Despite 38 hours in transit, and very little sleep on flights, my arrival went surprisingly smoothly.  The best advice I can give to all students, irrespective of previous travel experience, is sign up for the pick-up service.  With this, you are met on arrival at the airport or T-centralen (central metro station) by another KI student who helps you to purchase an SL card (public transport card) and shows you to your accommodation.  Whilst the Stockholm public transport system is very well organised, I very much doubt I would have been able to navigate it without this help, especially in my jet-lagged state. 

Reading other elective reports, some students have clearly had problems getting into their accommodation on arrival.  Happily this did not happen to me, and the keys to my accommodation were ready and waiting for me, and my accommodation was immaculately clean.  All in all, I struggle to see how my arrival could have gone any better.

I arrived in early May, and therefore missed orientation, so am unable to offer comment regarding the introduction day etc.

Sweden, and Stockholm in particular, is battling a chronic housing shortage.  In 2016 it is estimated that there are 500,000 people in the housing queue for Stockholm.  Therefore, unless you have personal contacts in Sweden, I would strongly dissuade all exchange students from trying to find their own accommodation.  Instead apply for accommodation through KI housing, and do this as soon as your application to study has been approved to avoid missing out. 

KI housing offers a number of different accommodation options.  What you choose depends very much on finances, where you clinical rotations are (i.e. Solna versus Huddinge), how far you are prepared to commute each day, and whether you want to live in close quarters with other students.

I am an older student who works part-time. As a result my outlook regarding accommodation is likely to be a bit different to that of many other students.  I opted for a studio apartment at 7 Larsbergsvagen on the island of Lidingo.  This is one of the more pricey options at 240 kronor per night, but for this you get a newly refurbished apartment with kitchen, bathroom, and combined living room and bedroom.   The relevant tram and bus stops are within 300-500 metres, as is a large ICA supermarket.  I thoroughly enjoyed staying here.  Compared with the cost and quality of student accommodation back in New Zealand, I think 7 Larsbergsvagen was excellent value for money and of superior quality.  However, a word of caution.  The commute to Solna is approximately 55 minutes, and Larsbergsvagen 7 is much more a typical suburban apartment complex with both KI housing owned and privately owned apartments.  Therefore, if you are on a tight budget, dislike long commutes and really want to socialise 24/7 with other students, Lidingo is probably not the best option for you. 

I missed the initial orientation, as I only arrived in early May.  As a result, I was a bit out of the loop regarding social activities.  This was compounded by living on Lidingo which is well away from where most other exchange students are housed.  However, I do not feel that I was overly disadvantaged.  My advice to other students who find themselves in a similar situation, is to purchase a Lonely Plant pocket guidebook and make a conscious effort to see and do something new each day from the list of ‘top attractions’ and ‘the best of Stockholm’ sections (study permitting of course!). 

There were no Swedish students on either of my attachments, so regrettably I made no Swedish friends while in Stockholm. 

In the final year of the New Zealand medical degree, we undertake a 3 month elective.  This can be done virtually anywhere in the world.  Not surprisingly, we all look forward to this opportunity enormously, but with so many possibilities it can sometimes be difficult to make that final decision.

Sweden, and in particular Stockholm, was my preferred choice from the beginning as I had been fortunate enough to spend a week in Stockholm for a conference before commencing my medical training.  I had really enjoyed this brief visit and felt Stockholm would be an easy and enjoyable place to do my medical elective.  And then of course, Stockholm is the home of the world renowned Karolinska Institute (KI).  Even people with no background in medicine or biomedical research have heard of the KI, and for good reason.  Therefore, my decision to apply to the KI ended up being a very easy one.

The application process for New Zealand students, at least students doing medicine at University of Otago, is a two tiered process.  You cannot apply directly to the KI.  You must first submit a CV and a letter stating why you would like to study at the KI to your own clinical school.  If your initial application is successful, you can then apply online to the KI for the clinical rotations that are of interest.  It is important to keep in mind that there are only two places reserved for University of Otago medical students per year, so do spend time perfecting your covering letter and CV.  Also you will be asked to select a second choice of clinical rotation as not all students get their first choice.

Once I was selected to apply to the KI, I found the online application process was very easy and the information provided by the KI was excellent.  Moreover, the international coordinator I dealt with was incredibly helpful and responded to all my emails with astonishing speed.

New Zealand students do not need to provide evidence of their immunisation status, nor do you need a visa if you are in Sweden for less than 3 months.  However, you will need to undergo MRSA screening at Student Health on arrival at the KI, even if you have been recently screened back in New Zealand.  Therefore it is important to arrive a few days before the start of your clinical rotation.  The MRSA screening is free.

I loved my time in Stockholm and am truly sad to be leaving.  It is a beautiful and imminently liveable city, which I found to be very clean and safe.  The KI and associated hospitals provided an amazing array of high-quality learning experiences in a supportive and refreshingly non-hierarchical environment.  I would thoroughly recommend the KI to other students as a medical elective destination.  All-in-all I cannot think how my experience could be improved, and hope to find an opportunity to return to Stockholm and the KI in the future.  Thank you for the amazing memories.

Top Dos and Do Nots for future elective students

The following are things that I found made my life easier or I wish I had known before arriving

·       Do NOT bring clinical clothes with you.  Due to MRSA precautions all medical staff, including students, wear ‘scrubs’ in clinical areas.  These are provided for you on arrival. Outside clinical areas, the dress code is very causal.  T-shirts, jeans and sneakers are the norm.

·       DO bring a padlock with you, or purchase one on arrival, for the lockers in the changing rooms.

·       DO bring your student ID card from your home university.  Many top attractions in Stockholm offer student discounts but only if you have your card.

·       DO apply through KI housing for accommodation as soon as possible

·       DO NOT assume that internet in your accommodation will be WiFi, often it is modem based. If your lap top doesn’t have an Ethernet port you will need to buy an adaptor, preferably before you leave home.

·       DO bring your phone and ask at the information desk on the ground floor of Berzelius vag 3 (next to the library) for a Swedish SIM card.  All exchange students should receive this free.

·       DO arrive a few days early for MRSA screening

·       DO use SL Stockholm website to plan your commutes on public transport (there is an English version).  You can save yourself a lot of time and hassle.

Regrettably my arrival did not coincide with any of the Swedish language courses on offer. Whilst most people do speak English, it would have been nice to learn more than a few Swedish phrases.

Here also seems an appropriate place to issue another word of caution.  Do not be surprised or disappointed if the majority of patient consultations you sit in on are conducted in Swedish.  Although many, especially younger patients have excellent conversational English, most doctors prefer to take their consultations in Swedish to ensure that there are no misunderstandings.  This can be frustrating, particularly when the patient is comfortable speaking English.  However, I do understand that patient safety is paramount and most doctors do an excellent job of summarising the patient’s history and presenting complain before the patient arrives.  And, time permitting, most will also discuss the likely diagnosis and their initial treatment strategy after the consultation.

My immediate and enduring impression of Sweden is of a very egalitarian society, and this also comes through strongly in the study environment.  In New Zealand we have adopted the British model for medical education, which regrettably is very hierarchical, and by its very nature routinely results in ritual humiliation and bullying of students and junior staff.  Indeed the culture of bullying in New Zealand hospitals has recently received widespread national media attention and public condemnation.  Hopefully we can learn from our mistakes, and adopt a more Swedish outlook on medical education in the future. 

Since arriving at the KI, I have been continuingly impressed by the quality of teaching and supervision I have received.  All the doctors I have followed have been very supportive and eager to teach.  I have also, with appropriate patient consent and supervision, been allowed to do procedures such as punch biopsies.

The feedback I received on formal assessments (e.g. case presentations, essays) was always very constructive.  I was told what I had done well, and more importantly where and how I could improve for next time.  I really appreciated this non-ambiguous and helpful approach to assessment.