La Reunion


Report 1

Reporter: Arunkumar Krishnakumar
Contact at destination: Emilie Maillot, Mme Brigitte RAMAYE-ELLAMA (medical student secretaries, email: etudiants-medecine@chu-reunion.fr, phone: 02 62 90 58 97).
Year of visit: 2015 (June-August)
Country: Reunion Island (France)
Region: St. Pierre
Institution: CHU Sud Reunion
Department: General Surgery (4 weeks) + Paediatrics (4 weeks)

Work / Study undertaken:
I started with a 4 weeks placement in General Surgery. I spent most of my time on the morning ward round and assisting in theatre. The surgeons and trainees are keen to get students involved in theatre. There were 4 other German medical students on placement with me during that time.
Then, I undertook a 4-week placement in the Paediatric department. I spent most of my time on the Paediatric Emergencies unit where I was clerking patients. I quickly got used to the system and the staff was really friendly and welcoming. I was also able to carry out an audit during this placement as the emergency department has all the notes on computers and it was easy to access the data I needed.

Description of the service and department:
CHU Sud Reunion is a University teaching hospital with over 900 beds across 5 sites in the south-western side of the island. The hospital had all major departments including A+E, surgical departments and maternity units. The General Surgery ward had about 20 beds with Vascular surgery and Urology departments next door with 20 beds each. There were 15 operating theatres in the hospital of which 2 were assigned for general surgery.
The paediatric department was split into 4 units. There were the Paediatric emergency unit, the paediatric day unit, the yound children’s unit and older children’s unit. As it was school holidays during my placement, the department was not as busy as it usually is, but I was still able to see many patients.

Description of destination:
La Reunion is a great destination both to improve your medical French and learn about French culture in an overseas department. It is also a volcanic island so there are many opportunities to get involved in outdoor activities. Road safety and other regulations are of EU standards so it is a pretty safe place to be.

Were the local people friendly?
Locals were extremely friendly and would get out of their way to help out.

Did you feel safe and if not why not?
I felt really safe on the island. Only downside is that it was night by 6pm, so better hire a car if you want to go out after the sun is gone.

What did you do in your spare time?
In my spare time I attended many musical events. There are always free or cheap concerts around the island. La Reunion is a lively place and people love their music! I enjoyed discovering “La Maloya”, the locals’ music. In the evenings, I went swimming in the lagoon or walking along the coast. On weekends I went hiking in the stunning Mafate Cirque.

Is there anything that you would particularly recommend others to do?
In hospital, show enthusiasm and people will be willing to get you involved and teach you! They usually have a lot of time for you. Get a cheap bus pass (20 euros for 3 months for students). Try to hire a car with friends on weekends, you’ll get to do more. Go to “Rondavelles” in St-Leu on Sunday evenings from 6pm onwards for some great live music with the beautiful St-Leu beach and the Indian Ocean in the background.

What time of the year were you there?
I was there from June to August, which is Austral Winter in La Reunion

What was the climate like?
Austral Winter is still quite warm with temperature around 22 degrees at sea level. The weather was quite unpredictable as we had heavy rains, lots of sun and even below 0 temperatures! As it’s a volcanic island, it’s easy to get to high altitudes from the sea quite quickly! So choose carefully when you choose your accommodation, the higher inland you go, the colder it gets.

Where did you stay?
I stayed in a house with the landlord living in one of the 3 rooms. I found the room on leboncoin.fr, most people seem to advertise on that website. Make sure you don’t sign a contract until you have read it fully and discussed the terms with the landlord.

What was your accommodation like?
I shared a house with a school teacher (the landlord) and a german medical student who was also on placement. My accommodation was in the Terre Sainte area, which is great as it is only a 10 min walk from the hospital. Many other students and trainees who worked in the hospital also stayed in that area. Alternatively, I would try and live in St Pierre city centre.

Was it provided?
No, I had to arrange the accommodation myself

How much did it cost?
£300 per month for accomodation

Did you enjoy your visit?
Loved my visit to La Reunion!

Did you find it useful medically?
Definetely! I got a lot out of this placement but that might have been because I am fluent in French. I was also able to dramatically improve my medical French as I was clerking patients.

Has it improved your French?
I definitely improved my medical French

How has it increased your knowledge of French culture?
Yes, as I was not aware of the French culture in the overseas departments.

If you went back would you do anything differently?
Not really

How did you get there?
Flight

What was the approximate total cost?
£2300 total cost for 8 week placement and 1 week holiday
£800 for return flights
£600 for placement accommodation
£600 for food (food is quite expensive in supermarkets)
£300 for a week holiday including car hire, youth hostel ect.

Report 2

Reporter: John McCullough
Contact at destination: Dr. Bernard-A. Gaüzère (Head of medical education)
Emilie Maillot (Medical student secretary).
Year of visit: 2014 (June-August)
Country: Reunion Island (France)
Region: St. Denis
Institution: CHU Felix Guyon
Department: Radiology (4 weeks) + Neurology (4 weeks)

Work / Study undertaken:

For the first 4-weeks I was attached to Neurology department which consisted of 2 wards; stroke + general neurology. When I first arrived I was the only medical student so got free reign; mainly doing histories, examinations and healthcare assistant type work. Medical students in France are expected to get much more involved with day-to-day work on the ward than in the UK – following up bloods, taking patients to other departments + answering phones etc. All good French practice, if not a bit gruelling at times!

During the second half of my placement I worked in the radiology department. It was really ‘hands on’ and a definite highlight was scrubbing in for interventional procedures. I got lots of practice performing ultrasounds and interpreting X-ray, CT, MRIs under consultant supervision. I also attended teaching sessions with junior doctors and spent time with the radiology registrars, who were always happy to explain things in nice slow French!

Throughout the placement I was fairly ‘free’ to come and go as I pleased. This meant that I could have a three-day weekend if I wanted to, or leave early if the ward was slow in the afternoon.

Description of the service and department:

CHU Felix Guyon turned out to be much bigger than I expected for such a ‘small island’. It’s a 600 bed tertiary centre, comparable to any large university teaching hospital in the UK. There’s another hospital on the south side of the island at St. Pierre (where there are also elective opportunities), but its not as big.

All the staff I encountered were welcoming and there’s a great community of interns and externs who take an hour or so every day for a big, free lunch out on the terrace.

Description of destination:

Reunion is a beautiful volcanic island, due east of Madagascar. It has about 800,000 inhabitants who mainly live in picturesque towns dotted around the coast. Inland there are few roads + its mostly unspoilt forests and mountains. There are 3 great ‘cirques’ – valley basins surrounded by substantial mountains on all sides (up to 3,000m) and there’s an active volcano (which erupted during my first week!).

Although the island was uninhabited until about 300 years ago, Réunionese cultural is famously diverse. Its people originate from Madagascar, mainland Africa, India, the Caribbean and France. However, as a DOM Reunion has much in common with mainland France; they use euros, have French shops, state funded hospitals and a university and most importantly the boulangerie is excellent.

Were the local people friendly?

Yes. For example, my taxi driver invited me on a family picnic with her children + elderly relatives.

Did you feel safe and if not why not?

Yes.

What did you do in your spare time?

I was fortunate that all my flatmates had cars and were keen to get out and explore at weekends.
There was lots to see (local towns, beaches, attractions etc.), but it would have been much more difficult on public transport. I did a lot of walking in the interior of the island – well marked paths, incredible views and waterfalls for when you fancy a swim.

The beaches are great, but you can only swim in certain places because of tiger sharks (people get attacked every year). However it is possible to go diving, sailing, surfing etc. Going whale watching was a highlight + so was paragliding along the coast.
Is there anything that you would particularly recommend others to do?

Top three recommendations;
-The volcano (you can walk right up to the main crater).
-Cannoning at Takamaka
-Climbing the Piton des Neiges (Reunion’s highest peak) over 2 days. You can stay at a mountain gite just below the summit, then walk up the next morning to watch the sunrise. The view of the entire island + Indian Ocean is incredible!

What time of the year were you there?

June – August (which is the Austral winter)
8 weeks of elective placement + 1 week holiday.

What was the climate like?

Extremely variable. Around the coast it was warm – 25’ most days, normally dry with the occasional massive storm. Once you go inland and start to get up in to the mountains it’s a lot colder – you can even get snow. I hear it gets a lot hotter in the summer (Dec – Feb).

Where did you stay?

I hadn’t arranged anywhere to stay in advance, so checked into a youth hostel for the first 10 days. This wasn’t cheap (30 euros/night) or nice and there were no other guests!

Having made friends with the junior doctors on my ward they offered to put me up in their spare room. I ended up in a house-share with 4 French medics around my age. They were a great crowd + was very lucky to fall in with them. I paid around 300 euros/month in rent.

What was your accommodation like?

Excellent – we had a large house overlooking the sea. Fully equipped kitchen, bathrooms, 5 bedrooms, garden and swimming pool. The only downside was proximity to the centre of town – it would have taken an hour to walk there. However, all my flatmates had cars and there was a very cheap + regular bus.

Was it provided?

No. There is no hospital accommodation and the university in St. Denis didn’t seem to let out rooms in student halls either.

How much did it cost?

In total – about £2500 (including a ‘holiday week).

Basic costs:
Return flights – £800
Accommodation (youth hostel + private rent) – £700
Travel insurance – £20
Local unlimited bus pass (3 months) – £20
Local PAYG phone + credit – £50
Food – Supermarkets quite expensive by UK standards.

Holiday costs:
Car hire – £20/day
Bus journey around the island – £10
Bed and board in a mountain refuge – £50/night
Day’s cannoning – £80
Paragliding – £80

Did you enjoy your visit?

Absolutely.

Did you find it useful medically?

Partly. I would definitely have learnt more medicine on an English-speaking elective. It was a bit frustrating not being able to understand everything on the ward-round and at times it was demoralising. Having said that, the doctors and medical students were very patient with me and always explained things slowly if they had time.

Has it improved your French?

Definitely. I was completely immersed in French speaking – at home, at work and in my free time. There were no other English speakers, so I had to get on with it. I feel much more confident holding a conversation now, even through my written French + grammar is still fairy poor.

How has it increased your knowledge of French culture?

Yes.

If you went back would you do anything differently?

Sort accommodation out in advance if possible.

How did you get there?

Flight (London Heathrow – Paris CDG – Reunion). Returned via Mauritius.

What was the approximate total cost?

£2500

Report 3

Reporter: Samantha Harrison – King’s College London

Contact at destination: Emilie Maillot – Undergraduate Student Coordinator (email: etudiants-medecine.fguyon@chu-reunion.fr)

Year of visit: 2014

Country: La Reunion (France)

Region: St Denis, Reunion Island

Institution: CHR Felix Guyon

Department: Urgences

Work / Study undertaken
Time seeing patients in A&E

Time with SMUR and SAMU (ambulance services)

Observing the 999 phone calls from SAMU

Emergency orthopod and trauma list

Time in Service Porte – our equivalent of RATU/MDU

Night shift opportunities

Resus

Description of the service and department

Fairly large A&E department in the capitol of the island with lots of opportunities to get involved.

Description of the destination

Beautiful French island in the middle of the Indian ocean, near Mauritius. Lots of beaches as well as mountain scenery in the middle of the island. Lots of outdoor activities!

Were the local people friendly?

Yes, everywhere, and so excited to see an English person!

Did you feel safe and if not why not?

Yes 100%. Although there is a drinking problem so don’t go out alone very late at night.

What did you do in your spare time ?

Visited the volcano

Rum museum

Paragliding over the beautiful beaches of Saint Leu

Markets at St Paul

Mountain drives – salazie

Beaches

Swimming in the waterfalls at les trois bassins

Is there anything that you would particularly recommend others to do?

Try and do canyoning. We didn’t have time. Always try to rent to car for one week to do all the big things

What time of the year were you there? What was the climate like?

July/August – winter there but still 28-30 degrees most days

What was your accommodation like?

One bedroom flat with a balcony, all the equipment we needed. 45 minute walk to the hospital

Was it provided?

No

If not who arranged it?

Private – online – homeaway.com

How much did it cost?

$800 for one month

Did you enjoy your visit?

Yes!!!!

Did you find it useful medically? If so, in what way?

I was made to feel very welcome in urgencies and I was allowed to see patients on my own and then later with the doctor, it was great hands on practice. I also learnt how to do casts and was allowed to write up in the notes with supervision!

Has it improved your French?

Definitely, especially medical acronyms!!

How has it increased your knowledge of French culture?

Yes it was really interesting to see how the colony of reunion had developed and learn of the French history of the island as well as the current French tourism there

If you went back would you do anything differently?

Be more confident early on. Everybody is so lovely that if you make mistakes nobody minds, everyone just wants you to take part.

Is there any other information that you think may be useful?

GO TO REUNION!!!

 

Report 4

Reporter: Pamela Mazoyer

Contact at destination: Accident and Emergency; Dr Arnaud Bourdé

Paediatrics; Dr Siguarly and Dr Houdon

Year of visit: 2010

Country: La Réunion, DOM France

Institution: Centre Hospitalier Régional St Denis

Centre Hospitalier Régional St Pierre

Aide aux Jeunes Diabétiques (AJD)

 

Departments Accident and Emergency (4 weeks), Paediatrics (4 weeks)

Work/study undertaken

In the emergency department it was very hands on. I clerked in patients; took histories and examined patient then I would write up my findings on the electronic patient records (tricky to get used to!!). I would then present the case to the doctor on shift and once decided upon, would undertake investigations and instigate the management plan. I got experience of suturing, plastering, blood taking etc. I was also allowed to be a part of the SMUR team or rapid response team with a doctor, nurse and intern on board.

 

I spent one week on the paediatric ward in the south of the Island before I was recruited through a paediatrician on the ward and the association AJD to be part of a medical team to go into the mountains (Cilaos) for a 3-week holiday camp for thirty, 8-16 year old diabetic children. We were given some training before hand. At the camp I would help, along with another medical student, the doctor adjust the doses of insulin for the children and would accompany groups on activities e.g. mountain biking, canyoning, hiking. We would also take part in education sessions for the children to teach them how to better control their diabetes and still lead an active and healthy life.

 

Description of the service and department

The emergency department was extremely friendly. They were very helpful and willing to spend time showing me the ropes, explaining medical cases, demonstrating skills and allowing me to get hands on and practice new skills. We were given a very flexible timetable with days off but also had very productive and interesting days in the department.

 

My paediatric experience was brilliant. I learnt so much about diabetes type I; adjusting doses, how to treat hypoglycaemia and hyperglycaemia in remote areas. I learnt how to work effectively as part of a medical team in a non-hospital setting, how to prepare a medical bag for activities and work together with the children to make it easier for them to live with diabetes…all in beautiful surroundings and with lots of laughter.

Description of destination

La Réunion is a beautiful and diverse Island. It has a population of 800 000 on a land mass of 80km by 45km. The coastal towns are populated with colourful markets on all the time and a great selection of fruits! The west of the Island is where the majority of the French ‘metropolitan’ settle due to the hot sunny weather all year around and the white beaches and lagoons. The south is where the most dynamic town is, St Pierre. It is also known as the ‘sud-sauvage’ as there is a deserted stretch of coast where no-one lives and nothing grows due to the regular lava flows from the active volcano to the south east of the Island. Amazing to go and visit. The east is where it rains the most and is therefore green and lush, with fresh water basins and magnificent waterfalls. At the centre of the Island there are 3 spectacular mountain ranges called ‘cirque’ formed by the volcano many thousand of years ago, the highest point being at 3070m. These ‘cirque’ are accessible and lend to some brilliant adventures.

 

Were the local people friendly?

Very, the population is a diverse mixture of Africans, Indians, Arabians, Madagascans and French that live harmoniously together.

 

Did you feel safe and if not why not?

Yes, just like any French region, though I avoided walking alone at night as I would in all towns/cities.

 

What did you do in your spare time?

I went hiking, cycling, canyoning, climbing, diving, snorkelling, whale watching, socialising with friends, swimming, sunbathing, visiting volcano, helicopter ride, music festival, swimming, cinema, eating out, visiting sugar cane factory, drinking rum, going to the markets, visiting temples… lots and lots was never bored!

 

Is there anything you would particularly recommend others to do?

Go walking into the three cirque and stay in ‘gites’ and taste rum!!

What time of year were you there, what was the climate like?

June to August, it was their winter. In the north it was on average 26degrees every day in June and beginning of July. The south was windier and rained more towards the end of July. In the mountains it was cold at night but perfect climate for activities during day. Sunny and warm days towards the end of August, the majority of time the west is hot. Water about 26 deg in lagoons.

 

What was your accommodation like?

First month I organised my own private accommodation from the internet site www.iledelareunion.com.

I rented private studio in the south for second placement (through friends) but then stayed in the holiday camp for 3 weeks in Cilaos.

For the last 3 weeks after my placements I stayed with friends, whilst visiting the Island.

 

Was it provided?

First placement, no but it was provided by AJD for the 3 week diabetic holiday camp in Cilaos.

 

If not who arranged it?

I did. Visit www.iledelareunion.com.

 

How much did it cost?

300 euros, 100 euro deposit, no internet but bills included at St Denis

Studio in south was 300 euro, no deposit, internet and bills included.

 

Did you enjoy your visit?

Yes one of the best experiences of my life.

 

Did you find the visit useful medically? In what way?

Yes, I learnt lots in AnE; new skills such as suturing, plastering and then generic history taking and examination but in FRENCH!!

Became pretty clued up on diabetes type I after 3 intense weeks.

 

Has it improved your French?

Yes, no-one out there speaks in English and there are virtually no English tourists. I spoke French only for 3 months.

 

Has it increased your knowledge of french culture?

Yes, a different side, the ‘outre-mer’ side. I even learnt a bit of dialect, creole!

 

If you went back would you do anything differently?

Go for longer, move to live there.

Maybe hire a car, public transport not always that great.

 

How did you get there?

Flew with Air Mauritius, approx: £850

London-Mauritius-Reunion

Reunion-Mauritius-Paris-London

 

What was the approximate total cost?

I spent about £3500 in total, expensive place but took professional loan out as did not want to miss out on anything!

 

Is there any other information that you think may be useful?

Go to Tourist Info when you get there to get bus times, info about activities, evening music/theatre shows, how to book ‘gites’, maps etc…

 

Feel free to email me on: pamazoyer@hotmail.com for more info!