Report 1

Reporter: Donald Waters

Contact at destination: Dr Gaël Gheno

Year of visit: 2014

Country: France

Region: Annecy

Institution: Centre Hospitalier Annecy Genevois

Department: Accident and Emergency

Work / Study undertaken: Contrary to my expectations of an emergency service fairly identical to the NHS, I actually spent my first week flying around alpine roads at speeds of up to 200kph with the Service Mobile d’Urgence et de Reanimation (SMUR)! In France, although general ambulance cover is provided by the all-purpose emergency service (the Pompiers) along with several private companies, for potentially life-threatening medical scenarios such as acute chest pain a physician-led ambulance unit is sent out, consisting of two highly-trained paramedics and an emergency medicine consultant. They provide acute medical care at the scene, up to and including intubation and ventilation, before stabilising patients and returning them to hospital. Annecy hospital has two SMUR teams on constant standby, one of which can also be dispatched by helicopter to incidents such as severe skiing/mountaineering accidents. I spent two weeks with the SMUR team, shadowing the doctor on the time and helping out where I was able. The rest of the time I worked in the hospital A&E department, comparable to that of Edinburgh both in size and caseload. I was expected to clerk patients on my own, present them to a senior doctor and write their case up on the electronic system, enabling me both to gain a huge amount of practice of my medical French and also see a wide variety of acute medical and surgical conditions.

Description of destination: Annecy is an incredibly beautiful place, sitting at the top of a sparkling blue lake and surrounded by majestic snow topped mountains. The Haute-Savoie welcomes tourists from all over the world every year and it is easy to see why! It was really nice however to feel like you were there with a purpose rather than just being a tourist.

Were the local people friendly? The whole hospital has a really friendly feel and I was welcomed incredibly warmly by everyone I worked with. Patients were also very accepting of having a bumbling British medical student taking charge of their care and were surprisingly happy to put up with my grammatical errors!

Did you feel safe and if not why not? Yes. Annecy is a small and very safe city although I’m told has quite a lot of problems with pickpockets and bicycle thieves in the centre of town.

What did you do in your spare time? I did have to work pretty hard (8-18.30 every day and some weekend shifts) so didn’t have that much spare time but managed to cram it as full of stuff as I possibly could. Annecy is basically a gigantic outdoor playground and I spent a lot of time in the hills, mainly walking as I was sadly there in between the skiing and climbing seasons. There are many easily accessible paths up all of the incredible mountains surrounding the lake which are of varying difficulty to suit how energetic you are feeling and the views from the top are simply incredible. I also entered a fell race while I was there which was an amazing way to get up into bits of the mountains you wouldn’t normally see. If the hills aren’t your thing then the cycle round the lake is absolutely incredible and perfectly topped off by a jaunt in a pedalo on the water itself. Annecy is also a culinary centre and you can try numerous different Haute-Savioe specialties including the most amazing cheese I’ve ever tasted!

Is there anything that you would particularly recommend others to do? Perfect day: cycle round the lake, walk up an alp, eat lots of reblochon with a local beer to finish off.

What was the climate like? Variable and actually rainier than I was expecting however still a good bit more pleasant than Scotland!

What was your accommodation like? I ended up moving in with one of the doctors after a couple of days as he said he thought I would like it more than the student accommodation I had found (an indication of just how nice the staff at the hospital are). The student halls I moved into initially were nice however and very reasonably priced at about €350 for a month, website

Was it provided? No

If not who arranged it? I found the student accommodation online. As Annecy is a student town there are many different halls of residence to choose from, most of which accept people for short periods of time if they are matriculated students.

How much did it cost? See above

Did you enjoy your visit? A huge amount, was incredibly sad to leave

Did you find it useful medically? Really useful. I was exposed to a huge range of things, many of which I hadn’t seen before, and my opinion was genuinely respected in a way you aren’t very used to as a medical student. I was also constantly on-call for any English-speaking patients as not many of the rest of the team spoke any English so was able to be of genuine use a couple of times which was really nice. The experience of pre-hospital medicine with the SMUR team was invaluable and something it is very difficult to find in the NHS.

Has it improved your french? I had to hit the ground running as they expected me to be able to practice medicine in French from day 1. I found this very tricky to begin with and clutched my AFMS handbook to me like a lifejacket for the first week or so but found myself pleasantly surprised by how quickly I became comfortable clerking and presenting in French. I also learnt a lot from living with the French doctor as it meant I was really speaking French all of the time.

How has it increased your knowledge of French culture? I learnt a huge amount from living and working with French people, both about their culture and about how Britain is perceived by one of its closest neighbours. My favourite moment was when one of the consultants sat me down and asked if life in Scotland was really as hard as the film “Trainspotting” suggests! I also gained a big insight into the lives of the people of Annecy by going into many different homes with the SMUR team.

If you went back would you do anything differently? I’d have gone for longer, 4 weeks flew by!

How did you get there? Cheap flights with easyjet to Geneva along with many other carriers

What was the approximate total cost? €700 in total. No placement fees. Easyjet flights from Edinburgh to Geneva were about €150 plus transfer for €15 although with a car share website you could get it much cheaper. I ended up only paying €100 for first few nights of student halls but spent a surprising amount on food and general living costs, partly due to the rather poor exchange rate.

Is there any other information that you think may be useful? All elective students get a free lunch in the hospital every day which is absolutely amazing, three courses including an incredible pudding and a glass of wine if you want one!