Arrival at KI was not a problem. I had really great communication with the registrar prior to arriving. The contact person for the Internal Medicine department that I was told to work with was on extended leave, but after working with KI, I was quickly directed to the appropriate people, which made preparations easy. I was aware of the option of having someone meet us on arrival at the airport, but did not feel that was necessary for myself. I did not arrive in time for an introduction day, so I am unable to comment on that.

I applied for accommodations with my fiancée (she was also doing a KI rotation). We were told that a room was available in Varberg about two months prior to arrival. We had made arrangements through AirBnB, but were eager to save some money and use the student housing. In our experience, the housing was located about 50 min from the Solna Campus. The Varberg building shares accommodations with non-KI individuals. The room was not completely cleaned from the previous residents. We decided to seek alternative housing, but discussed our concerns with KI housing. They were extremely helpful, had the room re-cleaned and gave us no problems with canceling our housing contract. They also did not charge us for the night we stayed in the dormitory and assured us that they would work to improve the room for future guests.

I personally did not participate in the international student social activities because I was with my significant other and we had our own travel plans for our time. I know other people who did and really enjoyed it. Tip: if you’re looking for a gym membership and do not have a Swedish ID number, Friskis and Svettis has monthly memberships and locations all over the city (the gym recommended by KI).

I really enjoyed my month. I was able to see how a different health care system functioned and see different disease management practices given system constraints and a different culture of medical practice. There is really nothing I would change other than a more streamlined housing system that takes into account that exchange students do not have the same time to become comfortable with Stockholm and could be placed closer.

Courses: I only completed a one month Internal Medicine rotation. I worked in the ED for two weeks. Due to the shift changes in the ED, I worked with different people each day, but had the opportunity to work with the same people multiple times. Depending on the patients, I was able to take histories or shadow and examine most patients. I was also able to give input into diagnostic and therapeutic plans. I spent the second two weeks on the GI service. I was bale to join the team on rounds in the mornings, joined multiple attendings in clinics (hepatology, IBD) and spent a good deal of time observing endoscopy. I also had the opportunity to learn some endoscopy technique in the simulation lab. I really liked how flexible the departments were in allowing me to do and see what interested me most and tailor my month to my interests. As an exchange student, I did not complete any formal examination.

In terms of language. Every physician I worked with spoke English. I estimate that 50% of patients spoke English. Overall, about 25% of my patient interactions were entirely in English if the patient was comfortable. Otherwise, the physician would translate periodically in patient encounters so that I knew was was going on. In addition, all teaching and medical discussion without patients was done in English. I rarely felt lost because everyone around me was speaking Swedish. I did not participate in the Swedish language courses offered.

Overall, I found that the learning environment was great at Karolinska Hospital in Solna. I worked in the ED and on the GI service and found faculty and junior doctors eager to teach and eager to work with me. Coming from an American medical school, our medical teams are more hierarchical and the learning environment is more structured as you move up the food chain. This is in contrast to KI where it was refreshing to work one on one with an attending (overlakare).