Chulalongkorn Medical School, Bangkok, (Thailand)
Impressions of Thailand
Jerson Yau - medical student from Sydney Medical School, undertook an ILA with ISSIE in 201213
As the inaugural exchange student from the University of Sydney to the Chulalongkorn University's (CU) Faculty of Medicine, it was a great privilege and honour to undertake a four week placement at its associated teaching hospital, the King Chulalongkorn Memorial Hospital (KCMH), in the heart of Bangkok.
I spent four weeks rotating through the diagnostic modalities in the Department of Radiology as well as extended rotations through Interventional Radiography and Paediatric Sonography. Overall, the schedule was well thought-out and the supervision was excellent.
Generally, CU medical students who undertake their clinical rotations at KCMH are not well-integrated with the clinical staff day-to-day. As an exchange student however, I was allowed unprecedented access to the residents, fellows, and the teaching consultants showed great flexibility in accommodating a foreign national in their day-to-day ward rounds and tutorials. They treated me virtually as one of their own (sans any real responsibility and thus, paperwork) and I thoroughly enjoyed participating (and competing) with residents during tutorials. The clinical pearls every radiologist applied was insightful, but how they integrate small objective clues into a larger diagnostic picture was a fascinating experience.
The KCMH is one of Bangkok's largest hospitals and is in a constant state of flux: the patient-load is unrelenting, the presenting cases cover the entire spectrum, the facilities and the allied staff are a mix of old school and the cutting edge. On an average day, I would encounter hundreds of patients, equal numbers of staff, the odd lottery seller, walk through wards from a bygone era, observe a 64 channel CT for an occult CSF leak or a 3T MRI machine specifically used to visualise the dynamic beating heart, and conclude with the small number of on-premises 'guardian' cats and dogs that emerge to play at dusk.
Some of the things that surprised me were how well-presented each radiologists' reports were (often shaming the reports I've read locally), how each and every patient was given full diagnostic care and consideration, and that if you know where to look you might find the odd American Army doctor who is happy to teach you highly effective experience- and observational-based medicine that is rarely practised in Western Medicine anymore.
On any given day, the staff and patients never seemed to ebb in this microcosm of Bangkok and whatever the caseload and challenging presentations, the radiological staff are willing to teach a respectful student and - along with the patients and their families - represent some of the warmest people I have encountered.