Exchange report - incoming teachers
Home university: Addis Ababa University
Study programme: Medicine
Exchange programme: Linnaeus-Palme
Semester: Autumn semester 2015/2016
Duration: 24
Name: FEKADESILASSIE MOGES
Email address: fshsim@yahoo.com

Accommendation

My accommodation was arranged through the International coordinator's office and my apartment was booked through Karolinska Institutet Housing AB. I signed and sent the rental agreement via an e-mail. The standard of the apartment is good.

Language and Culture

The course was conducted in English. But I have heard that sometimes the communication may be Swedish language especially if everyone in the class speaks Swedish. Some lecture notes (power point presentations) and some case discussions in the seminars were prepared in Swedish which could have created a language barrier, but those materials were translated to English by students and the teachers and discussions were conducted in English. The Swedish Culture was not significantly different from my previous experiences and I haven't encountered cultural clashes.

Leisure time

Dinner had been arranged for me in two different occasions by Prof Lars Smedman (he covered the expenses him self personally) and I was also invited for lunch by Dr Magnus Nilsson (the first day I arrived at the Hospital and I was introduced to his colleagues in the department during the lunch time). I also had Lunch with Anna Dahlerus (International coordinator, Faculty Office and International Relations, and Karin Forslund (International Coordinator, Educational Support Office) and that created a chance to discuss on various interesting ideas.

I had also the opportunity to visit the city with my friends and family from Ethiopia and with Prof Lars Smedman.

Miscellaneous

The Teacher Exchange program was a great opportunity to look in to our similarities and differences in our teaching approaches. It also gave me the opportunity to look in to the Technological advances employed in improving the operating techniques. It also gave me the opportunity to meet up with experts in various fields of surgery and in creating communication between us which could potentially grow in to further cooperation and collaboration in teaching, research and other relevant projects.

Other activities

During my stay I had the opportunity to visit also Karolinska University Hospital Solna at two different occasions and I had the opportunity to assist in one case of Endo-luminal stent placement for a patient with Abdominal Aortic Aneurism and during my 2nd visit I had observed Thoracoscopic left upper lobectomy. Both were great opportunities for me to learn from experts in the field.

After a discussion with colleagues from the Upper GI surgery unit here in KI, we are considering a possibility of conducting a trial at Black Lion Hospital in patients who will be operated for Esophageal Cancer.

I had also the opportunity to attend the Nobel Lectures at the beautiful Aula Medical  by the three winners of the 2015 G.C. Nobel prize in Medicine or Physiology and that was a big honor and opportunity for me.

Preparation

I came to know about the programe through Prof Lars Smedman and I accepted the invitation to be an exchange teacher. The expenses for my visit was covered by the Linnaeus-Palme exchange program. However, I have covered the cost for processing my visa at the Swedish Embassy in Ethiopia. Since the language for the course was in English, I was not supposed to study the Swedish language. Vaccination was not also required.

Reflections

The teaching learning activity in KI is student friendly and the teacher-student relation ship is exemplary. Students freely communicate with their teachers and this intimacy is vital for the teaching activity. I would like to work hard with my colleagues to improve teacher-student relationship in our department. I would like to incorporate patient oriented seminars in our teaching activities as well. We should also further strengthen both the faculty and student exchange program in the years ahead. 

Teaching

The teaching activities at KI are good, specially the small number of students in a group gives an opportunity to closely follow students and understand their weaknesses and strengths. The teacher- student relationship is excellent. There are similarities and differences in our teaching methodologies.

Similarities
  1. Conducting seminars and lectures - though we give lectures for one hour every day (Monday to Friday from 8:00 am to 9:00 am in the morning for a period of 6 months (2 times/week in the 1st semester and 3 times/week in the 2nd semester alternating with the department of internal medicine)
  2. Teaching rounds: In my center we have 2 teaching Grand rounds per week (from 9:00 am to 12;30 pm) and many people participate in the rounds. these includes Consultants, Residents, Interns, Medical students and Ward nurses. Students will divide patients admitted in the wards and they are supposed to clerk their respective patients and they will present their patients when required. 
  3. Patients are assisted in preparing them for their examination. The skills center is used to that effect here in KI and consultants also get involved in the process, which is also similar in my center except that we use real patients for the discussion.
Differences
  1. We conduct bedside teachings in a selected patient. I haven't seen bed side teachings here.
  2. We have about 10-15 students in a group, at KI only 3 students are in a group.
  3. Lectures are given here on Fridays the whole day. 
  4. Here in KI I have noticed that students have radiology lectures while they are in surgery. In my center they have a separate radiology attachment. However, some important images relevant to surgery will be discussed to them by the Surgeons during the surgical attachment. 
  5. In my center, each student is supposed to present one seminar (on selected topics in surgery) organised in a group of 4 during their attachment. I haven't encountered similar activities here. However, I have participated in the Evidence Based Medicine (EBM) presentation by students here in KI and that is an excellent addition. Presentations on research works are lacking in my institution.
  6. Students are given a chance for hands of training in skills like removal of a nevus in the presence of a consultant which we lack in my center. Instead we try to train our students on basic surgical skills at our skills lab for one week when they come for their 2nd attachment in our department (as a final year medical students)
  7. The teaching experience is student friendly here in KI, for example students are allowed to have something to eat and drink (like coffee and snacks) while discussions are going on while this kinds of activities are not encouraged in my center.
  8. KI has a well organised skills center which creates an opportunity to train students on basic skills to students which are difficult to train using real patients. Though we have developed a new skills center recently, we are not frequently utilizing it.
  9. The clinical examination here in KI is OSCE. We haven't yet started OSCE exams for our undergraduate students. We conduct exams using real patients (one long case and three short cases) for every candidate and VIVA examination in the afternoon.
  10. We implement Preceptor-ship programs with a small group of students - by assigning one teacher for a group of 4 to 5 students and the preceptor would be responsible to assist those students through out their attachment. One of the responsibility of the preceptor would be to correct case reports submitted by his/her students in the Group.

Teaching hours

It is difficult for me to comment on this issues, specially it is difficult for me to indicate the number of hours spent in the different activities. However,  I have managed to participate in three different seminars which were based on case discussions. These includes seminar on gall bladder diseases, dysphagia and Urologic seminars. The seminars were conducted in small Groups (group of 3 students except for the urology seminar in which larger number of the class participated). I have also participated in one round at the ward during which only one medical student was present. During two of the Fridays, I attended the lectures given (the whole day) and one week there was Evidence Based Medicine (EBM) presentation by the students. I had also participated two lectures at the department of radiology given for two different group of students which was case oriented. I had also participated at the outpatient clinic where we assisted 4 medical students to remove a nevus from three patients, and that was done in the morning. In addition we had also conducted a revision at the skills center so as the students would be ready for their practical examination. The skills revision was conducted for one day.

I have also been participating in different operations at Karolinska University Hospital Huddinge, particularly on Esophageal (with minimally invasive technique), Gastric, Hepatic and Pancreatic Surgeries. In addition, I gave two different lectures during my stay.
  1. "Experience from Black Lion teaching hospital, Addis-Ababa, Ethiopia'. This lecture was given for one hour for the medical students taking the course. Different patients (cases) treated at Black Lion Hospital were discussed. The lecture was also attended by Prof Lars Henningsohn (who is the director of the course) and Prof Lars Smedman.
  2. "Global Health, the Ethiopian Perspective". this lecture was given to Global Health students and it was organised by the Department of Public Health, KI