How is life after MBBS by AFMC
Urology - SCOPE (clinical traineeship exchange)
by Eva-Lena, Marburg
I wanted to do an internship in an English-speaking country. Since I've been in England for some time, Canada and Australia came first.
Canada has long interested me because of its unspoiled nature and the many national parks. I therefore wanted to combine the opportunity to gain insights into the Canadian health system with the opportunity to marvel at nature.
Unfortunately, the preparation was very time-consuming and costly. The contact to the various organizational units was very good!
If you apply for an internship in Canada via the IFMSA website, you have to prove a Toefl or IELTS certificate in addition to the bvmd English certificate.
This takes place in larger cities in Germany. Check out the dates for this in good time.
Cost: approx. 230 €
You will receive an email relatively early with the request to register on the AFMC Student Portal (Association of Faculties of Medicine of Canada). It is advised to take care of it early and it is all well explained, take this seriously and take care of it early! Canada has strict deadlines for all students. On this portal you have to 1. create your profile and 2. apply for your electives. For the profile you need:
-English certificate (in my case IELTS, 230 €)
-Criminal Records Check (certificate of good conduct, costs approx. 15 €)
-eTA (electronic Travel Authorization, I explain below, 5 €)
- Proof of international health insurance
-Proof of personal liability insurance
- Proof of malpractice insurance (professional liability, e.g. through Deutsche Ärzte Finanz, approx. € 10)
-> CAVE: You first have to pay $ 214 for the Canadian Malpractice Insurance, you get the money
but back as soon as you can prove your own
- Immunization Form (a somewhat more complex document in which you have various tests
have to prove. Take care of it early so that you can get laboratory results and TB tests
be available on time. Cost me a total of about 110 €)
- Medical Exam: If you enter Canada and work in the medical sector there,
you have to prove this medical exam. There is a list of them through Immigration Canada
Medical practices that offer this medical exam. Costs: 275 € plus 80 € laboratory costs)
- Passport, photo
- Proof of the N95 mask fitting (can be done on site in Canada and then prove the
Hospitals also offer these fittings free of charge at regular intervals)
As soon as you have uploaded all important documents, the profile is complete. For every university there is a visiting electives coordinator, in my case it was Angie, who was at my side with advice and assistance. Step 2 in the AFMC portal is then to choose the right one for you from a large selection of electives and send an application request. Most electives in Canada are 2 weeks long and cost around $ 250 for Canadian students, but are free for us.
As a German citizen, I didn't need a visa, just an eTA (electronic travel authorization), it was uncomplicated and quick, 5 €.
Also required for entry:
As already described above, you have to prove that you have international health insurance, but I think it makes sense to have one anyway. I had to prove my vaccination status for the Immunization Form, so I still got the influenza vaccination. In addition, you had to prove the TB skin test twice. In addition to the normal vaccination status, Hep-B antigen AND Hep-B antibodies ...
The medical exam included: a brief medical history, physical examination, eye test, chest X-ray, blood collection and urination.
I have not taken any special precautions for my safety. I felt absolutely safe at all times. I drove a lot with lifts and have only had positive experiences.
The currency is the Canadian dollar, which is currently a little weaker than the euro. Nevertheless, I found the cost of groceries to be particularly high. On the bus in Edmonton you have to pay appropriately, there is no change. Otherwise everyone actually pays by card. I received $ 200 as "pocket money" from the host organization, but only at the end and with proof of receipts ($ 100 is for leaving the room properly and $ 100 as support for food & social programs).
Bilingualism in Canada is mostly seen in public life. Signage, packaging or announcements are in English & French. At the hospital in Edmonton, Alberta, we only spoke English and the French language skills of the English-speaking Canadians are rather mediocre.
I flew 9.5 hours from Frankfurt - Calgary. There are several bus companies in Alberta that connect Calgary & Edmonton and they are reasonably priced. Otherwise, I managed longer distances very well using carpooling (Facebook groups, apps, websites: poparide, rideshare). I used to run in Edmonton, but there is also a good bus network.
I decided against a Canadian SIM card because I found $ 45 a month just too expensive.
There is Wi-Fi everywhere and for those situations in which I needed internet on the go, I paid 5 € / week at AldiTalk.
I lived in a shared apartment with two Canadian students, with whom I got along really well. I was able to use the large kitchen and everything else and bed linen and towels were provided.
Jasper & Banff National Parks:
To take with you
In addition to normal clothing, I also took my ski clothes with me. I was very grateful for the ski pants on my hikes at -25 degrees.
For the internship I should bring my own smock and "professional clothing" (it was clearly stated that you are not allowed to wear sports shoes / sneakers or jeans). In the end, I just walked around in scrubs in urology and missed my sports shoes with better soles on the long days.
Journey and arrival
I arrived a week before the start of my clinical traineeship and looked for a host family in Golden, BC via helpx.net. I wanted to spend some time in the Rocky Mountains and I would have liked to have spent more time there. The time difference of 8 hours and the associated jet lag should not be underestimated. From there I took a lift to Calgary and then took the bus to Edmonton. I was picked up by my LEO and taken to my accommodation. I had to find the way to the hospital and the orientation within the hospital myself. But there were nice medical students on the ward who helped me.
Job description and professional impressions
My days in urology started at 6:00 a.m. with my rounds and I was mostly in the hospital until 4:00 p.m. / 5:00 p.m. I was assigned to a senior physician (attending) every week and followed his weekly schedule. On the first day I had to complete a training session for the new database that is now used for medical professionals in Alberta. This database enables every medical practitioner in Alberta to view all findings, doctor's letters, laboratory results, surgical reports, etc. from any specialist department. The family doctor does not have to wait for doctors' letters from his colleagues, but can find them directly online. The subject of data protection was therefore dealt with very, very, very often in the training.
I rotated between the clinic (outpatient department), cystoscopy and the operating room. In the outpatient department, the senior physician always let me speak to the patient first and then I reported to him. To my surprise, there were unfortunately no Sono devices there, as I know from Germany. There a CT is done faster to check kidney congestion, which I found quite strange. Otherwise it was exciting to see how openly and easily the doctors in Canada talk to the patients and also "teach" a lot while they are explaining details to the patients.
I really enjoyed the day in the cystoscopy, the nursing staff was super nice and explained a lot to me. At the end of each examination, I was allowed to examine the bladder with the cystoscope. There was also a circumcision in which I was allowed to assist the doctor. In the operating room, I was actually always allowed to wash myself and sew and staple myself from time to time. One more day I rotated into pediatric urology, which in Canada is another additional training of 2 years after 5 years as a specialist in urology. There I was in the operating room with a super great pediatric urologist who explained a lot.
Because the work in the outpatient department was so unpractical, I found it a bit boring and would have preferred to have been in the operating room more. I missed the sound very much, because I found it particularly good during my clinical traineeship in urology in Germany.
Even if in the end I got along better with the language differences, I have to say that I would have imagined it would have been easier to understand the medical terms more quickly and to be able to answer doctors' questions more quickly.
Overall, the mood was always pretty good. Nursing there is much better staffed than here in Germany: There are 6 qualified nurses available for around 20 patients on the ward, and that naturally has a positive effect on the atmosphere. I also found it particularly interesting that the patients there are asked early to get moving again. There are posters in every room to inform the patients why it is good if they do as much as they can to get fit faster.
The healthcare system in Canada is organized by state. Most of the medical care is financed through taxes and everyone can also book an "Insurance Plan", e.g. for expensive medication.
I had a long conversation with a patient with ulcerative colitis, because the current conservative government of Alberta means that the costs of her biologicals will soon no longer be covered and she will not be able to raise the $ 500 a month herself.
country and people
I particularly enjoyed my first week in Golden, BC. From there I went skiing for one day at Kicking Horse and one day at the tourist attraction Lake Louise. From the small village of Lake Louise, you can hike to the actual lake in 1.5 hours. That day it was 3 ° C and bright sunshine, so perfect conditions. In the Rocky Mountains, however, the weather can change suddenly. It is therefore particularly important in winter to take advantage of the good days. During one trip, e.g. because of an avalanche, Highway 1 was closed, which is why we had to make a 100 km detour. But even that was great, because the drive through the Rockies alone is beautiful. At the edge of the highway are some national parks where I could spot a couple of bison. There are also reservations for the indigenous people of the First Nations. I had a touching conversation on the subject with a patient whose wife is a Siksika. There is no clean drinking water in the reserve, which is not far from the major cities of Alberta. Therefore, many people there resort to soft drinks or alcohol. Substance abuse and the disappearance of hundreds of indigenous girls and women are also recurring topics. First Nations equality has a long way to go in Canada.
Aside from the racism against the indigenous people, immigration seems to be working well in Canada. Based on the patient's surnames, I have often guessed their origin and as soon as I mentioned that I come from Germany, they spoke very openly about my own origin. Basically Canadians are really very friendly and helpful, I always felt that I was in good hands and it was never a problem to find someone who could help. Even though I'm not that big of a city person, I really liked Edmonton, there are numerous beautiful viewpoints and through the North Saskatchewan River there are some green corners where you can go for a walk. I can also recommend the Art Gallery in Edmonton and the sports center right on the University of Alberta campus (right by the hospital). For a day trip, Elk Island is great (a small national park where you can see moose and bison). On my weekend trip to Canmore and Banff it was -25 °, so I only took short walks there. Actually, my roommate and I still planned to drive along the Icefield Parkway, which connects the Jasper & Banff national parks. I'll make up for that in the summer, when the path isn't frozen over and it's just a bit dangerous.
I definitely want to go back to Canada! At the top of my list is to see the National Parks of the Rockies and the beautiful lakes again in summer when they are not frozen over.
I was also able to take a lot with me from my internship, but I was simply super exhausted every day and was less able to do practical things than in Germany.
I have to say that I simply underestimated the costs in advance and, despite the generous travel allowance, I still had to pay a lot more.
Canada or Rocky Mountains again: YES !! Definitely!
Internship in Canada again: rather no.
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