During my residency, I worked in a lot of different places, since my hospital does not have all the specialties I need to learn. Every time I moved, I tried to temper my expectations and regard everything I gained as a bonus. I was just hoping to get some new skills in regional anaesthesia at Cork University Hospital (CUH), good enough to apply them in my home hospital when I got back. However, I can tell you that this experience exceeded my expectations by magnitudes.
I learned new ways of doing things, as in medicine nothing is certain. I managed difficult emergent cases and I am sure that I am a better anaesthetist now than I was before. I may also add that I have never worked with so many nationalities; there were people from a variety of countries (Ireland, Hungary, Spain, Germany, Egypt, Pakistan, India, Philippines, Canada, South Africa), cultures, and religions. It is incredible how much you can learn if you see the world from a different perspective.
This exchange programme gave me the opportunity to learn ultrasound guided nerve blocks and to be able to use them for anaesthesia in difficult cases, like patients with chronic obstructive pulmonary disease and heart failure, in order to avoid general anaesthesia or opioid use. I ascertained that music can be helpful when dealing with anxious patients and that if you can take your time every nervous patient is able go through surgery without general anaesthesia. I would totally recommend this host centre to other applicants. The conditions offered are ideal for training and teaching because patients are usually sent for in a timely manner, there is an actual physical space for performing blocks (called the “block room”), and there is always someone available to teach. I guarantee that any fellow would be proficient in ultrasound guided nerve blocks after this exchange; however this job is hard work and one should not expect it to be easy.
All the professionals at CUH are friendly and helpful. You can tell that they really want you to have a good time while you are there. I can add that I will miss them and I made some really good friends while in the Republic of Ireland. Comparing to my hospital, CUH is much larger, has more specialities, and is connected to a university. The practise of anaesthesia is a bit different as well.
There were some issues I struggled with at the beginning, such as the lack of a nurse dedicated to anaesthesia, the fact that the Consultant Anaesthetist is responsible for more than one theatre, and intravenous drug preparation and administration is exclusively the responsibility of the anaesthetist. You can tell from these that you have many more opportunities to do different things and learn to work in a totally different way. In my hospital, we do not have a “block room” and I think having one would ensure performing more procedures in a single day. In addition, it gives trainees more time to learn the skills. I believe that after this exchange I can treat my patients better and teach some of my new skills to my colleagues back home.