I began my elective in a rather rainy Sydney at the beginning of June in the department of Geriatrics at the Royal Prince Alfred Hospital. I worked primarily in the high turnover Geriatric Medical Admissions Unit which was a fantastic opportunity to see a wide variety of common presenting complaints. The department was large, modern and well-staffed by a dedicated multi-disciplinary team, which allowed a high level of patient care. I was particularly impressed that, despite a 48 hour time-limit on Medical Admission Unit stays, patients always had a comprehensive plan for the continuation of their care in place before they were discharged from the unit. I had not anticipated that I would encounter significant communication issues in an English speaking country; however, as Australia is relatively young country, many of the elderly population are immigrants and do not speak English. Particularly in Sydney, suburbs are often populated by specific ethnic groups who have maintained native-language speaking communities so we were frequently reliant on family members as translators – which is far from ideal.

The Jewish community in Sydney were very welcoming and I was able to attend a Shabbaton in the beautiful Blue Mountains during my trip. I was also able to reconnect with friends I had met in Israel on my gap year who showed me around the city and ensured that I had hospitality for Shabbat. I was also fortunate that, after my initial housing arrangements fell through, I was able to stay with a lovely local Jewish family who I met through connections with my synagogue at home.

In July I moved to the department of Infectious Diseases at the Royal Melbourne Hospital for the second half of my elective. In contrast to my geriatrics placement, I was mostly based in out-patients as the department holds clinics for the whole state of Victoria and is therefore very busy! The department holds clinics dedicated specifically to HIV, TB, Hepatitis and Travel Medicine as well as general infectious diseases sessions and clinics for refugees. All of the patients at the refugee clinic had been ‘picked up’ through immigration health screening with a variety of infectious diseases, particularly latent TB and hepatitis B, often at an advanced stage, and many had no idea that they had been carrying these illnesses for years. It was also very interesting for me to see tropical diseases that are rarely seen in the UK, such as Dengue Fever. I was fortunate to be able to stay with a friend from my gap year in Israel and then another friend I knew through volunteering at Limmud so I felt very much part of the community and get a true insight into the Jewish life in Melbourne.

I am very grateful to the JMA for their bursary which helped to make my elective possible.

Joanna Ish-Horowicz
Newcastle