Exchange report - incoming teachers
Home university: Christian Medical College, Vellore
Study programme: Medicine
Exchange programme: Linnaeus-Palme
Semester: Spring semester 2013/2014
Duration: 24
Name: Vijay T K Titus
Email address: vijaytkt@yahoo.co.in

Accommendation

The accommodation in Jagargatan 20 was excellent , ideally situated with easy access to both bus and Zinkendamm and Sodrastation. The ICA being very close was very useful and supplied most of what I needed to buy in the whole stay.The apartment was great and well furnished and had all the necessities and amenities were all there.

The maps , instructions laid out and the booklets available were all that I needed and the SL card was good as I could just jump into the bus on the first day without needing to even buy a ticket .The keys and instruction were just as perfect even to get on Sunday night .

Suggestion: Maybe towels and sheets could be given at a extra charge , though I understand that getting laundry done is the problem in Jagargatan.

Overall accomodation was fine: Grade 5/6 

Language and Culture

Though most of the teaching for medical students and those morning and 430 pm meetings including in my speciality was done in swedish , those in my sub  speciality was entirely conducted in English for which I a very grateful  for their concern for me , otherwise I would have understood very little . The Medical students also switched to English when asking me a question or discussing anything with me , and I understand that they definitely conversed faster in swedish but made that extra effort so that I could understand . I remember swedish students coming to my Institution 30 yrs were not very conversant in English and it made communication very slow . 

Having lived in Australia and USA I found swedish culture did not have a few faults that those other two cultures had .The Amercicans dont know any other country exists in this world and Australians are a little intolerant of some other cultures . It was great to experience Swedish culture of being knowledgeble , accepting and concerned of other cultures . There were obvious cultural differences but having lived in Westernised countries and being aware of European cultures obviously ensured that there were no cultural clashes .

Leisure time

There were so many social activities arranged for me that if any thing I was too busy . The in  doctor in charge of this programme  met me for coffee in the early part of my stay and invited me for lunch at the end of my stay and we a good discussion about this programme and its future and collaboration between our two institutions .

The SL card was very useful as it allowed to freely visit and travel all over Stockholm . The card being kept in the accomodation was thought ful and useful as I could get to KI on the first day itself .

My department took me out for two  dinners in one of which was in one of the best restaurants in Stockholm .Another Senior doctor who was in my Institution last year called me to his house twice for dinner and we had long discussions about work , sweden etc. One my junior sub speciality colleagues also called me home for dinner and long discussions about work life and Australia where he also worked for some time . 
Al this was out of the week ends which I kept for visting the Islands ,boat trips , city hall, Nobel museum ,  places , Museums , seeing the Stockholm half marathon and seeing as much of Stockholm in three weekends . I also made a trip to Ikea and bought as much as my luggage allowed .

 

Miscellaneous

Overall it is a excellent programme and very useful to me and I would make it very beneficial to my Institution also .Though initially I thought 3 weeks was a bit long especially being away from work so long finally there a few small things which were left out so I think the time frame is correct . It benefited  me a lot and I do hope this continues with my Institution so that we could be by extension making more changes in our country and continent .

As we dont have the resources in Asia it always good to see KI and reflect on how different approaches to tackle the same mediacal condition . Also lack of resources in our country restrain us in many ways so its good to see it done in the ideal way . It was also a good time to reflect on how my work is going and make the necessary  changes to my work . In teaching also as we fundamentally teach in a different way its great to see the KI way .

Other activities

I had the oppurtunity to discuss many research projects with my sub speciality staff and we are in the process of starting some work with at least two of them . I also met people in the non clinical departments and have initiated discussions on research projects . In general orthopaedics also I had two meetings with a person and will be probably starting some projects soon . I also discussed a project with another 
person in a area related  to my Sub speciality and have got a new assessment scale and am hoping to get something off the ground soon .

I think the future collaborations are very bright especially with my sub speciality colleagues . In fact we have even planned our next meeting in two differtent sub  speciality meetings in the next year so that we could get our research and clinical cooperative activities moving more and iron any clarifications etc .



Preparation

I had planned visited Karolinska Institutet, Sweden, in the month of Sept  2014 for the teacher exchange programme. In my Institution we have had Uppsala students for over 40 yrs and I met a Uppsala teacher on exchange from my department in 2009, but then I thought it was only from Sweden to my Institution and also met a KI teacher in 2013 with whom I got very friendly and had long discussions.

I got know of this progranmme in 2011. Having my Speciality doctors earlier in a short 3 day visit in 2010 when I came for a conference to Gothenburg, I prepared questions , doubts , clarifications etc to be asked. One the junior colleagues ( who I met briefly in 2010 ) I knew thru a mutual friend I was in constant E mail contact with him .

I did print out a few words in Swdish but could not master them and found English was good enough to communicate with everyone but one 
person in my three weeks.

Reflections

This programme has influenced me a lot ,work wise and surgically though I work in australia and have visited hospitals in USA and Italy I found work and operating techniques very different and surgical speed much faster in KI . In my speciality they work with one fundamentally different approach from the rest of the world as far as Pathology goes and it works . I hoping to work on that in my Institution also .


The registry system which which stated in sweden and the culture of evidence based medicine and followup based and result based outcome based decision on management ( which I had a little idea about ) is something I would like to improve in my Institution .As I am the first sub speciality person in my area in my Institution it was great to see what KI has done and ask doubts and pick up better techniques from KI .

Having a little free time allowed me get me upto date with my journal and book knowledge as  internet facility available for me to cross check anything I wanted from my table .

Teaching

The teaching with students was very different experience as though we have only 60 students. In India we teach in groups of 15 or so , even the combined teaching in Emergency department of nursing , physiotherapy and medical students was new to me .

Though we stated using PBL 40 yrs ago thru Uppsala teachers coming to Vellore even now it does not work as well as it works in KI , probably because our students join younger at 17 yrs and are still a little confused why they are doing medicine . Any way I was looking out for things to improve our teaching and have picked up many things , some of which I can implement right away , some more which I can start in March 2015 when a person retires . Other things need clearance from higher administrators and since one them is from department I am quite hopeful it will be at least partially  done .

It was good to see patients being asked for permission for students to examine and treat them ( we usually dont do this in our country ) and it was surprising to see a medical staff allowing students to do part of the management ( under supervision of course ) which may have resulted in a change in final management also . The individualized teaching to small number of students and a full morning session for post graduates was excellent to see and partake in .

The consultants are being assinged to teach  full time with the students from Monday to Thursday is something we will try to introduce in our Institution . Earlier we didnt have the staff for that but in the last five years we have incresed our staff and can spare one person for this 
We have to schedule it in that way . 

Teaching hours

In my three weeks and one extra day there I was lucky that two of speciality junior colleagues were assinged to teach students in my first two weeks so it was very easy to tag along with them and join in with the teaching . By the third week I knew the system well and introduced myself to the teacher and as she a little more junior and a registrar did quite a bit of teaching .On days that there was a cancelled theatre ( Tuesdays ) due to the shortage of nurses as there was no out patient I spend most of the day with a students, in fact on one Tuesday the whole day with students . In the theatre also I used to teach medical students while scrubbed up and during the long breaks in between cases .

Also as I have been doing teaching for longer than most of the teachers I was with them often I volunteered  do a lot of the teaching. I also attended a teaching sessions for Post graduates and medical students at Danderyd hospital  where the whole morning session was classes .In the second week the total hours would have been 15 hrs , the third and first were a little close to that . I found in general as the students were older than in India they were more interested and focussed in learning and there did not need spoon feeding teaching .