Exchange report - incoming students
Home university: Christian Medical College, Vellore
Study programme: Medicine
Exchange programme: INK
Semester: Spring semester 2014/2015
Name: Arunava Saha
Email address: saha.arunava100@gmail.com

Arrival and registration

Me and my batchmate, Ankita Chowdary left for Stockholm by Lufthansa airlines on the 10th of April 2015. The arrival arrangements were smooth enough. We had mailed the student pickup service so that they could send someone to pick us up from the airport and also arrange to pick up the keys to our apartments. Though we couldn’t find anyone waiting for us at Arlanda airport, we contacted them again by mail and they asked us to take the Flygbussarna to City terminalen. There, we were met by a fellow student, who guided us to our rooms in Strix and helped us to settle in. As I looked out the window, it finally sunk in. I am in Stockholm. The dream had just become real.

We met our international coordinator a day after our arrival in Stockholm. She welcomed us warmly, introduced us to the college and hospital campus, explained to us about our postings and gave us really valuable information about how to go about our life in Stockholm. Being the amazingly organised city that Stockholm is, it didn’t take us long to figure out that the only way to survive and live comfortably in this city is with discipline and punctuality.

Acommendation

The housing arrangements were perfect to the hilt. I had applied for housing through the KI housing website, and was allocated a room in the student apartment, Strix. They were single rooms, neat and clean, spacious, comfortable, and had an attached bathroom. Bed, mattresses, pillows, blankets were provided. We were asked to bring our bedsheets and linen. And the best part, they had high speed wifi with a lan connection. What more does one need in life?

Leisure time and social activities

I made acquaintance with a lot of Swedish and exchange students from other countries and it was a really fun experience to spend time with them. We went out to the various cultural programs happening almost every day at Kungstradgarden, including the Indian cultural festival, NAMASTE STOCKHOLM. It was an experience I am never going to forget. Seeing your country being represented in another country with such gala, glamour and grandeur was an extremely proud moment for me. Other times, we went to the Nobel museum, the Kulturhuset to see a concert, and the Royal palace, to name a few.  The programs organised by KI, like the Holi and the open seminars, were also very enjoying and informative at the same time. I had the best time of my life as an exchange student in Stockholm and really wish to come back here some day in the future to pursue my further studies. I did manage to sneak in a few tours to some other European countries during my stay period, mostly during the weekends, France, Germany, Switzerland, Finland and Spain being some of them! Visiting all these places I had heard off since childhood was one more dream come true!

Pre-departure

I will begin by introducing myself. I am Arunava Saha, a 3rd year MBBS student from Christian Medical College, Vellore, Tamil Nadu, India. I consider myself privileged to be part of such a renowned medical institution, and since the day I joined I have been trying my best to uphold the name it has in the global community. I had come to know about the exchange program to Sweden the very first day I set foot in this college, and I badly wanted to go for the program. After about a year and a half later, my prayer was answered as I was one of the two extremely lucky people who were selected for the exchange program to Karolinska Institutet, Stockholm. And since then, the preparations for the impending journey began.

The exchange program was a once in a lifetime opportunity for me to represent my institution in the outside world, and to explore and discover parts of the world I had never seen before. It is said that travel makes a wise man better. That was part of the incentive, no doubt! But I had aspired to participate in the exchange program not only because of the chance to travel, but also because it was an excellent platform to get an insight of the healthcare facilities in the developed world, and to compare how as a country, we are lagging behind in India. It gave me a fantastic opportunity to get acquainted with the best treatment and research facilities available in the present day.
Albert Einstein had said; “If we knew what it was we were doing, it would not be called research, would it?” Research is something which I had aspired to do since the days I joined CMC. And what better place for a research enthusiast to visit than the holy grail of cut-throat modern research- Karolinska Institutet, which
accounts for over 40% of all medical academic research conducted in Sweden. They even decide the winner of the Nobel Prize in medicine! All these factors together contributed to me choosing Karolinska Institutet as my dream destination for the exchange program.

Immediately after our selection, our exchange program coordinator gave us all the necessary information on how to go about applying for the program. We did as we were told, sending mails to our international student coordinator in KI. And we heard from her almost immediately. She gave us clear cut instructions about how to apply for the courses and accommodation, what forms to fill up, and what all documents required etc. Everything happened really smoothly and very soon we had our acceptance letters in our hands. We were even put in touch with a travel company who would arrange our flight tickets for us. We did not need any vaccination or had to bring any particular certificates of any sort for the travel. Now, the only thing to do was to wait and let the time of departure inch slowly closer.

Courses during the exchange period

DVKX01 : Medical Development in Sweden/Europe
The second month was Medical Development in Europe, the cross country course. Introductory week in Stockholm was boring; we just had one day class in a week, that too for only 2.5 hours in the morning in the Huddinge campus. The whole week I had to content myself with roaming around Stockholm. I had to make a presentation about the healthcare system in Europe along with a few other exchange students at the end of that week. In the second week, the proper course started with the arrival of students from Sweden, Kaunas and Florence. This course was mostly about the travel and the free lunches and dinners provided as part of the course, though we did have some classes in between. These classes gave us a clear insight about the healthcare system and the prevalent health problems in all these three countries. We were divided into groups and had to make presentations about specific topics allotted to us. This was our examination, after which we received a certificate of merit.
ELAXX6 : Surgery 1
I had two clinical postings during the three month period, in medicine and surgery. In both these postings, more emphasis was laid on clinical practices and skills. The other course was a more theory oriented course, ‘Medical Development In Europe’, though we did have some clinics during that also. I started off with my clinical rotation in Surgery, in Karolinska Sjukhuset, Solna. My first two weeks were in Urology, where I had the best time of my stay period in Stockholm. The doctor whom I was shadowing allowed me to scrub up for almost all the procedures he did during those two weeks. He helped me improve my clinical examination skills. He even let me do some procedures all by myself, all the time teaching me bits and pieces about urology, yet giving me more than enough time to explore Stockholm, including helping me my find my way to some of the best sight-seeing spots. He translated almost everything he communicated with the patient for me, for the entire time I was there with him, because most of that conversation took place in Swedish. By far, I would suggest sending more and more exchange students to urology in the future because it is an amazing department and the place I learnt the most. He was even kind enough to invite me and my friend over for midsummer celebration at his house. We were overwhelmed by the hospitality and love offered to us! Next I went to Gastroenterology and Trauma for the next 2 weeks of surgery. I was going around with the trauma team. It was amazing to see and know how they go about managing trauma patients, the protocol followed, the team work needed, and the coordination among doctors and other health care personnel in the management of these patients. All this increased my admiration for the system a few notches higher. Though I couldn’t do much actively during this posting, following the doctors around was an enriching experience.
ELA005 : Internal Medicine 1
The third month was in Medicine, in Sodersjukhuset. I started off my posting in the ER, where I saw a wide variety of patients coming with both major and minor emergencies, from stroke to RTAs to DVTs. I learnt about how to examine the patient, what investigations to order and their management. Next was in cardiology ward, where I learnt a lot about ECGs, arrhythmias and other cardiac complications. Finally, it was in gastroenterology ward, where patients ranged from stomach/colonic carcinoma to IBDs to even fracture femurs, as the other wards were full and couldn’t accommodate the patient. All the postings helped me to sharpen my clinical skills and definitely made me a better student than what I was. Each of the three courses was excellent in their own way. The patients I saw, the surgeries I performed and assisted, all helped to hone my skills as a doctor, and which will definitely be extremely useful in the upcoming years. The courses gave a very good birds-eye-view about the existing healthcare problems in the Scandinavian countries and their management strategies. The teaching and supervision was beyond excellence. I was there for less than 3 months; hence I didn’t participate in any Swedish language course. Even though I didn’t understand Swedish and was clueless in front of the patient, the doctors after talking to every patient translated the entire conversation for me or gave me the gist in a nutshell so that I never felt out of place. The examinations at the end of the posting also helped me to consolidate my learning and also helped me to evaluate my progress.

Summary

In our home university, the MBBS course is of 4.5 years, plus an added 1 year of internship, which is quite short and compact compared to the Swedish curriculum. Hence, the study pattern is relatively relaxed here. Also, our university still has the practice of allotting marks to individual students in an evaluation as an assessment of how they have performed, compared to here where what only matters in a test is pass or fail. Although I felt this system takes off undue burden form the student’s shoulders, it does come with its fair share of problems, one of them being; you as a student can never assess how well or how badly you have performed. But the Swedish curriculum gives ample opportunities to develop your other concurrent skills, being of a much long and easy-going variant, something which the Indian system has a long way to go before it can achieve.
The doctor patient relationship was extremely cordial and respectful. The doctor spends about 30 to 45 minutes with each patient, taking a complete history, doing clinical examination and ordering appropriate investigations. This is in sharp contrast in India, where we have about 7000 OPD patients in a day, and each doctor sees about 50 patients in a single day. So, the doctor patient interaction time naturally comes down to a maximum of 10 to 15 minutes. Secondly, the healthcare in Sweden is paid for by the government. This leads to a way more better standard of care than what can possibly be achieved in India, mostly because we have a huge population, and about 80% of them struggle to make two ends meet, let alone afford medications and investigation for treatment. Hence, we might never be able to achieve the healthcare milestones achieved by Sweden, life expectancy and quality of care being a few of them. Despite all this, Sweden does have its fair share of problems, lack of hospital beds being the most important of them. And the most astonishing part, despite having just 8 hour shifts and a forty hour week for every working personnel in the hospital, it still manages to keep going as smoothly as it can be done. This is in such a sharp contrast to India, where some doctors, mostly juniors, work about 20 hour shifts 7 days a week, and are totally deprived of their social or family life.


The Linnaeus-Palme exchange program to Karolinska Institutet marks the best period of my life I have had, and it is something I am never going to forget. It will always hold a special place in my heart, the people, the places, and the culture. I just hope that more such exchange programs are started so that more and more students can avail this opportunity, and get a taste of the big and beautiful world out there.

I would like to sign off with a quote by the famous English author, Sir Terry Pratchett, “Why do you go away? So that you can come back. So that you can see the place you came from with new eyes and extra colours. And the people there see you differently, too. Coming back to where you started is not the same as never leaving.” This same thing has happened to me. The 3 months abroad has made me realise the beauty of my motherland with renewed intensity and vigour, and I am indeed proud of belonging to such a country.

Goodbye, Stockholm. Goodbye, Sweden. Goodbye, Europe! TACK, for everything!!!

 

Language and Culture

Each of the three courses was excellent in their own way. The patients I saw, the surgeries I performed and assisted, all helped to hone my skills as a doctor, and which will definitely be extremely useful in the upcoming years. The courses gave a very good birds-eye-view about the existing healthcare problems in the Scandinavian countries and their management strategies. The teaching and supervision was beyond excellence. I was there for less than 3 months; hence I didn’t participate in any Swedish language course. Even though I didn’t understand Swedish and was clueless in front of the patient, the doctors after talking to every patient translated the entire conversation for me or gave me the gist in a nutshell so that I never felt out of place. The examinations at the end of the posting also helped me to consolidate my learning and also helped me to evaluate my progress.

Studies in general


Studies involved clinical rotations in Medicine, Surgery, and the ‘Medical Development in Europe’ course. I met a lot of exchange students in the place where I was staying, and also met some Swedish students in the hospital during the clinical postings. All of them were exceedingly friendly and welcoming. They never made me feel out of place, never made me feel left out. As I had absolutely no knowledge of Swedish, they communicated to me entirely in English. Hence, I never really missed home. It became a home away from home. The study environment was extremely chilled out. The campus was clean, green, beautiful and calm and quiet. The library was at the epicenter, with ample study and discussion rooms, computer rooms and well stacked books, journals and reference materials. With a canteen serving sumptuous food 24 hours a day, I couldn’t imagine a better place to study than that.

I found the existing student-teacher relationship to be extremely easy going and friendly, though the component of mutual respect was always present.