When I started planning my elective I thought it would be a good opportunity to explore the surgical specialities, so that was very much the guiding factor when picking the departments.
Beyond the speciality, I wanted to spend some time in Addenbrooke’s before travelling abroad as I thought this would be optimal for learning opportunities and hands-on work in preparation for my time in Israel. Utilising the teaching opportunities to develop my skillset for the upcoming practical aspect of the placements. My time in Israel was then geared towards gaining experience outside of the NHS, and on a personal level exploring whether moving back to train in my home country would be a possibility for me.
My time in Addenbrooke’s was spent with the critical care team. I went into the placement
having little expectations, being very open minded in terms of what my agenda is. I just
hoped the time spent with the team would be beneficial for my learning and my upcoming
time in Israel. In practice, every morning I would attend the handover and then shadow one of the junior doctors on the team, who would take me with them on the ward round and then to complete their jobs. We would have designated teaching after lunch, which was included both theory as well as specialised practical skills utilised in critical care e.g. taking blood under US guidance, learning about the mechanics of ventilators, types of feeding etc. We would then join the afternoon ward round, finish the jobs for the day, and finally handover to the on-call team. My fortnight spent at the hospital was even more engaging and hands-on as I had hoped. I found it incredibly useful to have one-on-one time with the junior members of the team to learn and gain confidence. It far exceeded my expectations. A memorable part of my elective there was receiving training on the US machine and being trusted to take bloods and cultures in this way, which is necessary for patients who are unwell and difficult to cannulate. It was also great to have consistency with the same team, I think this was crucial to my learning too. At the end of the two weeks I felt far more prepared to undertake my elective in Israel, particularly feeling slightly more refreshed on my practical skills.
My time in Ichilov on elective was spent with one of the three general surgery teams at the
hospital. I was initially put in touch with the administrative team at the hospital through a
family friend who is also a previous Cambridge graduate (Dr Sara Renshaw) who trains at
the hospital in the General Surgery department. She suggested coming to Israel would be a
great opportunity to learn the system and experience the culture in the hospital. Hence, this family contact was very much my segue into the hospital, which would otherwise have been difficult to achieve. I had a phone call with a member of the team and was required to submit written work as part of my interview/application process. The administrative side of things was straight forward to organise once I had been offered a place for the summer, entailing some emailing and phone calls only.
I planned for a very diverse and informative time with the team, full of teaching and exposure to a wide variety of operations, as well as pre/post operative care. I found out quickly on arriving at the hospital that there was not a proper elective programme that I would be joining. It resulted in a slight adjustment period initially, until I managed to find a few individuals who were willing to teach and be involved in making my elective productive and fruitful. It then was a matter of contacting them directly to seek out opportunities and exposure in the hospital. This was a great opportunity to build some connections within the hospital and to have some teaching directly from surgical registrars (predominantly). I very much relied on good teaching and involvement from the seniors who I shadowed to maximise my time. Being restricted to observation only was the most difficult part of my elective. But once I settled in and found a few enthusiastic doctors, I did manage to join a variety of clinics, ward rounds, surgeries, departmental meetings, conferences that took place at the hospital, team working on the surgery wards etc. I met some medical students who involved me in their tutorials and study sessions. Overall, I managed to find the right people to make it beneficial for me. I met some incredibly talented young surgeons who inspired me with their abilities and work ethic, something I wish to take with me. The sense of leadership and responsibility each member of the team had was inspiring to see. I returned to my final year of medical school with a new understanding of what leadership in healthcare needs to look like and what role I would like to have in shaping this in the future. I also found it particularly helpful to speak to the more senior members of the team who offered valuable mentoring. My biggest lessons learnt were about the healthcare system in Israel and the culture within hospitals. It was an important opportunity for me to reflect on what I wanted for myself once I qualify and if Israel would ever be an option for me to move back to. It was eye-opening to see a healthcare system so different in another modern and developed country.
Since Tel Aviv is “crowned” the most expensive city in the world, I began looking at funding
opportunities as soon as I secured the elective. I applied and managed to receive a bursary
from the UK’s Jewish Medical Association. This bursary was immensely helpful in paying for
accommodation and transportation during the elective period, and for that I am immensely grateful.
The view from the hospital rooftop social space; and trips to the beach with the junior doctor team
I think there is a lot of pressure surrounding the elective period, often being branded as a “once in a lifetime opportunity”, and whilst that is partially true, I think once I took some of the pressure off, I managed to enjoy it much more and felt grateful for the things that did go well, rather than fixate on those that did not. If I had to give advice to any students making decisions regarding their electives now, my words of wisdom would be to go as a group and to join an established elective programme or (equally) ask to receive contacts and a timetable in advance.
Yaara Arnsberg (Cambridge)
