Université Pierre et Marie Curie (UPMC) (Paris)
Impressions of Université Pierre et Marie Curie
I spent eight weeks in Paris through UPMC, the first four weeks in Infectious Diseases at Pitié-Salpêtriére and the last four weeks in Emergency at Saint-Antoine.
This placement provided a remarkable insight into a medical system that I felt differed little from the Australian system in its knowledge base and availability of resources, but differed tremendously in terms of its administration and culture.
In France, medical students have considerably greater responsibilities than in Australia, requiring them to regularly assess patients and implement care at the direction of senior medical staff. Students are rostered and assigned tasks and patients as for any full time position (even on Public Holidays), making for an extremely effective introduction to the working environment of the hospital. I personally feel it was a fantastic opportunity to feel like a valuable team member in a way that I haven’t experienced in Australia and to practice clinical examination and history taking techniques in a practical setting.
Furthermore, although the underlying knowledge of medicine remains constant, practicing medicine in another language and system, aside from causing several hilarious misunderstandings, caused me to consider the ways in which I communicate in medicine, why I structure my knowledge in the way that I do and ultimately forced me to be more flexible with my medical thinking in regards to communicating with patients and with other medical staff. For example, in French I found that the slight delay in finding the right words made it considerably more difficult to control the flow of a patient’s history and thus, I would compensate by listening all the more carefully to their answers and processing the information more efficiently, a skill that I feel will change my history taking technique. And of course, the skill of being able to practice medicine in another language is itself valuable.
Finally, in terms of the culture of medical practice, I feel that, perhaps as a benefit of having a heavily funded public system, Doctors were far more willing to order tests and to pursue hypotheses, and patients had a remarkable level of faith in the public system, typically being more than willing to submit themselves to extra tests.
Overall, I found my experience in Paris to be a fantastic learning experience that will not only change the way in which I practice in future, but also provides a great insight into hospital work and responsibility. On top of all that, it’s Paris! What’s not to like?
"My experience opened my eyes to a different system of healthcare which is largely public healthcare in the department of infectious and tropical diseases at the Hopital Pitie-Salpetriere in Paris.
The department (infectious and tropical diseases) had a rapid turnover of really interesting patients with a wide variety of diseases. I feel that I consolidated some of my basic clinical skills (needing to perform full respiratory, cardio, abdo and neuro exams) in identifying possible causes, and also learnt a lot about antibiotics, and antivirals which was challenging (given it was all in French) but fun nevertheless!
I learnt that basic medical skills are transferable and useful in many different contexts regardless of the system in which you are based which motivated me to practice and hone some of those developing skills.
I also learnt to read people a bit better (body language, subtle signs etc) given the language barrier at times which was quite an amazing experience. I also learnt to be a team player in a new system, whilst being useful but not overstepping the boundaries in which I was comfortable.
I think I learnt that there are many ways to do our job as a trainee doctor and to do it best it should be patient centred and our communication should aim to be a responsive reflection of the patient's level of understanding (both of the words and concepts being conveyed) and on their terms (with family or support around them), rather than simply a didactic one-way message about their treatment plan between doctor and patient on our terms."