Canada 2018


AFMS Elective Report

Reporter: Alyss Robinson

Year of visit: August 2018

Country: Canada

Region: Montreal,Quebec

Institution:McGill University Health Centre (Montreal General Hospital and Montreal Children’s Hospital)

Contact at institution: Mary Cecere (electives.med@mcgill.ca)and Frank Rizzo (surgerycoord.med@mcgill.ca)

Department: Plastic Surgery

Work/ study undertaken:

This was a clinical placement in the Montreal General Hospital Plastic Surgery department.

Description of service and department:

Plastic Surgery is a specialty interested in restoring normal form and function. It covers a wide range of tissues and areas, often including cases combined with other specialties. MGH is a trauma centre, so many of the acute cases would involve facial trauma, complex lacerations, degloving injuries and hand fractures. Common techniques used involve skin grafting, tissue flaps, different styles of fracture fixation, nerve repair, tendon repair, and microsurgery. As a medical student, I joined the residents in the service to help them cover the operating theatre, clinics and inpatients. There would usually be two or three days operating per week (this was sometimes only one due to a quieter summer schedule), and five clinics per week. I was able to see my own patients in the clinic, and come up with plans to present to the other residents and attendings. There would sometimes be some minor procedures to do during the clinics too. In theatre, it was mostly observational with some opportunity to scrub in and assist, and help suture.

Description of the destination:

Montreal is a friendly, fun and dynamic city. It is situated in Quebec, on an island on the St Laurent river. As the second biggest city in Canada, there is always a lot going on. Throughout the summer there are different festivals almost every day. From the outset, it is French-speaking. However, many will speak English as a second language. Montreal has a number of different neighbourhoods, and the MGH is situated downtown at the foot of Mont Royal (the large hill/mountain with park in the middle of the city), so many neighbourhoods make for an easy commute.

There are a number of cycle routes in excellent condition, there is also a bus and metro system serving most of the city. The main tourist centre is in Vieux-Montreal and the Old Port. Other exciting areas include the Quatier Latin, Village Gai, Le Plateau and Mile End.

Were the local people friendly?

The local people were incredibly friendly, and always interested in me and why I was in Montreal. There are loads of students in Montreal because there are quite a few major universities there (McGill, Concordia, UQAM, UDM etc.) so it has a nice vibe and good nightlife.

Did you feel safe and if not why not?

It’s an incredibly safe city. I cycled pretty much everywhere, as there are excellent cycle paths throughout the city. The drivers are very mindful of cyclists. However, I didn’t go out alone at night very often so I would not know about how safe it is in the evenings.

What did you do in your spare time?

I had some studying to do so I went and frequented some of Montreal’s many cafes. The weather was incredible, so on the weekends I would see a lot of the city. I visited the Mont Royal park and viewpoint, le Vieux Port, Vieux Montreal, Park Jean Drapeau, Little Italy, Marche Jean Talon, Marche Atwater, Mile End, Le Plateau and cycled up and down Canal Lachine multiple times. I visited some of the museums: La Musee des Beaux-Arts and the Canadian Centre for Architecture.

I went on a weekend trip to Quebec City, which is a must. You can take the Orleans coaches which are reasonable, comfortable, have wifi and take about 3.5 hours.

After the elective I travelled to Ottawa, Toronto, Boston and New England which are all within easy reach. There is a 7-hour overnight bus from Montreal to Boston. You could also consider New York too, there is a direct train and bus.

Is there anything you would particularly recommend others to do?

Get a bike and cycle along the canal. I really enjoyed chilling on Plage D’Horloge (Clocktower beach) at the old port with my book (it only costs $2). Go to one of the festivals if you are there in the summer, such as Osheaga, Ile Sonic or the Jazz Fest.

Every Sunday there are live performers at the foot of Mont Royal, which you can sit and watch for free (Tam Tams). Poutine must be tried (the most famous is at La Banquise in Le Plateau). There are also some exceptional bagels (Fairmont and St Viatur), and Schwartz’s Smoked Meat Deli on Boul. St Laurent is famous for their smoked meat sandwiches. There is some incredible fresh produce in Quebec, which you can buy from either Marche Jean Talon or Marche Atwater.

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

I went in August. Montreal was having a particularly hot and humid summer, with temperatures sat around 30 but with humidity making it feel a lot stuffier. On a fresh day, it was beautiful. Winters are known to be incredibly cold, but with that comes the benefit of snow with cross-country skiing available in Mont Royal park and ice skating around the city.

What was your accommodation like?

I rented an Airbnb for the month in a neighbourhood called Saint-Henri. It was an excellent location, just off the main road Notre-Dame which was full of nice bars and restaurants. The host was francophone only which was useful for practicing French. I had a huge room with loads of storage and a big comfy bed. Use of kitchen and washing facilities was all included, and my host also gave me a bicycle to use!

Was it provided?

McGill does not provide accommodation for visiting students, nor will they help you find accommodation.

 How much did it cost?

Accommodation 28 nights – £380 ($20 per night)

 Did you enjoy your visit?

I loved the time I spent in Montreal, it’s a great city and I would definitely consider living there in the future. It is a lot more French than I thought it would be which is great because it meant I improved even more than I expected.

Did you find it useful medically? In what way?

I learned a huge amount about a specialty that medical students are rarely exposed to. Spending time in clinics meant I learnt about the indications for surgery and the clinical presentation of hand injuries especially. I learned how to check wounds, grafts and flaps and how to dress wounds. I also now know how to splint injuries. I was able to practice suturing too. It was really important for me to gain experience and show interest in Plastic Surgery because it is a competitive specialty requiring early exposure and planning.

Has it improved your French?

Massively so, and more so than I thought it would. Full emersion is key; with my Airbnb host and at the hospital by throwing myself into clinics with francophone patients meant my French vastly improved. It has also inspired me to continue practicing!

 Has it increased your knowledge of French culture?

The culture in Quebec is a little different to France, but I certainly appreciate a lot more about the history, cuisine and linguistic differences.

 How did you get there? What was the approximate total cost?

Flights ~£370 (bought with airmiles)

Accommodation 28 nights – £380 ($20 per night)

AFMC Portal fees – £320 ($575)

McGill fees – £264 ($475)

Vaccinations and blood tests – £350

Registration with college de medecins du Quebec (CMQ) – £71.70 ($120)

Visa Medical – £330

eTa – £4.50

Spending money – £350 (approx. £87.50 per week, but I am lavish)

Total : £2,420 ish

 Is there any other information you think may be useful?

In order to apply for electives with McGill University Hospitals, you need to apply via the AFMC Portal (https://www.afmcstudentportal.ca/). This portal serves all of the university hospitals in Canada. This is a rather expensive and lengthy process. The portal registration is £320, without guarantee of an elective placement. Then you need to pay for the university you apply to and any associated administration costs. You are required to complete a long immunisation record form in order to apply for the elective, which for me included needing to have some extra blood tests and vaccinations (I received a whooping cough vaccine, needed a varicella serology and a Quantiferon assay for tuberculosis which all came to £350).

In addition to this you need a medical for Visa purposes, which costs £330 regardless of where you get it from (you need to go with a certified Canadian Visa medical clinic), however you can wait to do this until right before the trip.

Applications open 7 months before the start date and close 5 months before. You need your immunisation form ready before this. The rest of the application is relatively straightforward.