Trainee Exchange Programme (TEP) is going on!

Trainee Exchange Programme (TEP) is going on!

  • Issue 73

Pawel Piwowarczyk
Piwowarczyk.pawel@gmail.com

I am a Polish anaesthesiologist and I finished my specialty training in Lublin, Poland. During the Award Ceremony in London at which I received my EDAIC diploma, I saw people being rewarded with ESA scholarships in the best centres in Europe. What for many people would look like an end of a struggle with difficult exams and completion of a long specialty, to me seemed as a next opportunity to enlarge my horizon. From that moment, with the full support of Dr Czuczwar, the head of my department, I knew I wanted to apply.

One rainy November morning I received an email that my application had been approved, and next year I can pack my suitcases because I’m going to famous Papworth Hospital near Cambridge. That was the place of the UK’s first successful heart transplant in 1979, the world’s first successful heart, lung, and liver transplant in 1986, as well as Europe’s first successful heart transplant using a non-beating heart in 2015. History of cardiac surgery was written there. Papworth has been a well-established ECMO centre since 2011 (one of five in the UK). Since in my original hospital in Lublin we had already done 16 ECMO support therapies, I was largely interested in improvement of my ECMO skills and knowledge.

After a warm welcome by Dr Alain Vuylsteke, clinical director of ICU in Papworth Hospital, during my primary visit, I was looking forward to starting my exchange programme on the first of July. I was appointed by my tutor, Dr Marc Gimenez, to join the ICU team. The daily schedule started at 7 a.m. with a handover of information about patients. Every morning before the operation schedule was started there were lectures given by experienced consultants as well as Journal Club updates prepared by clinical fellows and registrars. It was an opportunity for us to refresh our knowledge on perioperative issues as well as a lesson in critical appraisal of the quality of evidence in medicine.

My colleagues in Papworth were rooted in multiple anaesthetic traditions and came to Papworth from many countries including Australia, Republic of South Africa, Canada, USA, Italy, Austria, Germany, and the Netherlands. We had an opportunity to share our experiences in stimulating  discussions. During the daily routine, every patient was thoroughly discussed in multidisciplinary team meetings and during ward rounds. I had an opportunity to see treatment of many patients with ECMO support in multiple modalities and for the first-time witness emergency VA ECMO procedure after in-hospital CPR. In operating theatres, just during one month, eleven transplants were performed, of which six were heart transplants (one DCD), four bilateral lung transplants, and one single lung transplant. Moreover, Papworth Hospital is the only centre in the UK that performs pulmonary thromboendarterectomies, so I could witness this unique procedure here.

Papworth Hospital is also a well-established educational centre with a variety of courses and workshops available. Every Wednesday focused intensive care echocardiography skills were discussed and evaluated by experienced consultants. I had the opportunity to practice during transoesophageal echocardiography workshops, as well as take part in the great Papworth ECMO course. I was very impressed with the organisational details of ECMO support in Papworth.

Many research projects are performed in Papworth in the field of cardiac surgery and intensive care. This stay was also an opportunity for me to converse with experienced researchers. Thanks to my tutor, Dr Marc Gimenez, and Mrs Jo Fowles – lead ECMO nurse, I had a chance to take part in a retrospective study on ECMO patients and improve my research skills. I can also admit that sightseeing in Cambridge was a great inspiration for research. I could experience the historic and scientific atmosphere of this city. Members of the University of Cambridge have received more Nobel Prizes than those of any other institution. Ninety-six affiliates of the University of Cambridge have been awarded the Nobel Prize in every category, including 26 in Medicine.

This stay was a unique and in many ways eye-opening experience for me. I got to meet so many young anaesthesiologists from all around the world who, apart from their knowledge, were fascinating people. I would like to thank Dr Vuylsteke for the invitation to Papworth as well as my tutor, Dr Gimenez, for all their support and interesting discussions, and sharing their knowledge and experience with me. I would like to thank the board of directors of the ESA TEP programme for creating this great opportunity for us young anaesthesiologists to gain professional experience. I would recommend that exchange programme for every trainee as well as young specialists who seek for ways to improve their clinical skills. Lastly, I would like to express my gratitude to Anny Lam, the Secretary of TEP for her patience and support.


Pawel Piwowarczyk