Bursaries awarded in the past
Final year medical student, Hull York Medical School
I was privileged enough to receive a travel bursary to help with my medical elective. Here is a quick run-through of what I managed to pack into six weeks!
My medical elective was completed in the ‘Jewel of the Mediterranean;’ Malta. I was placed in Mater Dei, the main hospital in the country, providing care for everyone on the islands of Malta, Gozo, and Comino. I did a six-week elective and made the most of my time there. Choosing Malta was an easy decision as it has a health care system very similar to the one in the UK; namely being free to access and with a Primary and Secondary care system. I wanted to further my knowledge of radiology and decided it was vital to go somewhere with similar technologies to the UK so that I could gain transferable skills to use back home. Malta has a huge amount of history and culture; something else appealed to me as I have always had an interest in history, and I thought I could combine several of my passions. I wanted to be able to say that I had truly explored whichever country I had visited whilst on my elective as it is such a great opportunity to live as a local for six weeks, and with Malta being so small I certainly managed this!
I found the first day very daunting, mainly due to the language barrier. I was aware that English is the official second language after Maltese, and was told that a vast majority of the island speaks English, but in reality, whilst they are all fluent, most of the time they communicate in Maltese. This was quickly resolved, and I got to know the team well. Soon I was being invited to observe and get involved with numerous procedures/imaging techniques. The department was large, so there were always procedures going on, and everyone was willing to teach. I spent time with many consultants and registrars which gave me the opportunity to see many imaging modalities. This included time spent in Interventional radiology; where I saw many angioplasties, a cerebral angiogram which revealed a stenosis in the sigmoid sinus, performed in the brand new angiography suite which opened while I was there!
I watched many paediatric ultrasounds, where I saw a Wilm’s tumour, another post nephrectomy, and also many screening scans for developmental dysplasia of the hip (DDH). I discussed the possibility of scanning every child for DDH and not just for those at high risk. This is something that other European countries are currently doing, and something currently up for debate in Malta.
In particular, I found the time spent with the Musculoskeletal radiologist extremely useful, as seeing so many ultrasounds being performed reinforced my knowledge of anatomy, and helped me appreciate what is ‘normal’ and thus to recognise when there is pathology present. I managed to follow some patients from their initial ultrasound scan, through to their fluoroscopy-guided steroid injections, right to their arthrograms, allowing me to see how different pathologies are seen with different modalities. I saw lots of breast MRI’s and ultrasounds being performed and reported, including some fine needle aspirations and biopsies, which also allowed me to improve my technique of breast examination, as I could examine the lesion, and then seconds later actually see what I had felt; giving me a much better understanding of what a fibroadenoma feels like as opposed to a probable malignancy for instance. I learned some simple things like how to determine on scan whether there is fatty infiltration in the liver, which is something I appreciated, as due to the nature of our MBBS course we do not get to spend much time observing scanning or reporting. I was even allowed to do some supervised scanning, which was really beneficial, as it gave me a better appreciation of the technique. This is something I had been unable to do in the UK. Another great experience was being allowed to insert a drain for malignant ascites; a great experience after watching so many of them being inserted over the previous six weeks.
I spent the majority of my time with a hepatobiliary radiologist, as he gave me the most time and taught me so much. He introduced me to procedures such as microwave tumor ablation, and elastography, just to name two. I was exposed to so many modalities and procedures, and genuinely feel like I have learned much more about the specialty I want to pursue in the future and feel more motivated than ever; as radiology is something we only get limited exposure to in our normal medical curriculum.
On the whole, I undertook an observational role; however, I made a point of asking the clinical indications for a scan or looking up any findings or abnormalities I had not been exposed to or witnessed before. Most things I learned about the practicalities of scanning such as how to actually use the ultrasound machine and the physics behind the process will probably not be useful until I start my postgraduate training, but it is always good to appreciate. I feel that I have gained a vast amount of knowledge from my elective, including my favorite fun fact; it is very common on Malta’s smaller sister island of Gozo to have familial splenomegaly! I scanned someone from Gozo and found a spleen of 18cm, and naturally was shocked! Only to be told that it is a common occurrence!
I found speaking to other radiology trainees useful as it made me realise what is important for me to do in order to improve my chances of being accepted onto the training programme in a few years’ time. Being around so many scans and people reporting also gave me more experience in plain films, ultrasounds and CT’s which will be extremely useful as a medical student and junior doctor on the wards. I loved reporting, as it gave me the opportunity to test what knowledge I had obtained over the six weeks and put it into practice. I can honestly say that my knowledge of the specialty has improved immensely, and more importantly for me, it has confirmed that this is the career path that I want to follow, and made me motivated to do so.
Overall, I thoroughly enjoyed my elective. As well as being in a great department who were very supportive, I took full advantage of my weekends in Malta and discovered several lovely places and made many memories that will last a lifetime. Due to so many students of different nationalities coming to Malta for their elective, I met great people from all over the world, such as Australia, Vietnam, Spain, Italy, New Zeeland and of course Malta, giving me the opportunity to talk about what medicine is like all over the world and discuss both the advantages and disadvantages. I consider myself privileged to have been awarded a bursary by the Royal College of Radiologists to help with the costs of my travel, and appreciate the help so much! It allowed me to make even more of my elective, and learn lots about both radiology as a specialty and the Maltese culture! What’s more, to top off an amazing experience, I was proposed to by my now Fiancé, truly making Malta the best experience I could ever have wished for.
Year 4 medical student, University of Newcastle Medical School
For my elective, I travelled to Thailand and spent four weeks at a big university hospital in the middle of Bangkok called King Chulalongkorn Memorial Hospital. I spent my time in the bustling radiology department, attached to the neuroradiology sub-team. The aim of my elective was to not only to improve my skills at spotting pathology on films but also to explore radiology as a possible future career.
There were film reviews every morning, where the registrars presented particularly challenging or interesting cases. The consultants would then work through the case, quizzing and teaching. I saw a huge amount of rare (and sometimes bizarre!) pathology, and getting teaching from leading consultants in the field was a brilliant experience. I was always so impressed with their ability to look at subtle differences in the scan in front of them and confidently make a diagnosis, which would make a big difference to the patients up on the wards.
I spent time in the afternoons on the hospital radiology system looking at emergent scans. I made myself work through the scan before looking at the provisional reports - which were fortunately in English! Over the four weeks, I (slowly!) started to spot more and more abnormalities myself which was a brilliant feeling. Every week there were MDT meetings to attend, chaired and led by the radiology consultants. My favourite was the paediatric neuroradiology MDT. As a tertiary center, any interesting or rare cases were seen by the department, meaning the MDTs were full of lots of unusual pathologies that I had never seen outside of textbooks before. It was lovely to see each doctor presenting a case at the MDT begin by thanking the radiology team for their input with each case, something I hadn’t seen so far at MDTs in the UK! There was always a lot going on in the department, such as afternoon journal clubs. Everyone on the team, including the most respected consultants in their fields, were keen to stay on top of advances in radiology to provide the most up-to-date care to the patients passing through the department.
For any undergraduates considering organising their elective, I can thoroughly recommend spending time in a radiology department. It is a valuable opportunity to see what the specialty is really like, and I certainly left wanting to see more. You also get to work with some of the most knowledgeable doctors in the hospital and see a huge variety of medical and surgical cases. I’d like the thank the Royal College of Radiologists for their very generous support which made my elective possible!