Dr Nicolas Leister
I am a 2nd-year Specialist from the University Hospital of Cologne, Germany, and an ESA Trainee Exchange Programme Participant 2018.
Already during my Preliminary Visit in April 2018, Dr Andrea Szekely had taken good care of me and showed me the advantages of a fellowship in Budapest. I was able to visit the Department for Paediatric Cardioanaesthesiology of the Center of Children’s Cardiology, Gottsegen, and the Department of Cardioanaesthesiology of Semmelweis University. All kinds of paediatric heart surgery, including transplants and assist devices, are offered at the Gottsegen Hospital. The heart surgeons of Semmelweis University transplant more than 50 hearts each year. My university clinic does significantly fewer adult heart transplants and performs no heart transplants in children.
I started out from Cologne at the beginning of August for my 3-month stay as part of the Trainee Exchange Programme in Budapest. My expectations were high and 3 months later I was not disappointed. I hoped to expand my skills in Transoesophageal Echocardiography and deepen my knowledge in Paediatric Cardioanaesthesia. I had some misgivings about my rudimentary knowledge of the Hungarian language. However, these were smashed quite quickly, as I was welcomed in an eerily friendly and caring way. With German and English, comprehensive communication with my colleagues was possible. I improved my Hungarian knowledge by regularly visiting the language school in Budapest.
From day one, I was able to participate in all the anaesthesias performed and, for the most part, carry them out independently. The anaesthesiology and the surgical colleagues in both hospitals tried very hard to bring the respective operation and its implementation closer to me. At any time it was possible for me to look at the operational situs and get a detailed explanation on the respective surgical progress. I was particularly impressed by the routine of the heart transplant performance. Every day I was able to accompany the rounds at the intensive care unit and also actively participate. In doing so, I was able to observe how decisions were made in an interdisciplinary manner without obeying large hierarchies.
The management of heart-assist devices in the paediatric patients was very interesting. The staff roster at the Children’s Cardiology Centre seemed to me to be very desirable (2 weeks each in the operating theatre, in the intensive care unit, and catheter laboratory), as it allowed me to experience the entire clinical course of the patients. It offered colleagues a varied field of work and they seemed to be happy with their working conditions. Longer intervals are common in Germany, which sometimes restricts the view of the entire course of the disease.
In particular, I remember the flat hierarchies and the interdisciplinary rounds, which I believe are very efficient, as well as individual case reviews. In this way, colleagues were able to anticipate problems and significantly increase the safety of patients by informing all participants.
My expectations for the Trainee Exchange Programme were exceeded, which was largely made possible by the commitment of my colleagues. My special thanks go to Dr Andrea Szekely, who, through her knowledge and tireless commitment, helped to make the exchange a medically and humanly unforgettable experience.