Ruth Delaney, General Surgery elective

Hospital, Location: Johns Hopkins University/Sinai Hospital of Baltimore, Baltimore, MD, USA.

Supervisor: Dr. Adrian Barbul, MD. Professor of Surgery, Johns Hopkins University & Surgeon-in-Chief, Sinai Hospital.

Contact person (if different from above): Personnel have changed but either write or make a phonecall to – Medical Education Office, Sinai Hospital of Baltimore, 2401 Belvedere Ave, Baltimore, MD 21215, USA.
Tel: 00-1-410-9720

Main Activities including Practical Aspect: Sub-intern on the General Surgical Service. Rounds never later than 6am. Most of the day in the OR, always scrubbed, I often got to close or even do some of a simple case e.g. appendicectomy. On-call I saw surgical consults first, then presented them to the chief resident & was involved in their subsequent management. I also got involved in management of major traumas on-call, I was often scrubbed for most of the night. Other practical things I got to do as the opportunities arose included endotracheal intubation, inserting central lines & suturing minor stab wounds etc in the ER. Public outpatient clinic once per week, saw patients on my own & then presented them to the attending. Surgical grand rounds at Hopkins once per week.

Advantages: Huge amount of practical experience – the American attitude to medical students & how much they are allowed to do is vastly different to the Irish attitude! Exposure to many different areas – GI, hepatobiliary, breast, thyroid, trauma etc. All of the general surgical residents were Hopkins residents & the attendings were Hopkins faculty so the standard of teaching was very high.

Disadvantages: Early mornings! The adjustment to the American system & ways of doing things takes a few days, but give yourself time. There is a big difference between what is expected of you as a student in Ireland & what is expected of you in America – learn to be more forward with your superiors in asking questions etc. & learn to be more independent & confident about doing things on the ward/in the OR/in the ER.

Life outside the Hospital: Make friends with somebody who knows Baltimore as parts of it are dangerous, but parts of it are nice – the problem is that it’s not always clear where is safe! Inner Harbor is a great place to hang out. Lots of good places to eat. Boordy Vineyard outside Baltimore is a good place to spend Saturday/Sunday. Washington DC is close enough for a day-trip.

Most Memorable Moment(s): Seeing my first gunshot wound (the first of many). Putting in my first central line & being absolutely terrified. Asking a 13-year-old at clinic what happened to him & getting the answer “I got shot. They was tryin to kill me”. Going to DC for a “day-trip” with a classmate who shall remain nameless & not making it back until the following day.

Would you recommend this elective to others? Yes

Tips & How to Organize this Rotation: Hospital website is www.lifebridgehealth.org. Go to Graduate Medical Education link & search for “elective” to see the options. There was doubt as to whether Hopkins would continue to supply surgical residents to Sinai beyond 2005, so it would be worth checking whether Sinai still offers the back-door way into a Hopkins rotation (Hopkins does not officially take students from medical schools outside the US or Canada). In terms of organizing the rotation, contact the Medical Education Office. Rotation costs nothing & is relatively easy to set up.