Introduction
Honestly, I was a little apprehensive about my elective in Israel. Only a few weeks before there were confrontations in Gaza and several people were killed.
However, I need not have been worried. My elective was fantastic, and I felt safe throughout the entirety of my placement.
Hadassah Hospital is a fantastic and modern institution, it is the envy of all the hospitals I have been to and worked in.
I was scheduled to be with the Plastic Surgery team and it was a truly great learning experience. I saw third degree burns, paediatric melanotic naevus, breast reconstruction, skin cancer, bariatric surgery, cosmetic surgery – the list is endless.
The team were great, and I really felt a part of it, I attended ward rounds, theatre and clinics.
I was astounded at how modern the hospital was, the layout of the operating theatre and recovery room and the hospital itself. It really is a wonder, it even has its own shopping mall as part of it. Additionally, it was all built by donations, which was staggering and shows generosity on show.
What did I learn?
- I saw a lot of suturing, which was very useful for me. In hindsight I wish I had videoed some of this as its better than my drawings.
- I learnt about management of burns and principles of skin cancer removal and also Langers lines – in terms of making incisions
- Israel treats a lot of patients from Gaza and the West Bank
Comparison with UK
It is hard to take one hospital and apply it across the board between countries, as apparently Hadassah is one of the better hospitals in Israel.
However, there is no NHS, but patients have some form of sick fund insurance that covers all basic treatment and even some cosmetic ones. When I discussed with the staff, this insurance was very reasonable in price. If you pay more via private insurance that generally entitles you to see a more senior surgeon.
The GP system called Kupat Cholim serves like the GP system in UK, but in the GP centres they also have specialists such as dermatologists and oncologists.
Day in the life of a trainee
The trainees work incredibly hard starting daily from 7am – to sometimes 11pm. They do not seem to have any days off, because they all want to learn?
So from 7am – 4pm – is the normal rota. During this time and depending on the day there would be theatre, clinic, minor surgery or on call. After 4pm there are private surgeries and opportunities for registrars to undertake cosmetic cases under the tutelage of the consultants.
What surprised me?
- That everyone spoke Hebrew! Shock I know, but I thought there would be more English spoken. And so even though the experience was fantastic, I had to pick up a few words and also had to ask staff to explain!
- That even junior registrars would work without supervision, and that the senior registrars would act as consultants. Consultants only came for difficult or tricky cases.
- On a political aspect, hearing about both sides of the conflict was useful.
What I will take away?
That the care at Hadassah – or at least my experience of it – is first class.
Sometimes it is very easy to judge a country on the political climate, but I guess going there changes your opinion.
And I guess that applies to colleagues or patients – sometimes you may form an initial opinion, which turns out to be incorrect. I will be more open minded and try to understand patients and colleagues as a result of visiting Israel.
I will take the professionalism and skill that I saw throughout my elective into my future practise
This elective has really made me consider my initial trajectory – to undertake a career in oral and maxilla-facial surgery.
I enjoyed this placement and it has whetted my appetite for a career in surgery.
Finally
As an aside I urge anyone and everyone to visit Israel. It is a fantastic country filled with some of the warmest people I have met. Both Jerusalem and Tel Aviv are fantastic cities. I truly had a great time and will definitely visit in the future.
Israel is a country with great transport links and although my timetable was quite intense, I did get to go to the Dead Sea, visit the Old City of Jerusalem, go to the Mount of Olives, climb Massada – which was not what I was expecting – and visit Tel Aviv.
I loved the food and throughout my elective I got to taste all different types of Israeli cuisine.
A word on the people. On the whole I had a good experience, there was one experience in hospital that was unsavoury. However, it was not representative and the kindness and patience of Israelis to me cannot be understated. For example, I was in the reception of the hospital getting breakfast and I struck up a conversation with a couple who invited me to their kibbutz; and when a patient came back and asked for the surgeon who undertook the procedure and also for me (for I assisted) to give us a “thank you” card.
There were many conversations I had with Israelis about the current conflict. Even though my questions were sometimes unapologetically blunt, it helped get to the crux of the issue and I really began to understand their side and mindset. One discussion I had really stands with me, a young man was saying how I could never understand what it is like to live in constant fear of attack. And he was right, I could not, and that being the experience of living in Israel has influenced how I consider the country and people
I could continue to discuss my elective at considerable further length as I have not mentioned a considerable proportion of my trip. This has been a truly unforgettable experience both in what I learnt medically and whom I met. No doubt I will be returning to finish off my journey and visit other cities. I made many friends throughout my trip both in hospital, people on the birth-right programme and other elective students who I would like to meet again in the future. But I want to finish by thanking the Jewish Medical Association for this opportunity. I cannot thank them enough for this opportunity. It goes without saying I would (and have) recommend it to everyone, both Jewish and non-Jewish.
Olutusen Onafowokan
Manchester