Time to talk about the reason we came to South Africa.
After getting a confirmation letter telling us we would spend 2 months at the Chris Hani Baragwanath Hospital we were expecting to do exactly that. Well... things came not like we expected. We had applied for the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) and apparently that was the place that confirmed our elective, and the lady who organised everything for us just made a mistake and wrote the wrong hospital on the confirmation letter.
So we started our elective in the CMJAH in ward 394, general surgery with a specialty of endocrine, breast and melanoma surgery. That was interesting for me, Lou, because breast surgery is part of the surgical specialty in most parts of the world, but not in Germany where it is part of gynecology. So we saw enough DCIS, FA, mastectomies and breast reductions to get a general idea. Twice a week there were great rounds where the consultants explained practically everything about each case and the students had the opportunity to ask questions.
Ok, before I continue I should explain how the south african medical education and ranking works. The medical studies last 6 years in south africa and in the last 1,5 the students spend most of their time in the wards (in which they rotate) where they have to clerk patients, examine them and drip them. They also examine patients in the clinics. They have oral and written exams every two weeks on the field they are in and by then they must have examined 30 Patients. So this is the time to get your clinical skills.
When you are done with your final exams and you get your degree you are a doctor with the title Dr.. Then you apply for your internship. The internship takes two years and at the beginning you are assigned a hospital and a group of other interns with which you will work for the next two years. In these two years you rotate every 4 months to almost every department. As an intern you do the ward jobs. You are practically a paper pusher and do all the paper job that is needed. Your shift starts at 7 am where the ward round starts and finishes at ca. 4 pm if you are not on call. If you are on call you stay the night and do your own round between 1-4 am.( I know, the poor patients!). The next day you will stay after the ward round at 7 or if it is Thursday or Friday, the surgery and breast clinic. (around 12 am). Which makes it a 29 hour shift. They usually are on call 5 times a month. I must ad that as an intern you get paid, and not very poorely for south african standards. On their calls they get to assist at the operations and even perform some basic ones (cesarean, appendectomy etc.).
When you are done with your internship you have to do a year of community service and work at hospitals that can be in a very rural place. There you can work in a field that interests you if you are lucky. When that is done you are a medical officer (MO) and either become a general practitioner or a registrar. A registrar is a doctor who is specializing in a specific field. There are not enough registrar posts for every MO so many work as MO in the clinics. They also rotate from ward to ward and are having some kind of contract for 1-2 years. As a registrar you do the rounds of the wards and in the case of general surgery you rotate in all the surgical wards learning the skills a gen. surg. needs to know. When you are on call as a reg you are on call for a whole week but you only get called in when the MO and the interns can't manage on their own. After 4 years you are aloud to have your exams if your consultants think you are ready for them. They check your knowledge at the great rounds where you as a reg present the cases and are asked many questions about them. After passing your written and oral exams no.3: Congratulations!! You are a specialized doctor! Specialized doctors are consultants and they are only under the head of department.
So as you see south africans have a very different way of doing things in comparison to the Germans and the Greeks! It took us a while to really look through the system but we made it in the end!
In the last half of our elective we were at the Trauma Casualty of the Hospital, 163. This was a very intense and lets just say a very interesting time. It is rather different than the emergency units we are used to in Germany. Patients waiting on the benches for hours, some times half a day before somebody has time to see him. Regardless if he has a broken bone or a rather minor stab wound from an assault the night before, if you are not half dead, you are waiting while paramedics pushing patients in with several gunshot wounds and the next one of the many victims of PVA, pedestrian vehicle accidents. The Taxis really drive like crazy there!
CMJAH from Zoo Lake
CMJAH still from Zoo Lake
CMJAH from the Zoo (without Lake.)
CMJAH from above (in the back)
Jacaranda next to the casualty entrance
The back of the block
That door at the back was our entrance through the med school. The person sitting at the lest is a security guard. They stand/sit in every corner of the hospital.
To the right 163. Right at the left (see what I did there?! ;p) is the casualty radiology.
The med school is right next to the hospital. That's where we spent our lunch breaks.
The students have to leave their guns at home..
Louiza wants to say "Liebe Grüße, wenn ich schon diesen ganzen scheiß Text geschrieben habe, dann will ich auch meinen Namen drunter stehen haben."
LOUIZA
The Woodstock Dam. Just like you will find Bethlehem, Virginia and Heidelberg in South Africa!
