Reporter: Gabby Deehan
Contact at destination: Mme Ariane Favre, Responsable administrative de la 3e année de Master, Université de Genève
Year of visit: 2018
Institution: Hôpital neuchâtelois, Pourtalès. HNE is a medium-sized hospital, the equivalent of a DGH in the UK. I organised this stage through the Université de Genève (unige.ch), where I enrolled as a visiting student for the duration of the placement.
Department: Obstetrics and Gynaecology
Work / Study undertaken: I spent two calendar months (placements are strictly from the 1st day of the month, to the final day of the month) in the Obstetrics and Gynaecology department. My day started at 7h30 and usually ended after afternoon handover which was at 17h. I had already done a Woman’s Health block in my penultimate year but it was in a massive London tertiary centre so I was keen to do my elective in a smaller DGH-type hospital.
It’s not an easy placement: the hours are longer than those expected in the UK and the medicine practised is, in many ways, different too but I would highly recommend the experience. There are four different aspects to the O&G department in Neuchâtel: Operative gynaecology, Labour ward, Polyclinic (essentially a general O&G clinic) and Emergencies. Emergencies was a bit hit and miss with patient numbers and types of cases so I didn’t spend much time there. Polyclinic was super for basic examinations (women are encouraged to have an annual check-up with a gynaecologist and this, along with cervical smears was the main theme of the polyclinic) and I did it for a fortnight. Labour ward was difficult as it was overrun with midwifery students who get extreme priority on births, I ended up doing a weekend which was much better. However, there were plenty of opportunities to read CTGs, see patients who had come in for late pregnancy consultations (including doing ultrasounds), and to scrub for caesarean sections. Operative Gynaecology was great – plenty of opportunities to scrub and see a wide variety of gynaecological operations.
The day starts at 7h30 with either a CTG meeting (if on labour ward) or a ward round (gynaecology), before a team handover at 8h00. Activities other than those listed above included time with the trainees in the simulation suite, weekly teaching and – most importantly – team coffee and lunch breaks. In quite the contrast with the NHS, Swiss doctors take lunch very importantly and it tended to be a team affair in the canteen (where the food was superb and varied: menus included rabbit, horse, octopus and raclette). I spent my days with the médecins assistants (SHOs) who were all friendly and welcoming and are very well supported by the chefs de clinique (senior registrars), who were also nice. The Swiss system is not like the NHS: everybody had plenty of time to teach and I was able to learn a lot.
I turned up with a load of clinical clothes that I would normally wear in the UK: I needn’t have bothered because all medical students and doctors wear a uniform, usually with trainers: white polo shirt, white trouser and a white coat (with gloriously large pockets) which can be replaced as frequently as one likes from a Wallace and Gromit style machine in the basement of the hospital, which whirls around a massive rack of uniforms until it finds the item requested and deposits it into a small opening. Scrubs and theatre shoes are provided in theatres. Consultants wear jeans under white coats!
Description of destination: Neuchâtel is a small university town of approx. 34 000 on the beautiful Lake Neuchâtel. It is very picturesque and, on most days, you can see the Alps just beyond the lake. It is well connected by rail to the rest of Switzerland.
Were the locals friendly? Absolutely!
Did you feel safe and if not why not? Yes, I always felt very safe.
What did you do in your spare time? Fortunately there were medical students from Geneva and Lausanne also on placement in Neuchâtel: I was included in their WhatsApp group and they would organise things to do in the evenings about twice a week but also share information about teaching and organise to eat lunch together in the canteen. The medical students tend to go home for the weekend and I usually spent my weekends visiting other towns, which was very easy by train. I imagine the lake would be lovely in the summer (I was there February-March). Everybody seems to go skiing or snowshoeing at the weekend in the winter.
Is there anything that you would particularly recommend others to do? Students can take up to two days per month as holiday and I would recommend making the most of being in Switzerland by getting the train all over the country, eating Swiss food and making the most of the outdoors.
What was the climate like? Freezing.
What was your accommodation like? I stayed in hospital accommodation which was a 2 minute walk from the hospital and of a very high standard. Unfortunately, no kitchen utensils were provided.
Was it provided? The accommodation belongs to and is managed by the hospital but I had to find out about and organise it myself. When I asked the placement co-ordinator at the university, she sent me a document of all the accommodation available at all the hospitals they send students to.
How much did it cost? It was 200CHF/month for the room, which was in a modern three- bedroomed flat with a small kitchen and a bathroom. Extra nights (e.g. I arrived two days before the placement to sort out paperwork) are charged at 40CHF/night and the cost of hiring linen is 20CHF/month. It costs about 1.20CHF to do a wash in the communal washing machine.
Did you enjoy your visit? Yes.
Did you find it useful medically? Yes. It was a very different experience to being a student in the UK: no bedside teaching and I hardly saw the consultants outside of handover and in theatre. However, I had many more opportunities that I did during my placement in the UK to perform obstetric and gynaecological examinations which was very useful. I learned some obstetrical ultrasound skills and I felt I was treated like a member of the team: it was a leap from most of my previous experiences as a student. This attachment was extremely useful and relevant to my future career plans.
Has it improved your French? Yes, although I did struggle, even after two months, on the ‘phone and in theatres where everybody mouths are covered and everything has a French name! I found that the Swiss speak slowly and clearly, which was a delight.
How has it increased your knowledge of French culture? I tasted lots of Swiss chocolate, fondue and wine. I have also learned how to make Swiss bread. I also chatted with my colleagues about their medical school experiences (among other things) and travelled all over Switzerland at the weekends.
If you went back would you do anything differently? Bring my skis.
How did you get there? I took a train from London via Paris.
What was the approximate total cost? Train from London £130 + Accommodation £415 + Living Costs and Entertainment £450 + Hospital Lunches (unnecessary, but a great luxury) £270 + Weekend train journeys £160 = £1425
I am very grateful for the assistance of the Miss Ford Bursary, which enabled me to visit lots of different places in Switzerland during my placement.
Is there any other information that you think may be useful? Doctors work hard in Switzerland but their working conditions are excellent. The system is organised differently to the UK system. It is compulsory (by law) to have health insurance in Switzerland, but some things are not covered by most basic policies (for example, IVF and contraception). Patients can directly access specialists (who often work from an office in the town, not in the hospital) and I found the doctors and midwives to be slightly less evidence and guideline driven than in the UK, but they offer a very comprehensive, holistic service to patients (e.g. acupuncture and aromatherapy performed by midwives during labour). Waiting times for appointments and operations are very short.
It is possible to enrol with either the University of Geneva or of Lausanne but the former allows two month placements, the latter has a minimum of three months. It seemed as though the placement co-ordinator expected me to know how Swiss placements work (I didn’t and it’s very different to the UK, she was very kind and responsive to emails): basically you list some placements (search for “Catalogue de la Suisse romande et du Tessin des programmes pour l’année de stages” online for the full list of placement available) that you would like to do (I got my first choice), you are sent four copies of a contract which you sign and return, you then receive two completed copies of that same contract- one to keep and one you must forward (by post!) to the Human Resources department of the hospital who sort out your badge and stuff (and henceforth you deal exclusively with the hospital’s HR department: not the University) . It all happens quite far in advance: dates and deadlines are advertised on the universities’ websites. Swiss medical students are paid a stipend by the hospital (which was a welcome surprise when I arrived) which covered my rent and some living costs. I found the administration to be bearable and efficient.
Do not forgot your student card – there are student discounts at cinemas and museums. Monday is the “cheap” night at the cinema (but it still isn’t quite “cheap”!). It is possible to get cheap train tickets if you book online and in advance for a specific train, look up “supersaver” tickets on sbb.ch. Museums often have one day per month when they are free for all to access so it is worth looking on their websites and planning ahead. CERN (book tour ahead of time on website) and the UN’s Palais des Nations are both worth visiting if you go to Geneva.
Reporter: Emily Orr (5th year King’s College London) Emily.firstname.lastname@example.org
Contact at Destination: Roland Strasser
Year of Visit: 2011
Institution: Hopitaux Univeistaires Geneve
Department: Obstetrics and Gynaecology
Work/ Study undertaken: The placement was very well organized. I was given a timetable on my arrival which was varied and let me get experience in clinics, theatres, urgences and the birth centre. As I did my placement in August there were only 2 other students in my department so I was given a lot of time by the doctors. Most days I was attached to an ‘interne’ who is the young doctor in training for the specialty and I helped with their duties. In clinics I was often allowed to take the history and perform the ultrasounds myself and because of the nature of the private healthcare in Switzerland it seemed almost every patient who came to the gynae clinic got an ultrasound so I got really good at that. In theatres, they rely on having a student there to assist so I got to scrub in and help out a lot.
I found the doctors all very welcoming and patient with me as sometimes I struggled with my French. Most doctors speak good English so it was never a problem if I didn’t understand something, although I would say it is important to be able to speak quite well in order to take part in clinics etc..
As Geneva is quite an international city there is a very varied population. It was normal for the languages used in consultations to swap between French, English, Italian, Spanish and Portuguese.
My days normally started at 8am with a meeting for all the department, I normally had 1-2 hours for lunch in the amazing roof top terrace with views over the lake and then afternoon sessions ran until about 5pm.
Overall I was impressed by the organization of my stage. The doctors were friendly and used to teaching.
Description of Destination: Geneva. A small city but breathtakingly beautiful city. The city wraps around Lac Leman with the famous fountain spurting out in the middle and in the background are the Swiss Mountains. The city is home to large international companies and is therefore full of smart hotels, shops and restaurants. However you can still find small quirky areas and old cobbled streets in the old town. It is very clean with lots of parks and open spaces to enjoy. All the public places have wireless connection so you can sit in a park overlooking the lake and be on your laptop working. There is an efficient tram system and plentiful bikes around the city to hire. Buses and trains are easy to get to surrounding hills and countryside.
Were locals friendly? Yes, I thought so. I was told before I left that Swiss people are quite boring and unfriendly but I certainly did not find this. You will meet people from all over the world in Geneva though as it is home to many international organizations.
Was it safe? I felt very safe. The public transport stopped quite early 12:00-1:00am so it is necessary to make sure you know how you are going to et home. Taxi’s are extremely expensive
What did you do in your spare time? Fete de Geneve (1st 2 weeks of August) lots of free concerts, theatre, food stalls by the lake, finished off with an incredible fireworks display. Walking in mountains Chamonix, Gruyere, trip to Zurich and Bern, Swimming in lake, cycle ride through vineyards, visits to CERN, United nations, clock museum, red cross museum, enjoying good ice creams, wondering around the old city and just enjoying the weather in one of the many parks.
Time of year and climate? August. I had lovely weather, it was sunny and dry for most of the month. I had heard from students staying in July that it had rained a lot so I may have been lucky. Being close to the mountains the weather is less predictable than being further south.
Accommodation? I stayed in a n apartment in Carouge the old Italian district 15 mis walk to the hospital. My room was a room vacated by one of the local medical students who was away during the summer. This was organized for me through SWIMSA exchanges the Swiss medical student exchange programme. I was lucky as accommodation in Geneva is not easy to find and is extremely expensive.
How did I get there? Bristol to Geneva Easy Jet
Medically useful? For hands on experience it was very good, as I was allowed to scrub in a lot in theatre and use the ultrasound machines. The cases I saw are similar to UK. History taking and management of patients depended on which doctor was supervising me as some were more helpful than others and also would depend on language barrier.
French Improved? Enormously. First few days I could not follow the meetings or simple conversations by the end I could keep up and even take my own consultations. Useful to have a French/medical dictionary to hand as many of the medical terms are actually different. I had only done A-level French and one course at Uni before I arrived. It was tough but if you are willing to make and effort you can get by and improve a lot!
Overall Cost? Flights =£100, Accommodation = £500 Food and leisure = £250
Contact at destination
Year of visit: 2001
Institution: Hopital de la Tour
Department: Accident and Emergency
Work / Study undertaken: A&E Medicine, And SOS Medecin
Description of destination
Geneva is certainly a beautiful city. Apart from the aesthetic aspects and the ‘internationality’ of the city, its very easy to get around with its wonderfully efficient bus service – I don’t think I waited more than 3 minutes for a bus!
Were the local people friendly?
Extremely. They were more than happy to help out when you’r completely and utterly lost!
Did you feel safe and if not why not?
Yes, I very safe city.
What did you do in your spare time ?
My spare time consisted mainly of the weekday evenings, and the weekends. Switzerland is served by a very efficient transport net and hence most of the country could be experienced in the 7 weekends I was there. As for the evenings after work, reading in the park overlooking the famous fountain was most relaxing indeed.
Is there anything that you would particularly recommend others to do?
Go for a run by the lake and try and keep up with the rowing boats! And of course do plenty of sightseeing – Geneve is right in the heart of Europe and serves as an excellent base. On the medico-cultural side of things, SOS Medecin is great way to see how the Genevois live.
What was the climate like?
Quite variable during March and April, but much more sunny weather than in England!
What was your accommodation like?
Quite good, perhaps as I was living with a friend.
Was it provided?
If not who arranged it?
I was living with a friend there.
How much did it cost?
Did you enjoy your visit?
Very much indeed.
Did you find it useful medically?
I certainly did learn a lot of A&E. This is something I hadn’t yet been exposed to back home. I managed to see a wide range of conditions from the trivial ‘I’ve cut myself shaving’ to the univerally common MI, to the rare abdominal pain which turns out to be Behcet’s syndrome.
Has it improved your french?
This certainly was the case. I even learnt that the Swiss had a few variations on the language – noinante for ninety.
How has it increased your knowledge of French culture?
Working in a French environment and socialising in this group really did give a new slant on the culture. SOS Medecin was a great way to see how people lived – from the CHF 45million estate to the not so rich appartments, to the farmhouses on the city’s outskirts.
If you went back would you do anything differently?
No regrets whatsoever!
How did you get there?
By air – many airlines get you there – Swiss air and Easy Jet are some of them
What was the approximate total cost?
Is there any other information that you think may be useful?
If you’re a student, make sure to take an ISIC card – everything is much cheaper – a swim at the local pool was only CHF 2.