Articles and Case Studies

My Elective - Ho Chi Minh City (Saigon), Vietnam

27 May 2012

This elective is an interesting one although not without its limitations. As a final year male medical student I did a four week rotation in the Emergency Department (ED) of Cho Ray Hospital in October/November 2011.
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Member Name: Rowan Harrison
University: James Cook University, Cairns
Campus Destination: Ho Chi Minh City (Saigon), Vietnam
Year: 2011
Hospital: Cho Ray Hospital
Length of elective: 4 weeks
Overall experience: 6/10

Working in Vietnam

Based in Ho Chi Minh City (Saigon), Cho Ray is the largest teaching hospital in Vietnam. Patient presentations are essentially a 50-50 split between road traffic accidents and advanced clinical pathology.

Some of the trauma you see is at times, alarming. However, this had the added benefit of presenting opportunities to practice skills (i.e. suturing, intubation), many of which you wouldn't get in Australia.

In terms of illness, due to the fact presentations were partially funded by the patients, most would choose to present very late. This combined with the limited primary care available in the country resulted in some very advanced and bizarre pathology.

Some examples I encountered included end stage Wilson's disease, Steven Johnson Syndrome and a first presentation hepatic encephalopathy to name a few.

At Cho Ray you are placed with an ED team (A group of doctors) who work on a four day schedule – morning (7am to 2.30pm), afternoon (2.30pm to 9pm), night (9pm to 7am) and then a day off. The cycle then repeats again. The training office recommends you work the mornings and afternoons and not the nights, meaning you do two days on, two days off. This is of course open to negotiation if you would like to travel.

I would encourage you to do at least one night, as this is when a lot of the serious trauma comes in. You do get charged a small fee by the training department for undertaking your elective here and I would recommend to other medical students to be wary of how much they charge you. This should be listed on their website. I had a bad experience where I was blatantly overcharged by the department and when I tried to correct the error I was refused repayment.

Challenges working in Vietnam

The biggest limitation of working in Vietnam was undoubtedly the language. In the hospital all of the doctors are very friendly, approachable and all speak “some” English. This means you can know what’s going on roughly with a patient, but you can't sit down and have a full discussion about it. A lot of the time you are in an observatory role. Paradoxically the busier it gets the less you can do as all the doctors become too busy to interpret for you. Around 95%+ of the patients don't speak any English so if you are coming here to practice your history and examination skills you can forget about it.

Travel opportunities

There are of course plenty of opportunities to travel and this was a major reason for my selection in this country. Vietnam is an amazing country to tour and because everything is so cheap (accommodation and food), you can happily do a rotation and holiday here on a budget.

My recommendation

Overall I found this an interesting elective. I would recommend it to others but perhaps only for one month as the language barrier can become a bit frustrating at times. Vietnam is a wonderful country, good value and with plenty of opportunities to travel.

 

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