BLOCK TITLE

MEDICAL ELECTIVE PROGRAM

ELECTIVE 1

ELEC 303

ELECTIVE 2

ELEC 513

ELECTIVE 1

3 CR. HRS.

ELECTIVE 2

3 CR. HRS.

BLOCK CODE NO.

CREDIT HOURS

BLOCK DURATION ELECTIVE 1:

4 - 8 WEEKS

- ELECTIVE 2:

4 8 WEEKS

BLOCK COORDINATORS

Dr. Dakheelallah Almutairi

TABLE OF CONTENTS
I

Introduction

II

Objectives

III

Duration of The Elective

IV

Organization of the Elective

Field Supervisor

VI

Application Process

V II

Mechanism of Elective Term Approval

V III

Mechanism of Supervisor Reporting

IX

Student Assessment Requirements for the Elective

11

Program Evaluation by the students

11

Publication

12

University Contact During the Elective Period

12

Risk Management and Insurance

12

Appendix (1) Elective Term Application Form

13

Appendix (2) Assessment Form

15

Appendix (3) Students Elective Report

16

Appendix (4) Students Evaluation of the Elective

18

Student Agreement and Acknowledgement for International Electives

20

X1
X11
X111

Example of Student Reporting on Elective from Sydney

- Example 1

22

- Example 2

25

Elective Program Schedule

29
3

I.

INTRODUCTION
The Elective Program is an opportunity for self-education in an area of the students own
interest. The aim of the elective is to improve the students ability to function as a physician.
Elective studies form an integral part of the Curriculum Plan. They may be considered the
epitome of self-directed learning, since students must define goals for electives, which are
appropriate for their own learning objectives. These objectives represent specific areas of
educational need or interest. The responsibility for planning electives rests with each student
in collaboration with the student supervisor.
The Block Electives are blocks of curriculum time dedicated to full-time elective activities.
Their satisfactory completion is a mandatory component of the Undergraduate Medical
Program. Block Electives start in phase II (after the musculoskeletal block) and during the
Clerkship (Phase II). Clinical electives in the MD Program must be organized so that each
student has an elective experience in a minimum of three different disciplines, each of which
will take place for a minimum of two weeks.
Electives allow students to devote longer periods of time to the pursuit of special academic
experiences. The intent is to encourage students to explore special frontier areas of medicine
and health care such as community health projects, and international health opportunities. It
is an opportunity to prepare for a particular career direction, explore different experiences or
enhance skills in particular areas.
Students are allowed to use these elective blocks as an opportunity to travel and to
experience different cultures and medical practice in other countries. Students are
encouraged to use these elective blocks to obtain both knowledge and experience in areas of
interest in locations that will be beneficial to their learning.
Knowledge, skills & attitudes are further developed in a self-directed area of choice across
the curriculum. Individualized experience may occur within King Abdulaziz Medical City, and
other recognized sites of practice in Saudi Arabia under the preceptor-ship of the Ministry of
Health approved supervisors. Both the student and the supervisor are responsible for
ensuring a clear, mutual understanding of the learning activities designed to meet the
objectives of the elective.

II.

THE OBJECTIVES OF THE PROGRAM

The prime objective of the Elective is to provide students with experience in specific areas of
medicine of their own choice.
The general objectives are
To provide flexibility and opportunities to explore career possibilities,
To gain experience in aspects of medicine beyond the core curriculum, and
To study subjects in greater depth.
The specific objectives are:
Basic Sciences
Apply a broad based knowledge in basic sciences in the subject matter of the
concerned specialty.
Plan and participate actively in the health education program
Clinical Sciences
Takes proper history from real patients (15 20 patients)
Observes proper physical examination on real patients (3-5 patients)
Performs proper physical examination under supervision (10 15 patients)
Observes performance of some important clinical services.
Observes performance of some medical interventions (laboratory, X-ray, .etc).
Participates actively in practicing minor skills (taking vital signs, giving injections
including IV lines. suturing, etc).
Participates actively with the working team in delivery of some medical services.
Provides some direct medical service under supervision.
Participates actively with the working team in management of acute cases in ER.
Participates actively with the working team in chronic disease management
programs.
Participates actively with the working team in mother and childcare programs.
Attitude
Shows interest in the subject
Comes on time (punctual) for all sessions
Communicates effectively with patients and other staff members
Creates good relationship with others (staff, patients, etc).

III.

DURATION OF THE ELECTIVE

The elective term extends for a minimum of four weeks and maximum of eight weeks in
phase II and for a similar duration in phase II. Students may break each elective Block into
two components, with a minimum duration of four weeks.
Electives can be taken:
With members of the Faculty of Medicine, King Saud bin Abdulaziz Medical city, or in
settings that have received departmental approval;
At another recognized teaching institution or hospital, or in another approved setting;
At an approved physician's site of practice.
Elective One
The students will carry out Elective One during the 1st summer semester after the
Cardiovascular Block. All students are required to take Elective One in only one
discipline/department for a duration of four to eight weeks (30 hours/week) in phase II. The
rotation should be undertaken in general specialties of medicine or basic sciences, but should
not be undertaken in a subspecialty division. Students should select Elective One from the
following list:
a.
b.
c.
d.
e.
f.
g.
h.
i.

Emergency Medicine
Family Medicine
Primary Health care
Home care program
Other community based activities
Pharmacy
Laboratory
Radiology
Radiotherapy

Elective Two
The students will carry out Elective Two during the 3rd summer semester. Elective two
should be undertaken in different disciplines/departments, as well as subspecialty divisions, for a
duration of four to eight weeks (30 hours/week) in phase II. Students should select from the
following list:
a.
b.
c.
d.
e.
f.

Emergency Medicine
Family Medicine
Internal Medicine
General Surgery
Pediatrics
Obstetric and Gynecology

Subspecialties Divisions:
a.
b.
c.
d.
e.
f.
g.
h.

Orthopedics
Oncology
Endocrinology
Neurology
Psychiatry
ENT
Ophthalmology
Anesthesia

All documentation requirements related to the elective program (Elective Term

Application Form, Students Report and Elective Evaluation form) must be submitted by
the student to the Academic Affairs Office no later than the end of the second week of the
next academic year.
The Field supervisor should send the Student Assessment form by mail or via the student
in a security sealed envelope to the Academic Affairs Office (Mail Code 6556 P.O. Box 9515
Jeddah 21423 K.S.A.) no later than the second week of the next academic.
Students, who fail to submit all required documents by the specified date, will receive a
Failed grade.
Students will receive their final grades two weeks after the submission deadline.

IV.

ORGANIZATION OF THE ELECTIVE

Students are expected to organize their own Elective terms, but may contact the Elective
Coordinator, if advice or assistance is needed.
The Elective Committee Members, who have the role of advising, counseling and directing
students in application and approval of Electives, must approve applications for Electives.
Applications are approved on:
i. Relevance of the addressed topic;
ii. Clearly outlined and appropriate learning objectives;
iii. Achievable learning objectives, i.e.: that research can be concluded within the short
period of time available to students;
iv. Safety (particularly for overseas trips);
v. The work being appropriate for the level of training and experience.
On completion of an Elective, students should submit an Elective Report and complete a confidential
Evaluation of the Elective. This form must be submitted to the Elective program Coordinator, (Through

College of Medicine - Academic Affairs Mail Code 6556 P.O. Box 9515 Jeddah 21423
K.S.A.) within the first two weeks of the next semester.

Students who are thinking of undertaking an international Elective Term should consider the political
stability of any candidate country. If there is doubt, look for an alternative Elective term where your
health and wellbeing will not be compromised.

V.

FIELD SUPERVISOR

Field supervisors should review the students Application Form and sign it for confirmation or
there should be accompanying correspondence from them confirming the elective placements.
They are requested to provide the students with field experience according to the agreed
learning objectives on the Application Form.
Field supervisors are required to complete the Student Assessment Form based on attendance
and learning objectives.
Field Supervisors can contact the Elective Coordinator to discuss any issues.

VI.

APPLICATION PROCESS
Applications for Electives should be submitted at least three months prior to the
elective. If you have any problems with this deadline, please contact the Block
Coordinator.
Students are required to complete an Elective Term Application Form (Annex 1) in which
they must complete the demographic student data, the names and contact details of their
supervisors and note specifically the learning objectives to be achieved while completing the
Electives. Once completed, the form needs to be signed by the nominated supervisors or
have accompanying correspondence from them confirming the Elective placements. This
form needs to be submitted to the Elective Committee for approval.
Students applying for international electives are required to submit a signed Student
Agreement and Acknowledgement for Overseas Electives form.
It is recommended that students planning to complete an overseas Elective should
commence organizing it 6 - 12 months in advance of commencing the Elective.

VII.

MECHANISM OF ELECTIVE TERM APPROVAL

Completed Elective Term Application Form (See Annex 1) has to be approved by the Elective
Committee. The Elective Committee has the role of advising, counseling and directing
students in their applications and approving Electives. The points on which each application
is assessed are:
a. That the learning objects have been clearly outlined.
b. That the learning objectives are appropriate.
c. That the learning objectives are achievable, i.e.: if a particular project is envisaged, that
research can be concluded within the short period of time available to students.
d. That the term would be safe, particularly for overseas trips.
e. That the work the students would be involved in is appropriate for their level of training
and that they would not be placed in situations that are inappropriate for their level of
experience.
Notification of Approved Elective to Supervisor and Student
Once the Elective Committee has granted approval, letters will be sent to the Supervisor,
advising the Supervisor of the assessment requirements and to the student confirming
approval of the Elective.

VIII.

MECHANISM FOR SUPERVISOR REPORTING

The Supervisor will be required to complete the Student Performance Evaluation
(Assessment Form See Annex 2) based on attendance and learning objectives. As the
prime objective of the Elective is to provide the student with experience in a specific area of
the student's choice, it is very difficult to assess it in any other way than adequate
attendance, experience gained and participation during the term. If the student's
performance was thought to be poor by an individual Supervisor because of poor clinical
abilities, this would not mean the student would fail. This is provided that student's
attendance during the Elective was adequate, and therefore experience was gained,
and the prime objective would have been achieved. If the Supervisor has concerns or
problems during the term, the Supervisor should contact the Elective coordinator to discuss
any issues.
Elective Coordinator or any one of the Elective Committee members (staff supervisors)
may pay field visits to the different settings (Hospitals, Health Centers, Etc) for followup and to give more support and detailed explanation of the program to the concerned
field supervisors.

Students are required to be trained on the following competencies during their elective
programs:
1. MEDICAL EXPERT/SKILLED CLINICIAN
Knowledge (basic & clinical);
Technical and Procedural Skills;
2. COMMUNICATOR/DOCTOR-PATIENT RELATIONSHIP
Communication with Patients/Families/Community;
Written Records;
Oral Reports;
3. COLLABORATOR
Team Participation (Contribution within Interdisciplinary Team);
4. MANAGER
Awareness of and Appropriate Use of Health Care Resources;
5. HEALTH ADVOCATE
Recognition of Important Determinants of Health and Principles of Disease
Prevention;
6. SCHOLAR
Self-Directed Learning
In addition, specific learning objectives are to be agreed upon BEFORE the beginning of
the elective by the student and the supervisor. At least two and up to four major specific
learning objectives are to be listed in the space provided on the Elective Assessment form.
In order to receive credit for the Elective:
The supervisor(s) must assess all the competencies on the assessment forms.
Supervisor(s) must sign the forms {Application Form & Assessment Form}.
Supervisor should send student assessment two weeks after the elective
Students should submit their reports by the end of the second week in the semester
after summer break.
Assessment results and feedback will be given to students two weeks later.

ASSESSMENT OUTCOME
The factors which would lead to a Not Satisfactory Elective, are:
a. A Supervisor's Report which indicated a poor or inadequate performance
b. The Elective Report and Evaluation are of an unsatisfactory standard or incomplete.

10

IX.

STUDENT ASSESSMENT REQUIREMENTS FOR THE ELECTIVE

ELECTIVE REPORT
All students must submit an Elective Report, using the appropriate form, and the Report should also
be sent to the Supervisor where possible (see Annex 3).
The Report should be a narrative account of what was accomplished during the
elective, including details of the location, supervision, activities (clinical, research etc.)
and chief learning outcomes. It should be suitable for reference by faculty members
and other students. The text of the Report should be at least 1,500 words in length,
but not more than 5,000 words. It may be accompanied by a limited number of
relevant images (up to 4), if these help to illuminate the educational benefit of the
experience.

X.

PROGRAM EVALUATION BY STUDENTS

Students are also required to complete a self-assessment and evaluation of the
elective experience. This will assess the student's perception of his/her own
achievement of the agreed upon objectives, and the student's evaluation of the quality
of the elective. This form is to be submitted to the Block Coordinator upon completion
of the elective. The information is requested in order to assist supervisors, faculty, and
students in planning electives and to ensure that student objectives are being met.
Evaluations are also important for the supervisors and for improving teaching
effectiveness. Information from the student evaluation will be provided to the
supervisors with the student identification removed.
Students are required to complete an electronic Evaluation of the Elective. These
evaluations are kept confidential (see Annex 4).

11

XI.

PUBLICATION

Publication of the work from an elective term is a good indication of the quality of work
performed.
However, it is most unlikely that any work would be published prior to graduation or even
presented at local, national or international meetings within the assessment period. Publication
and presentation of work done during the elective term will be encouraged but is not a part of
the formal assessment.

XII.

UNIVERSITY CONTACT DURING THE ELECTIVE PERIOD

In response to student requests for a contact person within the Faculty during the Elective
period, it is most appropriate to contact Academic Affairs (Tel: 624-0000, Ext. #26221).
Although it is the holiday period at this time of year, but some members of staff and one
Associate Dean are always available during the summer months to assist with issues or
problems related to your Elective.

XIII.

RISK MANAGEMENT AND INSURANCE

All fieldwork must be planned in advance, including assessment of the possible risks. The
management of risks is essentially a four-step process:
1. Identifying the risks, i.e. those things that may impede the successful outcome of the
fieldwork.
2. Assessing their likelihood and the potential consequences of them.
3. Controlling them.
4. Monitoring and reviewing the effectiveness of the risk control measures and improving
them as needed.

12

Annex 1
National Guard Health Affairs
King Saud Bin Abdulaziz University for Health Sciences
COLLEGE OF MEDICINE

ELECTIVE TERM APPLICATION FORM

(To be completed and signed by the student and supervisor)
(Must be approved by the Elective Term Committee Coordinator before the start of the Elective
Training)
Date:

STUDENT DETAILS:
Name of Student:

April/10/2014

Samer Abdulmoghni Alamri

Student ID No.:

Badge No.:

320701001

Batch No.:

Email:

4061941
alamri001@ksau-hs.edu.sa

ELECTIVE DETAILS:
Inclusive Dates of the Elective
From:
To:
Name of hospital, institution or
organization to which you will be
attached:

Four weeks
8/6/2014
3/7/2014
King Khalid National Guard Hospital

Address:

King Abdulaziz Medical City -Jeddah

Department:

Hematology

Name of Department Head:

Title or Position:
NOTE: PREPARE ONE (1) ELECTIVE TERM APPLICATION FOR EVERY HOSPITAL,
DEPARTMENT OR INSTITUTION.

SUPERVISORS DETAILS:
Supervisors Name:
Title or Position:
Telephone Number:
Fax Number:
Email Address:

Submit this form to Ms. Manar Al-Mutlaq College of Medicine Academic Affairs
Email

MutlaqMA@ngha.med.sa

Ext. 26221

13

ELECTIVE TITLE:
DESCRIPTION OF ELECTIVE TERM:

(Minimum of 50 words)

4 weeks elective course in the hematology department in King Khalid National Guard Hospital and
the Oncology center in King Abdulaziz Medical City, Jeddah. The course will include the
application of a variety of skills required to approach patients with hematological disorders like,
history taking, physical examination, and laboratory interpretation.

LEARNING OBJECTIVE:

(As specific as possible.)

To use and apply the theoretical knowledge of different haematological aspects, including history,
physical exams, and investigations by being exposed to real patients.
To develop the skills required to interpret haematological, blood, and biochemical lab reports

EDUCATIONAL RATIONALE: (Why do you choose/devise this elective minimum 25 words.)

I chose the hematology department in the summer elective beacuse I found that I have an interest in
the different topics related to hematology, such as blood disorders, malignancies, inherited
diseases, lab works, and blood banks. In addition, I am trying to find out the specialty that I will
continue to work and learn about for my entire life, and the hematology is one of the specialities that
I think about.

PERSONAL AND PROFESSIONAL DEVELOPMENT THEME:

(How will this elective contribute to your personal and professional development?)
This experience will provide a great opportunity to gain the skills, knowledge, and attitude that
are required to work in a professional health care environment. However, being exposed to the
hospital, patients, and other health care staff before the clinical years will be a great advantage
in term of how to deal with other thoughts, specialties, personalties, and with people from
different origins.

Students Signature:

Date:

Supervisors Signature:

Date:

Supervisors Comments:

Approved:

Date:

Disapproved:

Comments (if any)

Elective Coordinators
Signature:

14

Annex 2
Assessment Form
Poor
74<

ITEM

Fair
75-80

Good
81-85

V.
Good
86-90

Excellent
91-100

KNOWLEDGE
1

Knowledge of Basic Science

Knowledge of Clinical Science

SKILLS
3

History Taking

Physical Examination

Interpretation & Utilization of Information

Clinical Judgment

Organization of Work

Emergency Care

Professional and Technical Skills

ATTITUDE
10

Scientific Interest and Activity

11

Responsibility & Self-Assessment

12

Discipline and Punctuality

13

Patient Relation

14

Inter-Professional Relationships

15

Global Evaluation of Competence &

Progress

TOTAL SCORE

Add 1-15

Divide by
15

(GENERAL )
(AVERAGE)

SUPERVISORS COMMENTS (Including needs for special attention.)

Supervisors Signature:

Date:

Note to Supervisor: Please return this form in a sealed envelope to: MS. MANAR AL-MUTLAQ
King Saud Bin Abdulaziz University for Health Sciences College of Medicine - Academic Affairs
Mail Code 6556 P.O. Box 9515 Jeddah 21423 K.S.A. (Tel. 02-6240000 Ext. 26221)

15

Annex 3
National Guard Health Affairs
King Saud Bin Abdulaziz University for Health Sciences
COLLEGE OF MEDICINE

STUDENTS ELECTIVE REPORT

(To be completed by the student after the elective program.)

STUDENT DETAILS:

Date:

Name of Student:
Student ID No.:

Badge No.:

Batch No.:

Email:

@ksau-hs.edu.com

Elective Site:
Elective Date:

From:

To:

Department:
Supervisor:

Position:

ELECTIVE TITLE

LEARNING OBJECTIVES

ELECTIVE DESCRIPTION

Email the completed form to:

MS. MANAR AL-MUTLAQ MutlaqMA@ngha.med.sa

16

ELECTIVE REPORT
(Not less than 1500 words)

17

Annex 4
National Guard Health Affairs
King Saud Bin Abdulaziz University for Health Sciences
COLLEGE OF MEDICINE

STUDENTS EVALUATION OF THE ELECTIVE

Name of Student:
Badge No.:

Date:

Supervisor:
Hospital/Institution:
Department:

LEARNING OBJECTIVES (as defined in the Elective Term Application)

BLOCK DURATION
1 How many weeks long was your elective?
How many hours per week were you on site
(average)?
ACTIVITIES DURING THE ELECTIVE
2

(Please choose 1)
3

Your main focus during the Elective program

was:

Clinical
Community Work
Research

Please describe it briefly.

Very Much

Partly

Not at all

Did you feel that you were part of the team?

Were you actively involved in this activity?

How was your relation with other members of

the working staff (other than the supervisor)?

What were some of the most essentials youve learned from activities or cases of your
elective? Please describe briefly these activities or cases?
Description

Explain

18

SUPERVISOR / STUDENT RELATIONSHIP

8

How often did you meet with your supervisor per week? (Please check)

All The Time

9

Most of the Time

Sometimes

Rarely

Never

How often did your supervisor gave time to explain cases, show instruments and
demonstrate skills, etc.? (Please check)

All The Time

Most of the Time

Sometimes

Rarely

Never

10 As best as you can, please estimate how you spent your time during the elective, generally.
SN
ACTIVITY
PERCENT (%)
1 Sitting / Waiting
0
2 Scut work (phoning, filing, etc.)
0
3 Observing service delivery.
0
4 Participating actively in service delivery.
0
5 Providing direct service under supervision.
0
6 Providing service with little or no supervision.
0
7 Other
0
TOTAL
100%
SUPERVISOR GRADING
11

Please rate the quality of your supervisor as a clinician-educator. (Please encircle.)

Excellent
5
5
5

Knowledge
Clinical skills
Communication
Providing
feedback
Providing
assessment
Involving you
in the team
Overall Rating
12

Very Good
4
4
4

Good
3
3
3

Fair
2
2
2

Poor
1
1
1

Please list in decreasing priority the main strengths of your elective.

1
2
3

13

Please list in decreasing priority the main weaknesses of your elective.

1
2
3
OVERALL ASSESSMENT
14

Please rate the overall quality of your elective as a learning experience?

Excellent

15

Very good

Good

Fair

Unsatisfactory

In general, what recommendations would you make for the improvement of the elective program?

THANK YOU FOR YOUR COOPERATION

Email this form to: MS. MANAR AL-MUTLAQ MutlaqMA@ngha.med.sa

19

STUDENT AGREEMENT AND ACKNOWLEDGEMENT FOR

INTERNATIONAL ELECTIVES
T o:

Fax:

International Elective Coordinator

Medical Education Department
College of Medicine
King Saud Bin Abdulaziz University for Health Sciences
920008668

I Student ID

Name

of
Address

Have applied to the University for Approval of my overseas Elective Placement at

Name of Host Organization

Address of Host Organization

I acknowledge and agree that any approval given by the University is given subject to the following terms:
1. Choice of Host-Organization
I acknowledge that whilst an elective placement is a requirement of my course, the choice of the Host-Organization as
a place to undertake my Elective Placement, is entirely my decision and is not a country that the Ministry of Foreign
Affairs has advised against as a travel destination. Should the University approve my application for Elective
Placement, such approval is solely based on academic requirements and does not otherwise represent an
endorsement of the Host-Organization by the University. Accordingly, I release the University in respect of any liability
arising from this decision.
2. Expenses
I agree to pay all expenses associated with my participation in the Elective Placement, including but not limited to:
University HECS or tuition fees, including any compulsory fees.
The cost of text books and educational supplies required by the host organization;
All travel, visa, accommodation and living expenses associated with my participation in the Elective
Placement;
All health insurance costs and medical and pharmaceutical expenses incurred for my benefit;
All costs resulting from the modification or termination of my participation in the Elective Placement.

20

3. Visas
I agree that I am responsible for obtaining appropriate visa, entry or re-entry documents prior to my departure.
4. Insurance
I agree that I am responsible for obtaining insurance that will provide me with medical and health coverage for the
duration of my participation in the Elective Placement, and I am responsible for travel insurance.
5. No payment by the University
I acknowledge that, except where it has agreed to do so in a signed letter addressed to me, the University has not
undertaken to provide any funds to assist with the payment of any costs or expenses referred to in paragraphs 2, 3 and
4 above.
6. Unforeseen Events
I understand that due to the international aspect of the Elective Placement, events beyond the control of the University
may occur including the outbreak of war, civil unrest or natural disasters and that these may require a modification of
my participation in the Elective Placement. I agree that the University may modify my participation in the Elective
Placement in these circumstances.
7. Ambassadorship, Rules and Regulations
I acknowledge that as a student of the University, being a good representative of the University and the Kingdom of
Saudi Arabia is an important part of the Elective Placement. I undertake to conduct myself in a manner that will not
offend either the laws of the host country or the cultural norms or behavior pattern of the people of the host country.
In addition, I acknowledge that I am subject to the rules and regulations of both the University and the Host
Organization.
I therefore acknowledge and agree that failure to abide by the applicable rules and regulations or failure to maintain
what the University reasonably considers to be an acceptable standard of public and private conduct may result in the
immediate termination of my participation in the Elective Placement as well as other relevant disciplinary proceedings.
I am aware of the University of Sydneys OH&S guidelines regarding Fieldwork Outside of Australia (found at
http://www.usyd.edu.au/risk/policies/ohs/fieldwork/FieldworkOS.shtml#5) and acknowledge that I am aware of the
current level of warnings issued by the Department of Foreign Affairs and Trade (at: http://www.smartraveller.gov.au/).
8 . On g o i n g O b l i g a t i o n s
I will keep the Universitys Overseas Elective Coordinator informed of my contact details (email, telephone, facsimile
and address) at all times. [This includes the period before I leave Australia and while away on placement and
traveling.]
I will also keep the University Overseas Elective Coordinator informed about my expected date of return to Australia
and will let them know of any changes in this date.
I have read and agree to the above:
Witnessed by
Name of Elective coordinator :
Date

Student Signature
Date:

21

Examples of Student Reports on Electives from Sydney

Example 1
2 weeks in Obs/Gynae and 2 weeks Emergency Medicine at Lautoka Hospital
Surname
Given Name

Burgman
Zoe

Clinical School
Supervisor

Canberra
Dr Douglas Pikacha

Supervisor Address

Fiji School of Medicine

Lautoka Hospital
Lautoka
Fiji
2 weeks in Obs/Gynae and 2 weeks Emergency Medicine at Lautoka Hospital

Elective Title
Learning Objectives

Elective Description
Report

To develop procedural skills e.g. suturing, cannulation, life support etc in

Emergency Dept.
To be exposed to a variety of deliveries and pregnancy-related procedures as
well as gynecological pathologies in Obs/Gynae dept
4 weeks at Lautoka Hospital, Fiji with 2 weeks spent in Obstetrics/Gynaecology
Dept and 2 weeks in Emergency Dept as clinical attachments.
Zoe Burgman SID:0149670 Elective Report Part One
(nb: part Two (Vanuatu) submitted separately; combined word count is >1500
words)
Elective Term Details
Location: Lautoka Hospital, Lautoka, Fiji
Supervisor: Dr Douglas Pikacha, Fiji School of Medicine, Lautoka Hospital
Placement Description 2 weeks Obstetrics/Gynecology +
2 weeks Emergency Department
Duration: 4 weeks, Dec 2003/Jan 2004
Report
I undertook the first half of my elective at Lautoka Hospital, located on the west
coast of Viti Levu in the Fiji Islands. It is the second largest hospital in Fji with
approximately 400 beds. The first two weeks were spent in
Obstetrics/Gynecology and the latter two weeks in the Emergency department.
During my time in the Department of Obstetrics/Gynecology I attended daily
ward rounds, in the antenatal ward where common presentations included preeclampsia, gestational diabetes and post-term pregnancies requiring induction
of labor. The rest of the day was spent in one of a range of areas. The daily
antenatal clinic reviewed large numbers of pregnant women, referring for
further management as required. I assisted deliveries regularly in the labor
22

ward. The ward was divided into two sections the first a general ward with 6
beds where the mothers spent the first stage of labor. The second stage of
labor was spent in the single bed delivery rooms, which were similarly
equipped to those in Australia. All births were attended by two midwives with a
doctor called if complications developed. The midwives conducted episiotomies
as required and were responsible for suture repairs. After monitoring the
progress of labor I was able to assist with the actual delivery and repairs as
well as monitoring the newborn infant, an extremely valuable experience.
The gynecology department had a busy outpatient clinic and conducted regular
surgical lists. Patients often presented with advanced pathologies, particularly
alarming were high rates of CINII/CIN III in women under 40 years of old.
Cultural reasons combined with lack of public awareness have meant a poor
uptake of pap smear services. Several unusual pathologies also presented
during my time there including a molar pregnancy.
I spent the other two weeks in the Emergency department which, though only
equipped with 5 permanent beds, saw approximately 50 patients per day.
Among the most frequent presentations were cardiac events, respiratory
distress, acute gynecology/obstetric emergencies and trauma. We also treated
large numbers of asthmatics daily as preventative medicine was too expensive
for the vast majority of patients and they were therefore managed acutely in
hallway of the emergency department. Although many presentations were
similar to those in Australia most presented at a more advanced stage of the
disease eg CCF and hypertension. Similarly the limited resources available to
manage the presentations greatly reduced the options available for treatment.
My time in the emergency department provided an opportunity to practice a
range of clinical skills on a regular basis including venepuncture, cannulation,
establishing IV lines, IM/IV injections, administering medication, vaginal
examinations, interpreting ECGS etc. It was a good opportunity to review
general medicine and to practice history taking and clinical examinations.
The most educational aspect of the experience was witnessing the
compensations made necessary by limited financial resources even in the
presence of capable and dedicated medical staff. The Lautoka hospital is well
organized and functions smoothly. Huge numbers of patients are seen daily in
the general outpatient department and treated or admitted as required.
Although many basic investigations are available and are performed
expeditiously treatment options in particular are vastly restricted. For example
there is no cardiac surgery performed in Fiji and patients requiring cardiac
intervention have to fund their own trip to New Zealand which is not a feasible
option for most. On a more routine level many items that we would consider
single use are recycled after being sterilized including surgical gloves, other
items such as surgical hats are reused by staff until they are no longer
wearable. We had been advised to bring our own supplies of gloves
(disposable and surgical) and were thankful that we had done so and would
advise future students to do the same. In the area of obstetrics much of the
equipment such as neonatal resuscitation units are similar to those used in
major Australian hospitals. However options for pain relief were restricted to
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nitrous oxide gas, epidurals were not available and other medications such as
antibiotics were rarely available when required.
Cultural differences made the time even more educational and unique.
Approximately 50% of the population is Fijian Islanders and 45% Indian, with
fairly small numbers of other ethnicities. Both the major groups have extremely
strong but very different cultural traditions, language and lifestyles. Although
the official language is English both Fijian and Indian are used widely and
many of the less educated only speak one language presenting a problem of a
lack of shared language with implications for communication and thus medical
care. Medically they presented with different problems for example the high
prevalence of gestational diabetes was almost exclusive to Indian patients.
There were also remarkable cultural differences in the expression of pain and
response to illness; the Fijians having a very stoic approach whereas the
Indians were more demonstrative. Both groups were extremely friendly and
welcoming whether as patients or medical staff.
During my time at Lautoka Hospital I fulfilled my learning objectives, namely to
gain practical experience and expand on procedural skills in the areas of
obstetrics and gynecology and emergency medicine in the context of a
developing country. The diversity of experience and the amazing
encouragement and support provided by the staff at Lautoka hospital made my
elective a thoroughly enjoyable experience which I would highly recommend.
The following information may also be of interest to future elective students.
Contact Dr Douglas Pikacha email d.pikacha@fsm.ac.fj
Cost of elective registration (payable to Fiji School of Med) in 2003/4 was $350
Fijian dollars (~$280 AUD)
Accommodation There was no hospital accommodation available but the
Cathay Hotel was recommended by the hospital. It is 10 minutes walk from the
hospital, and has a discount for medical students working at the hospital. It is
basic but clean, well located and has a pool.

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Example 2
Surname
Given Name

Ta n
Colin

Clinical School
Supervisor

Central - RPAH
Vicki Gordon

Supervisor Address

Mutitjulu Community Health Service

CMA Ininti Store
Yulara (Ayers Rock) NT 0872
Remote Aboriginal Medicine

Elective Title
Learning Objectives
Elective Description

Report

Experience and work as a medical student in a remote rural location within an

Aboriginal community.
4 weeks was spent in a remote Aboriginal community called Mutitjulu next to
Uluru. This included an orientation and then independant clinical work with
necessary supervision. The medicine was largely general practice medicine with
the occasional emergency evacuation. There was ooportunities to gain an insight
into the lifestyle and challenges that remote rural practitioners face.
Student Elective Term Report
Colin Tan (0149723)
Canberra Clinical School
ctan@gmp.usyd.edu.au
Elective Title: Mutitjulu Remote Aboriginal Health
Supervisors name: Vicki Gordon
Supervisors address: Mutitjulu Community health Service
CMA Ininti Store
Yulara (Ayers Rock) NT 0872
P(08)8956 2054 F(08)8956 2031
Email: mutitjulu@bigpond.com
Location and Climate
Mutitjulu is an Aboriginal community located adjacent to Australias most
photographed rock Uluru. It lies approximately 1.5km SE of Uluru and is
accessible by sealed road. The community is located in the National Park. The
nearest major town is Alice Springs which is approximately 4hrs drive in a
northerly direction, while the nearest supply town is known as Yulara. Yulara is
also the tourist resort and has the many comforts that tourist require; it is also the
supply town for some of Mutitjulus residents. Yulara is approximately 25km from
Mutitjulu and has an airport with regular services to the major Australian cities.
Uluru is in the centre of Australia and is extremely dry and hot. There are
supposedly two seasons a dry and a wet season. The wet season seems to
occur around Christmas/New Years and is very short. Otherwise it is very hot and
very dry.
It is located in one of Australias most beautiful spots and there are numerous
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stunning areas to visit.

The community consist largely of an indigenous population, but does have
residents of non-indigenous backgrounds. It has a population of approximately
500 who reside in approximately 60 houses. There is a resident population and a
smaller transient population also. Many of the indigenous population speak Pjaraptankinjara or another indigenous languages from the central Australia area,
while English is also spoken by some. The community has is run by a council and
there are numerous services, these include a community centre, a health clinic, a
womens council and a school. There are a variety of occupations by many of the
residents, these include being tour guides, rangers, artists, health workers and
some work for the council. The community is technically a dry community so no
alcohol is permitted. At times some students may feel a little threatened in some
of the communities, however, at no time did I feel threatened nor did I consider
security to be a risk.
The elective
The elective was conducted for a period of 4 weeks during Dec 2003/Jan 2004.
There was a week of orientation which was conducted in Alice Spring, organized
by NT general practice education (NTGPE). This was done to familiarize students
with the culture and to prepare us for the experience. Groups of medical students
from around Australia were put through this orientation which included bush
tucker tours, tours of the surrounding environment, wildlife education, cultural
awareness programs, hospital tours, lessons from specialists and ambulance
ride-alongs. A regular time was arranged for a phone conference between all the
students during their community placements. After this the group was split and
students sent to their allotted community for their nominated period of time. Some
of the communities were extremely remote and could most easily be accessed by
air-plane. Food and supplies in such instances had to be taken in with the
students. Other locations were more easily accessible.
Medical
The community health clinic at Mutitjulu was relatively well resourced in terms of
staffing and equipment. There were a number of buildings for the facility which
included the Mens room, Womens room, administration building and an aged
care and disabled building. There were 3 Remote area nurses, 3 Aboriginal
Health workers, numerous support staff, visiting allied health personnel and a
council and directors which ran the health facility. There was no doctor at the
time, but one was arriving after my departure.
The medicine was largely general practice with the occasional emergency or
evacuation. Many of the disorders were diseases of lifestyle and chronic diseases
which are so prevalent in Aboriginal society. Although technically a alcohol free
town, there was always alcohol available. This resulted in many problems. As a
student I worked largely independently, mostly providing healthcare for the males
of the community. Patients would present to the clinic and I would conduct a
consult as a general practitioner would. The clinic also acts as the local
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pharmacy, and after a consult, I would also provide the medications for the
patients. If patients were to arrive for their medications, a short review followed by
filling of their dossette box was done. If there were problems I could not deal with,
supervision and assistance was always available. With difficult problems, a phone
consult was obtained and advice given or a RFDS flight organized. At times, the
medical centre at the tourist resort (Yulara) provided assistance. Occasionally
there would be call-outs at night and I was able to assist in some of these.
Accommodation
Accomodation was provided at the community at no cost. I was residing with the
hospital administrator which was excellent. It was air-conditioned and also had
internet access.In most communities, the student would be provided with either a
house or a shared house. The house had one of the most stunning views in all of
Australia.
NTGPE
I was extremely pleased with the efficiency of the elective. This elective was
organized through the Northern Territory General Practice Education who
provides this service to encourage medical students to experience a rural lifestyle
in the hope they will return as medical practitioners in the bush. The service
provides a good orientation into Aboriginal culture and also organizes transport
(its all free) and places the student in a community or town.
Things to do (not medical)
Many students (including myself) hire vehicles to explore the many beautiful
gorges, canyons and ranges in the area. Usually done in a group, many of the
sights can be seen easily. Professional tour operators also conduct tours to Uluru
and Kata Juta (the Olgas).
In the communities there are many opportunities to learn about the cultures of the
area, with chances to observe ceremonies, participate in digs or hunts, purchase
aboriginal art, and even learn the language a little. There is not too much team
sport available, but lots of space for long pleasant runs or bike rides. Mutitjulu had
one of the best located basketball courts (provided by Nike) which was in
reasonable condition. During the wet, there were also secret waterholes that
some of the locals may reveal which can be swum in. I was fortunate to be able to
get on some of the local tours around Uluru and learnt more about the local
culture. I was also fortunate to score a helicopter ride with one of the helicopter
tour operators and this was a fantastic experience.
Recommendation
I would recommend this elective for students who are able to work independently
and are interested in remote, rural or aboriginal medicine. It was a great learning
experience often more about Australian and indigenous culture than medicine.
Nevertheless the medical experience was excellent. The cultural change is a
great to experience and the well-organised placement along with the free
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transport and accommodation makes it even more agreeable to students. It was

also worthwhile to see the professionalism of the remote area health workers and
experience the issues the remote health practitioners have to face. The
opportunity to experience the lifestyle and culture of the community was good.
Contact: www.ntgpe.org
Click on the student link and this should lead you to further information and
contact details.

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