Salut à tous et à toutes!
It's currently my second week at the hospital here. I'm with the department of internal medicine here - pretty much means that in the 20 bed ward and in the consultation rooms we see a huge variety of cases that can come under this enormous umbrella (infectious diseases, rheumatology, dermatology, haematology, oncology..) It's a small hospital with branches of cardiology and internal medicine. The 2 main hospitals in Noumea and the private day/elective surgery clinics service all of New Caledonia and its islands, as well as surrounding pacific islands like Wallis. X-rays and ultrasounds are done here but they don't have the facilities for CTs or MRIs. These have to be done at another hospital and so patients are often shuffled around. There are no radiotherapy facilties on the island, so the drs here liase particularly with the haematologists and oncologists at RPA! lots of emails that use google translate, but in the end everyone understands everyone.
There is 1 head honcho, 2 specialists and 2 specialists-to-be (called interns but the system in France is very different ours. They have one year of premed - easy to get into but with a brutal exam at the end. something like a 10% pass rate. Then 6 years of 'undergraduate' med and at the end of the 7 years and depending on their marks/preferences they get into a speciality right out of med school. It takes 3 years to be a GP and then 4-5 years to be a specialist. As a med student, I'm an 'externe' who is doing her 'externat' and once you finish med school and are in your speciality training you're an 'interne' doing his/her 'internat'. I'm pretty much the only student here because all New Caledonian med students have to complete their studies in (European) France or more specifically 'en metropole' (since NC is actually a French island like Mauritius or Reunion Island).
Things were pretty damn challenging at first - everything was going so fast and I couldn't catch a thing!
There are a lot of words that are similar (thank goodness), words that are different (many many many) and words that are 'faux amis' - words with different meanings in different languages - the bane of all learners of any language! for example - a 'ganglion' in french is actually a lymph node (rather than part of the nervous system)! Rx stands for X-Ray instead of treatment. Things are getting better day by day and for the most part I can catch what is going on, even if I don't speak a lot. Taking histories is suddenly 100x more difficult, I lose all structure!
Half the cases during my first week were due to dengue fever (there's a seasonal outbreak atm), then lots of diabetes (patient compliance with meds and treatment is very poor here), classic scleroderma, spondylosis, haematological cancers, terminal neoplasia, lots of gout and polyarthritis due to rheumatic fever. Idiopathic thrombocytopenic purpura that was refractory to corticosteroids, rituximab (anti-CD20) and splenectomy! A Jehovas' witness who agreed to imunoglobulin therapy in the event of a significant bleed after a very very low platelet count (normally you can't transfuse any products into their blood but since the IVIg is completely synthetic..)
In total, has been very challenging but interesting and cool! I went horse riding with one of the doctors at the hospital this weekend, twas my first time and it was awesome!! so many firsts on this trip, woo!
gotta go,
take care folks!
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