah, just sort of consider what you wanna get out of the experience the most that might help you in terms of how you want to organize your elective because you can organize things through the hospital directly. Um But if you're looking for that element of like cultural experience activities, um, more of a vacation vibe as well, sometimes a company can offer something more along those lines. But elective Africa can has a very good balance and a very good mix between the two in terms of funding as well because that's a big thing to consider. Um, a lot of people I know use the Turing scheme offered by Q BI. Don't know when exactly it opens. But um essentially if you just apply, uh just say, say that you're doing a medical elective and I think you just have to give the dates and then a call like contact or someone, they just say like someone will sign to say like when you've arrived and when you finished and submit all of that information. Um And usually it, they'll accept most, I think most applications I haven't really heard of anyone that hasn't. But yeah, keep an eye out for that. I think they emailed us about it last year. So just keep an eye out on your emails in case they mention anything. And of course, any other um, grants or bursaries that come up come around, um, look into them as well, especially if there's any pediatric specific ones, if that's what you're interested in doing. And yeah, just some more pictures from the hospital that I took. So the big one on the right is kind of after you get into the hospital, this is like the main corridor. So a lot of the corridors are like open and airy again just because of the climate. But there's a lot of nature in and around the hospital, which I thought made it quite relaxing and like quite a, quite a nice scenery for what can usually be quite a busy environment. Um, as you can see again from some of the other pictures, there's a lot of, um, trees and, and bushes and things in between buildings and in between blocks and woods and things like that. And this corridor on the bottom left is actually what led to maternity and pediatrics if you came in through the main entrance. So, yeah, quite a nice little walk through the hospital as well in the mornings just to kind of get you settled and ready for your day. But I've sort of sp spread through that, but I hope that all made sense and if anyone has any questions, feel free to put it in the chat now, or you can wait until the end but then there's my email as well in case anyone wants to contact me directly. Um but yeah, thank you very much for listening. I'll hand over to Romi now who's gonna talk about Vietnam unless anyone else has any questions? Thanks. Ok, I'll just share the screen for me one second. Thank you problem. Can you hear me? Ok. Yeah, yeah, yeah, perfect. Um can you see this? Yeah, that's yeah, that's fine. Thank you. Perfect. Um So hi everyone. My name is Roy. I'm one of the final years. Um I'm here to just give a quick talk on my elective experience in Vietnam. Um I previously took a gap year before doing medicine, so I had done like a premed elective in Ghana. If anyone is interested in that as well, you're more than welcome to email me. Um So I'll just talk about my experience of four weeks in the hospital in Vietnam. So next slide please, Joyce. Mhm. Yeah. So we did four weeks in total in university hospital which is kind of in the middle of Vietnam. And I split my time between two weeks in general peds and two weeks in general medicine, which I thought was a really good idea actually because it meant that I could, I didn't realize how much I prefer pediatrics and I just gave a bit more variety and we would sort of do our typical morning would be like a ward round in the morning and go seeing patients and often with the medical students from Vietnam as well, which is really interesting because you learned quite a lot of information from them. Um, and through our elective, we just organized this ourselves. So we went, we emailed the hospital, um, which we just got the email from, from the year above. Um, and it was kind of better than organizing it with a big company just because we knew where the money was going and it was quite simple just emailing back and forth. Um I think sort of before Christmas, maybe this time last year we sort of started emailing. Um, but it definitely just took a wee while just like sending forms back and forth from passports and things like that and then probably got our flights booked like January time. Um, we organized then a hotel just to stay in for the four weeks, just through booking.com, which worked out really cheap for a month to stay there. Um And it, we ended up breakfast was included and they had a little swimming pool which was great as well because it's very hot in Vietnam and we would normally eat out every night because it was only about 3 lbs. And so it was easy enough. We were in Monday to Friday mornings only really just because of how hot it got there and the hospital didn't have air conditioning, but it was very chill and it was up to you sort of what you wanted to get out of the experience. Um And then at the weekends we went exploring which I'll talk a little bit more about in a minute. Um And then in terms of funding so similar to what Matthew was saying that the turing scheme which you get emailed about and then Queens also have other scholarships. So I think, um, they're sort of 100 lb scholarships. Um, but they're normally based on sort of academic work and things like that. And then some people also went for the Bank of Ireland loan um which was pretty, pretty useful. Um And then for fifth year as well, there's an NHS Bursary that you can apply for where the NHS pay for your final year and you get a Bursary as well and I happened to have it all sorted out before I went to Vietnam and some of it came in. So that was great timing. Um But I think the main ones, there are the Bank of Ireland and the cheering scheme, but you get emails about all of that. Um So yeah, and then my experience, so honestly, if I could go back tomorrow, I 100% would and the food was amazing. The people are lovely. Everyone will just go above and beyond trying to help you. I'm really proud to show you that country and the beauty and the culture of it. I think even just seeing, you know, like a different healthcare system interacting with the patients is very humbling. And you know, you realize how lucky we are to have the NHS um in terms of some setbacks, I'd just say there is quite a language barrier. They don't speak a lot of English. So we went to some um language classes while we were there, which is really useful just to learn basic phrases. We use Google translate a lot, but even just the notes and things like that were in Vietnamese. So it was a little bit difficult in that sense, h was a great city but for four weeks, I think by the last week we were ready to sort of get exploring. So it's good to sort of get away at the weekends, the weather we got used to it, but obviously it was very different climate to in the UK. So um wearing masks and no air and things like that. So, and also Vietnam is quite monsoon climate as well. So it's just sort of researching, you know, times of the year and stuff like that. Um And they seem to have a lot of paperwork on their ward rounds as well. So we sort of be on the ward round and then so we left as they want to do that paperwork, but it just took us a good few days to realize what was happening and then we were happy enough to go to go see people or join our staff. So Yeah. And in terms of travel, um we landed into Hanoi, you probably only need about three days there. It's very busy. Um And then that island, which is kind of a bit like how long Bay. Um These are just images of Google, by the way, these aren't actually my images doesn't quite look like this. Um And then was another great weekend place with a lovely beach and the hills which is in the top left corner there and is the Lantern Town, which is lovely. And the hash loop, which is the one on the top, right, which is the motor bike rides, which was amazing, kind of scary, but I'm so glad I did it. I think even after five weeks there, I still haven't seen half of Vietnam, so definitely ready to go back. Um And just one of the other things quickly was just knowing how much time you want to be away. So, like I come from England, I don't get a lot of time with my family. So me and my housemate made sure. So she came with me to make sure that we had two weeks at home, you know, before fifth year started. Otherwise it can be quite tiring because you've been away from for the whole summer. So just something to consider. Um And then these are kind of my last sort of tips. I wish someone had sort of told me before I went. So, what do you want to get out of your elective. Do you want to be hands on? Do you want to be just observing? Um, we sort of took more of an observational role. We were able to examine patients and do histories, but in a country that doesn't speak a lot of English, it's quite hard to be hands on and you're safer just to, you know, take a step back and not work. It's important that you don't want beyond your competence and you respect the healthcare system. Um vaccines, there's a massive shortage of certain vaccines. So I would get on that early. Um Like there's a wait list and stuff and some people went without, you know, rabies vaccines, things like that. So definitely something to look into and there are some on the NHS, but you'll just have to check, you know, what your GP can give you. The visa was easy enough actually. Um I think it was 20 quid. Um And again, just depends on obviously your passport and things like that. But um yeah, easy enough and that she came within a couple of weeks. Um and then insurance and indemnity is something you do have to think about. So, Queens do offer like a elective cover um which I think most people usually just completed like a form for it. But then you need to think about like your own travel insurance as well. And then your indemnity you need either with the MD which you just do on their website and they send you out a form with all the information to prove that you're covered with their indemnity. Um So yeah, so that's pretty much everything. Sorry, I feel like I said all that very quickly, but thank you for listening. Have fun and enjoy your elective, like travel, explore the country as much as you can and just get out, you'll only get out as much as you put it. And so just really enjoy it. And if you have any questions, please feel free to email me. I know it's quite a lot going on in fourth year. So just take it a time and break it up and stuff. But yeah, thank you. Um If you have any questions, either ask them now or if you don't ask them, just pop, pop me an email. Thank you. I'll hand over to Joyce. Yeah, sorry. Let me just bring my screen up again. Ok. Um Can everyone see that? All right. Y yeah. Ok, perfect. Um Well, hello everyone. My name is George and um I did my elective in Canada. So in terms of my electives, I did two. so I did one in July for four weeks and that was in London, Ontario. Um Sorry, I actually don't have any pictures of the map which looking back at Romeo Matthews that would have been really smart to do. But, um, if it helps, I can tell where Toronto is, if you guys know where that is. Um And I did it in the London Health Sciences Center in the Children's Hospital. Um And for that elective, I was in the NICU and then I did another elective um in Halifax in Nova Scotia uh for three weeks in August, which is around on the coast. Um And I was in pediatric infectious disease for that one. So I'll just sort of take you through what my regular day was in each of them and how I got to getting these electives. Um So for my first elective in Nicu in London, it was a Monday to Friday, a regular day would usually be around 8 a.m. to 430. Um However, I will be honest and say there was most days I ended up staying later, but it really is up to you. I just felt like, um there is usually a lot of things going on and if you did wanna stay, you could, um, in the program, they did have me scheduled for a night shift. They are very relaxed though. So if this is something you really don't wanna do, you could just tell them you don't want to. But I did do it. The night shifts in Canada work a bit differently. So they do a one, a night shift is 24 hours. So basically when I, my, I did mine on a Friday, I believe. So when I came in at 8 a.m. that day. I did it throughout. So you're there the whole day until Saturday morning, uh around 8 a.m. then you do handover. So it was around from 8 a.m. Friday to around 9930. Um, on a Saturday. Um, in terms of just what an every like, what a regular day looked like handover would start at 8 a.m. And that's sort of just the night team meeting with the morning team. Um And then after that, that would take approximately like half an hour, 45 minutes depending on the type of patients we have. And then we would do uh there's usually a teaching going on. So actually, www I did it in July, which was actually really good because um that was also when all the new fellows were starting. Um So there was a lot of teaching, a lot of introductions happening at the time. And um so after the teaching or there would be like an introduction to every fellow or resident would sort of just do an intro about who they are, where they came from, their culture, things like that cause it was, it was a really good team, um very friendly. Um And everyone was very interested in helping out and knowing each other. So that usually went on after the handover and then after that, we would start war DRS. So Ward's usually lasted a couple of hours. Um So the Children's Hospital in London is a level three hospital. So it's one of um e everywhere in Canada, sort of a bit far. So I think within around like, um, like a 23 hour radius, it was the only level three hospital there. Um, and the, the NICU itself was around 52 to 54 beds, I believe. Um, so it, it was, it was definitely quite big. Um, so ward rounds would take a couple of hours and sort of your responsibility during the ward rounds would be very similar to what you would be doing here as like an F one or an F two. So um there are certain patients that you're usually responsible for and for those patients, you're the one that's presenting it on the ward round. Um and then you uh and making the de the decisions for them as well. So obviously this is all under guidance of like the senior fellow as well as the consultant, but you'd present the patient and then because it's NICU, there's actually a lot of people working um together in that ward drug, it would be doctors as well as nurses as well as uh respiratory therapists, which I don't believe they have here, but they're a really big part of the NICU team in Canada um as well as dieticians because um I don't know if any of you did your pediatric placements yet, but if you're in NICU, the baby definitely has sort of like a breathing feeding problem. So they're really like vital parts of the team. So, as a student, if you're responsible for that patient, you'd first sort of just present um what was handed over to you, you'd listen to everyone else on the team and then they would ask you what you think you should do next. So in terms of, if you want to change things, sort of like you think this baby is septic and you need to start the sepsis protocol or you think this baby has been stable and they're now ready to increase their TPN or increa, um put down their CPAP things like that. Sort of. Um obviously, the consultant and the fellow were always there. So they will take everything you say into consideration and then they'll give you feedback on that, um what they would agree with and what they would change and so on. Um You would also be writing notes. So if you're not, if you're not the one presenting the patient responsible for that patient, it's another person, then you would usually be writing notes at that time or trying to organize like any referrals that they might need um after the war drowned. Um That's usually then when we would do like a handover with the maternity team, um just to see if there's anything that's um that sort of needs our attention or any consultations needed um from any like high risk pregnancies or uh patients in early labor that we think are gonna need NICU input. Um And then there's always like throughout the ward rounds and then afterwards there's all the neonatal resuscitations. So anything that really happens, we get paged and the whole team goes over and that was actually really cool because um there was a lot of it and they really get you involved within the team. There are certain things that you can't do. So because we're not um licensed there, you and we don't have the like um neonatal CPR training f from Canada, we can't really do the CPR and we can't intubate the babies, but we can definitely help with um just inserting lines in the babies, um weighing them like a all the other things that go on sort of in the background. Um And then later on in the day, it would be a, that's when you'd also finish all your clinical procedures. Um And there was a lot of opportunities to be involved in clinical procedures. Um in this placement. I personally was able to help with a lot of lumbar punctures, picc lines as well as like insert my own like um uh umbilical venous and artery catheters, obviously under a lot of guidance uh and supervision and yeah, that was basically what a day would look like and then you have all the paperwork. So um you'd also be doing some like admission uh packages, you'd also be doing f like filling out discharges for patients and then if there was really any other time left, then it would sort of, um, you'd be doing like, um, there's opportunities as well for other teaching. So, like just teaching on the ward or bedside or as well research. So, um, when I was there, I personally was able to get involved in case reports, um which was really helpful, um, for me and it really shows you how things work there and then you'd also be scheduled for a couple of days in the developmental clinics. Um And honestly, I really don't think I ever memorized what like ii was never able to memorize what age a child should do uh until I attended those clinics and I feel like I could, um I'm a pro at it now really, but just overall this placement I think was just amazing. Um, the team, uh I have a couple of pictures there on the side. Um The one at the top is like the on call room which looks a bit grim, but everything else is sort of just pictures of my time there as well. Pictures with all the other doctors and team, they, everyone was really friendly, they were super friendly, everyone really loved their job. They were very passionate about it and they were passionate about making sure that you're involved and you're learning as well and really getting the most out of this. Um I would, it's not the easiest of placements. I would say it is, it is pretty full on every day. And really if we ever had free time, um we would usually spend that time like reading together research papers and sort of just seeing what more we could do what new advancements are there, which I found was an amazing environment. It was really what I was looking for. I was looking to get an insight into what the Canadian healthcare system was like. Um And I was really able to get that from there. Um And then moving on to my placement in Halifax. I'm so sorry, guys, I really didn't take a lot of photos. So this is all I have. Um Halifax was sort of very different from London. Oh, also just about the city. Um in terms of London, I was only really there during the week. I'm actually from Canada. So all the weekends I went back home to Toronto. Um but the city itself is quite nice. There's some beaches around, you would definitely need a car to get around anywhere in Canada really, unless you're in Toronto just because everything's quite far. Um But the city itself is quite nice. I think it's good as well to warn you that there is, there's a big um sort of IV drug users and homeless population there which you will encounter a lot in hospitals even in Nicu with, with parents and things like that. Um But still, like, I still think it was safe enough. And um, if you go, I think London's great, but you probably wouldn't find enough to do there for four weeks. You definitely wanna do some exploring around. And then in terms of Halifax, um so Halifax is on the coast in Canada, which made it a completely different environment really. Um It was, um the weather was amazing. You were just on the beach. Um There was lots to do uh but in terms of the hospital, so I was in the I WK Health Center and that center and I was with the pediatric Infectious Disease team. So this is the only infectious disease team that is in any of the maritime provinces. So in terms of like New Brunswick, Newfoundland, uh P EI all the cases, all pediatric cases that required infectious disease input would be uh referred to the I WK center. So it was a huge hub, there's always loads of patients and it was as well just amazing learning um in terms of the schedule. So your official schedule is Monday to Friday. But um I did end up going Saturday and Sunday as well. Um It's a smaller team. So pediatric Infectious Diseases is like a consultancy based specialty um which ii personally didn't know what that really meant until I started doing it. So basically, the pa your patients are usually not your own. So patients are usually admitted under like general pediatrics or orthopedics or something like that. And then they have an infection. So then they ask for a consultation by the infectious disease team. So you work with the primary care team of whatever ward the patient was admitted under to sort of, you know, get figure out what their infectious is the infection is, get under co control, et cetera. The team really just consisted of a consultant, a senior resident and then me, so whatever like medical student they had at the time, which meant that you had a lot of responsibilities. Um You're a lot more independent, which was which and that's why this experience was quite different from my London experience in Nicu. Um The day usually was 830 to around 4:30 p.m. Sometimes you got away a bit earlier, sometimes you got away a bit later, really dependent on the consultants and their speed. Um But in terms of what a day would look like at 830 we'd come in, it would be me and the senior resident and we would first round on all the patients under our team. Um And then at 11 o'clock, we would meet in the microbiology lab with the consultant in which then the microbiology lab would sort of feedback to us if there's anything concerning that grew on any of the cultures that were being processed in the hospital. Um cause certain things like, for example, if they got like a pseudomonas arenosa, like that's, you know, not your regular everyday infection So we would have to go and see that patient and ask their team if they need our input, for example. Um And then after the, after the microbiology meeting, we would then um round on the patients with the consultant again. Um So in terms of what your responsibilities were, obviously, we would first, we would have to write notes. Um So whatever patient I'm rounding on, I'm the one writing the notes for before we meet the consultant. And then when we meet the consultant as we're doing the ward round, you'd be the one presenting and again, you'd be the one making the decisions. So there was a lot of emphasis on both of my electives of not just presenting the patient but taking that next step, acting as an F one or F two and really taking that next step, you know, um what do you wanna do next, what tests do you really wanna do or examinations? And, and then they would tell you to go on and do them. Um So it was a lot of responsibility but it really, it sort of, it was like a throw you in the deep end type of elective, but it really, I think improved my learning and clinical development in ways that I really didn't think I could possibly get out of just three weeks. Um I have a picture there of the pager. That was my first time using a pager was, which was quite interesting. I really did not know. First time it beeped. Um, I wasn't even in the hospital yet and it really freaked me out. Didn't know what to do but you quickly get used to it. Um Your, so if the senior resident was there, most of the c like the calls would usually go to him. Some calls would still come to me. But if he's not there cause he wasn't there every day, um The calls would come to me first before they go to the consultant. So you're really getting calls from, if they're in hospital for like uh pages, then you would go and speak to whatever doctor try to page you, figure out what's going on and see the patients yourself, probably fill out a consultation and then go and feed that back to your consultant. If it's out of hospital then and it would um just other doctors from hospitals all around the maritime provinces just calling, asking for questions. Sometimes you'd be able to answer them, but obviously you still have to work within your capabilities. So a lot of times I don't have to refer it on, refer on to my consultant. Um And then yeah, so you'd be doing consultations as well. So whenever a team feels that there is a serious infection going on and they can't quite handle it on their own or they, they need infectious disease input, a member of the team has to go and do a consultation for them. So it'd be taking like a full history examination, sort of seeing what happened before writing that all down um before the consultant comes and sees them as well. Um We did a like you do a lot of that and it's really in different things, like you'll be pulled in for NICU cause the baby has like, you know, MRA or sepsis, you'll be, you'll be going to orthopedics cause this child has like a pseudomonas joint um as well as a lot of general peds. So like M RSA positive eczema and things like that. And there was also a lot of Lyme disease. Um So Halifax is one of the endemic areas for Lyme. So you were seeing a lot of like lyme arthritis, um Lyme meningitis as well and just um uh neurological um manifestations of it, which were really interesting. Um And then we'd also be doing there, there's opportunity as well for some clinical procedures, not as much as there would be in the queue, but there's still some opportunities to do like lumbar punctures mainly um and just a lot of examinations. Um there's also some clinics that you'll be assigned to. And again, this was a lot more responsibility. So your basically leading the clinics, some of the clinics that I did were sort of with the consultant. So I would go see the patient and then come back, you know, with the consultant and then they do it. But then towards like the, the last week of my elective, I was sort of leading my own clinics. So patients that were following up, especially the Zoom call ones. I would be the one calling them myself, sort of figuring out what's going on, making a plan. And then you'd also be expected to dictate your own notes, which, um, is a lot harder than you think it would be. Um, the first note I dictated, I really had to go back and like manually edit everything because I realized I really didn't speak in a coherent way whatsoever, which was quite funny to see. Um But again, overall, this elective, it was a great elective. There's more opportunity for like tourism stuff in this area with like, you know, the beach. There's a lot of, if you're a fan of seafood, you'll absolutely love Halifax. The culture itself was very nice. Everyone was um the, it, it, I think it really represented the, represented like the stereotypical um environment of Canada where everyone is extremely nice. Everyone's constantly trying to help everyone's very um just happy all the time. And it was just a, it was truly like a great environment to work in um and knowledge wise, clinical wise, it really would help like it helped me grow a lot. So then in terms of how you could organize these electives, so there's really only three ways for you to organize an elective in Canada. And that's either through AFMC, which is the sort of the big hospitals in Canada. So, any of the medical schools in Canada, I think there's, I don't know how many there are. I think there's around like, eight or, or 10, like, affiliated with the AFMC, all of their hospitals that would, it would be through that portal. And then there's another one called Rump. I personally didn't use that. I only use the AFMC but ROM is for the rural medical um medical program. So it's hospitals that aren't in like the main cities, sort of. And then, oh, and then you could, if you're looking for like a GP placement, then you could organize that yourself with the GP or if you wanna do like a privately organized thing that would probably probably be an observer ship. Otherwise in Canada, it's not really allowed for you to have an official clinical elective, which means hands-on, if it's not through rump or AFMC, anything private would be observer and you'd be mainly ha like it would be hands off in terms of when you should start applying for these things. So every university really has a different date and every university has different requirements. So some um some universities only really allowed Canadian medical students, some universities only allowed international medical students that had a Canadian passport and then some Canadian uh some universities allowed like just anyone really. So you'd have to look at that and that's all on the AFMC and the R uh website. And usually I would say at least four months. So for my July 1, uh both, both of my electives, I organized four months in advance. My July 1. I started like the date opens in March. Um And I think April was for my August 1 and I would say you really have to be on the lookout for them because they're not that like, it's not the easiest to organize and a lot of people wanna do it and there's not as much space. So I remember I was so, you know, at 12:12 a.m. the portal opened for my July 1 and I think that was around like 5 a.m. here. I was sort of up just waiting for it so I could like submit my application because it is sometimes like just on a first come first serve basis. Um And yeah, in terms of where places like British Columbia, Ontario, Quebec, Nova Scotia P ei New Brunswick, I believe, except students, not just from um not studentss who aren't just Canadian, but any student at all. And then in terms of cost, um I personally wasn't actually able to apply for the, I can't remember the name but that elective fund because I am Canadian. So um so you can't really apply for funding if you're going to a country where you're from or at least like the country that your passport with Queens is from So for AFMC for you to make an account, it would, it's around 650 Canadian dollars. So that's for you to make an account to then apply. So even if, um, like just this, just to apply to electives, you have to pay that before and then for applying for the elective. And, uh, and like getting the elective, usually it would be a range of around 400 to $600 as well. And that really only includes the elective that doesn't include, you know, they don't provide accommodation or anything like that. So it, it's definitely, it is a, it is costly. I'm not gonna lie and something you'd really have to plan ahead for. Um And then in terms of documents, I thought that would be quite important to warn you about just cause there are a lot of documents that are required for Canada. They require a lot of vaccines. Um I personally had to do like um they, they require proof like ATB test and they were, it was really hard to get it here in Canada, North America in total. They do like the TB test regularly, but here I had to go private for it and I it was, I think it was like 100 and 70 lbs or something like that. It was really expensive. Um So try and plan ahead for that and sort of see what you could do. They also require you to have proof of your HEP B which you'd have to contact like occupational health about um you would need a criminal record check. Some places like British Columbia will require, you require you to do some courses like, you know, like those online. Um IH II think that's what it's called, the ones we do for Queens. So it sort of up, up to that. Um you will need to have an up to date certificate for your life support uh or like CPR training as well as an N95 mask certification. They didn't do an N95 mask certification here. So I actually did it the day, the day I arrived in Canada, which was the day before my elective. Um You might need a visa. I personally didn't but um so I don't know too much about that. You need a letter of good standing Neil Kennedy provided me one last year. So I'm sure Cathy Coin will provide you guys um with one as well as health insurance and some places again, such as British Columbia require letters of recommendation from doctors that have met you before. And that's sort of it. Um This is my email and number. Uh this number is for whatsapp. So if you guys have any questions, just feel free to ask me. I know that was um a lot. Um But again, if you have any questions, you could sort of just ask them now or put it in the chat, we could talk about it later. Um But I really would recommend honestly, like if, if you are able to organize one and are happy to organize one and are able to get the funds. Um, I think it, I genuinely, I think it was the best clinical experience I've ever gotten. Um, they, they were amazing. So I do recommend it. Ok, thank you. Thank you very much Joyce. Um Would you just be able to share my slides? And I've got the last presentation of this evening, um my elective in the Belfast Trust and I try and be quick. Yeah, I will actually throw in all the speakers emails at the end there. Um or just give me a second, I can do that now. Um So that's everyone's emails if you do have any questions and it goes in the order that we've spoken as well. Perfect. Um So I'll get started there. So, um my name's Karen and I did um three weeks of um a pediatric elective in the Belfast Trust. I did two weeks in uh neonatology and then a week in Peds oncology and hematology. Just the next slide. Perfect. Um So things that I'm just gonna quickly cover in this talk are the details of my elective, how I organize my supervisor, um the teaching and the practical experience I got on the elective and then quick, quick tips about sign offs in the Belfast trust and a little quick conclusion about my experiences as well. Yeah. So as I said, I did two weeks in neonatology and I did that in the regional neonatal Unit at the Royal Belfast Jubilee Hospital, which is located on the Royal Victoria site and it's quite close to just the main reception to the main hospital block. Um And I, my supervisor was Doctor David Sweet. Um And then I did ped oncology and hematology in the sick Children to Anthony mccartney. Um Both of these um supervisors I found just by Googling um my interest. So I put neonatology, um you know, consultants in the Belfast trust and I found their emails and they were kind enough enough to take me on for the summer. Um If, for example, you have, um I did want to do a genetics um placement and not. Um and then I ended up doing a pediatric oncology one. But unfortunately that supervisor was off for the whole summer. So I wasn't able to get that. But if you do have like a niche interest or just don't know where to get started about finding a supervisor and are planning on doing an elective in the Belfast trust, your two points of contact would be Dr Claire Laugh and Dr Benjamin Norton. I'm happy to provide those emails. Um If you'd like otherwise they usually do send out an email around this time of year. Um asking people who want to take a take on a pediatric elective in the Belfast Trust for. Um just, you know, just to get an indication of how many people that they might have to be managing during the summer. So they will contact you. But if you'd like to contact them instead, I'm happy to provide those emails. Um Once you get your elective supervisor and all details sorted you email Miss Nicola Morrison in the Belfast Trust office. Um Usually the doctors also organize this, but if you wanna get ahead of the game, you can also um email her in advance as well. Yeah, so um I'm mainly going to talk about my neonatology experience on placement because a lot of my Peds oncology team was clinic based. Um And yes, and you know what clinics are like, but I'm happy to touch on that just at the very end. Um So I spent a lot of time in different areas of the neonatal department in the regional unit. So um I mainly was in the NICU but I also spent time in the high dependency unit in Sabba, which is kind of like the intermediate um kind of daycare um almost before people go home um as well as theater and the delivery suite as well. And then towards the end of my placement, I was mainly on the postnatal wards and in clinics in the INS as well. So a typical day in the NICU kind of started at 830 in the morning. Um and that was with a handover from the night team and they would discuss anything that was going, that had been going on in the night with any babies being sick, any new presentations, any new admissions, um, any, any, um, tasks that needed to be done that day as well. And that used to be is a relatively quick meeting. And then they're straight into the ward round uh in the NICU and the Belfast trust accommodates about 12 days, 12 beds. Um and some, sometimes it's full, sometimes it's not, it's kind of a variable because um the babies do get moved around a lot between HD scab and all. Um but yeah, so on the daily ward round, um I think the one thing that I wasn't prepared for was all the questions. So they love to test you on the different murmurs um presenting in people with Trisomy. Um they love um all the kind of the neonatal red flag or red flag conditions like um neck and your respiratory distress and stuff. So be aware of those conditions because you will be quizzed on them. Um throughout the time. Um I just kind of spent the majority of my day in the NICU um shadowing and assisting the pediatric trainees. But I also had opportunities to see the patients independently um or more so under the supervision of the nurses and towards the end of my placement, when the staff were more comfortable with me being around the the neonates. Um, and, you know, it was really good because if you wanted to listen, you know, for a heart murmur that you maybe hadn't heard or, um, you wanted to kind of just spend a little extra time examining a child who's got more rigid or whatever it was. It was nice to be able to have that time to do. So. Um, throughout the day also, we'd have other specialties popping in. So we had the ophthalmologist coming in to check for RP or um retinopathy of prematurity in the neonates. We had radiologists coming in to do cranial ultrasounds. Um And then also pediatric surgery and I was able to sit in on two big conversations. Um one on Ampho seal and then one on neck. So both of those Children needed um tummy surgery essentially. And that was really interesting just to see the kind of the surgical side. And then the MDT approach of how neonates or neonatal E just kind of um have input into that. Um As well as that I was able to see a lot of procedures. So I saw chest drain insertions, lumbar punctures, uh cerebral function monitoring in a child that was having seizures in the 1st 24 hours of life um as well as like peripheral and central line insertions. And that really helped me to get a understanding of the technical proficiency and the precision that the trainees are are required to have. Um And that's something that you kind of need when you're coming up to reg kind of level as well. So it was nice to have that understanding early on. Um as well as that I was attending theaters and delivery suites and attending those and attending those deliveries in particular, I found it kind of like to be a profound experience because it helped me to also become familiar with the neonatal resuscitation algorithm, which is also again, something that you need to know um as a read, it kind of becomes your bread and butter. And the fact that I was able to help with incubation and ventilation breaths, I kind of felt like I was part of the team, which was great. Um As well as that you also, when you're in theater, you get some ad lib teaching from the obstetricians and then the anesthetist as well, which was useful. Um They don't have too much time for you, but some are really kind and they do make the time just to, you know, explain what's been going on um with mom and why baby needs to come out and stuff. So that was also really helpful. Um And then just in terms of clinics in neonates, you don't get too many clinics, you get baby clinics to review, like maybe some a baby had um a murmur or they thought that it was a murmur and they thought right, we'll check on it in another six weeks. And, you know, have reviews and most of the time they end up, you know, just being quite benign and there's nothing, nothing really um insidious going on. Um Majority of the clinics that I attended was actually in my oncology and hematology um placement. Um And so I attended things like long term follow up clinics, um leukemia clinics, benign oncology clinics as well. Um and lymphoma clinics and they were all quite helpful in understanding kind of the future. Um and the present impacts of, of having a cancer diagnosis in childhood. Um and economy think about things that you maybe wouldn't have thought about before in the context of their actual life. So then the Children having to take time off school, avoiding hobbies, like contact sports once enjoyed um the changing relationships between friends and family members as well. Um And then the other thing that kind of struggle chord with me was the potential health consequences through adolescents if they had had the cancer quite young, um as well as into adulthood as well. Um So that was quite an interesting experience and um I gained a lot of insight there. Um Just the next slide, please. So I had got a lot of practical experience because my supervisor was very keen on me gaining that. Um because he thought if I was to do, you know, start pediatric training that it would be useful as a as a baseline um progressing through. Um So I conducted regular neonatal exams, as I said. Um but also as well as that I was able to do neonatal phlebotomy, umbilical lines carry out newborn heel prick testing BCG vaccines for those at risk of TB, as well as assist with like audiology screening and stuff. And that kind of helped provide a really nice um varied experience day to day. Um So that was quite useful and, you know, if you are looking to do an elective in the innate, it's you can do the simplest things like audiology screening, you're not gonna cause the baby any harm, but it actually is such a useful thing to know how the, how it's done and what it shows and stuff. Um Yeah, so the next slide, please. Perfect. Um So apart from that, that was kind of like my experience on um neonates. And he, the thing that I wish I knew a few tips for was the sign off. So a few tips just um would be organize a time to meet early on in your placement because the doctors get really, really busy. So it's useful to have to say even on your first day, doctor, doctor Sweet, can I meet you on Friday at 4 p.m. to, you know, sign off my my form. Um also print out the form in advance because sometimes they don't have access to printers and it's just really convenient for you to have all the um have the form right there in front of you and fill out the details like your name and your student number and stuff so that they don't have to. The other thing is sort out a stamp, make sure that your supervisor knows that they need a kind of um So mine was the Royal Jubilee hospital samp that I needed. Make sure that they know where that is and they have access to one because I don't think Queens accepts the form without it. Um And the other thing is they will ask you a lot of questions and ask you to reflect on your experience. So make sure that you have some points ready about what you learned and how it was good and all those things. Um And then if you had a really, really nice experience, like I did bring them some chocolates in the card because they always appreciate that and they all have sweet Tooth. So you'll be in their good books that way. And that's me, I think. Yeah. So just a few concluding points that maybe I haven't touched on before. Um So the teaching, as I said, that's gonna be very varied and you'll have a lot of people running through the wards. So your consultants, your registrars, your specialist nurses, and your physios, pharmacists. But as well as that people coming into the ward, like the um ophthalmologists um and the radiologists as well. Um Practical experience is really important that you, you have the opportunity and you feel competent too. Um Just try ask if you can do you know the vaccine or talk, um ask to be talked through and you do the next one. and then applications in training life. So one of the main things that I found useful was actually talking to the trainees um about how they got into peds, what kind of things that they did to improve their application and their chances of getting into the program and then also what life as a trainee is like. So I met one up to reg levels. So ST seven and they all kind of talk through the experiences of trainee, how it impacted their family life, how it's impact, you know, what kind of education, um education experiences and opportunities they've had um for clinical development as well, which is quite enlightening. Um But yeah, so that was kind of my experience in a nutshell. Hopefully that was somewhat useful if you have any questions I'd be happy to answer. So that's just my email there, but it's also in the chat box. Um I'm just gonna send the feedback form in as well just so you can fill that in, there's some optional questions. Um and then just some questions about how you found the format of the talk and what we covered. Um So just send that in. Um And then we'll also email you that as well. So if you could fill that in. That'd be great. But thank you very much for joining us on, um, this afternoon and we hope that it was somewhat helpful, uh, in you planning for your electives this summer. Um And again, if you could fill in the feedback form and if you have any questions, don't be afraid to throw them in, if not, um, you feel free to head on as well. Joyce, I think I'm gonna end the call there. I don't think there's any messages coming through. Yeah, there isn't. That's all right then. Yeah. Yeah, perfect. Thanks, Darren. No worries. Thanks very much. Thank you, Matthew. Thanks.