Another TEP (Trainees Exchange Program) Report

Another TEP (Trainees Exchange Program) Report

  • issue 81

Chief editor note:
We are pleased to go on with our tradition and publish reports on the successful ESA program, the Trainee Exchange Program (TEP), which offer our young colleagues a chance to spend some months in a well-known anaesthesia department and improve their clinical experience and skills.

Jan Jakus
I work in The National Institute of Cardiovascular Diseases, Bratislava, Slovakia.

My TEP destination was the Clinic for Anaesthesiology, Intensive Care Medicine and Pain Medicine at University Hospital Münster.

To my great joy, after two unsuccessful attempts, I have been chosen by the ESA committee and I have had a chance to be a part of the ESA Exchange Trainee Program. My destination was Műnster,  a large german city in Nordrhein Westphalian state. The city itself is unique, very environmentally and cyclist-friendly and it lies not far from the Netherlands border. Munster with its many parks and tree-lined alleys offers nice walks through the city.  Thanks to its location it was easy to organise visits to the Netherlands or other famous German cities during my free time.

University Hospital of Münster is a big hospital with two 19-floor high towers dominating its campus. It has multiple Intensive Care Units dealing with a broad spectrum of patients. I have been told the University Hospital Münster is well known amongst other hospitals in this part of Germany especially for its organ transplant program. Even during my stay, they started to use a specifically designed device for donor organ preservation during liver transplantation.

University Hospital Münster welcomes not only visitors from Europe but the whole world. Therefore I could meet some interesting colleagues from America and China to share a common interest in anaesthesia and gain knowledge of differences in anaesthesia practice in other parts of the world.

But my main and primary interest was cardiothoracic anaesthesia so I spent most of my time in cardiothoracic operating rooms.  Cardiothoracic operating rooms in Münster University Hospital, as well as other operating rooms, are extremely busy. Besides adult cardiac surgery, there is also paediatric cardiac surgery that has been worthwhile to experience too.  I could also observe endovascular cardio procedures, for example, Transcatheter Aortic Valve replacement, which is becoming more widely performed and is bringing new anaesthetic challenges.

A wide range of cardiosurgical procedures took place daily ranging from common coronary artery bypass grafts, which are the daily bread of most cardio surgery units. Quite common were also cases of valvular surgery. The unit also handles complicated cases of heart ventricular assisted device implantations, which are however due to worse than expected results becoming quite rare.  I was able to watch and learn the anaesthetic management of various cardiothoracic procedures including pre- and postoperative management of patients, management of postoperative complications, including indications for ECMO implantation. I was also able to experience and understand more closely a different healthcare system, including systems of health care insurance, management of waiting lists for various procedures, interactions with lower-level hospitals and so on.

However, the most useful part for me during my short 1-month stay was learning Transesophageal Echocardiography. Transesophageal echocardiography is something I consider a necessity for any cardio-anaesthesiologist, but at my home hospital, it is generally in the competence of cardiologists. Therefore, it was something  I wanted to practice more and get better in, which I was allowed to in Münster.

Doctors who were teaching me were knowledgeable and skilful in their field. I even have been provided with their internal guidelines as study material and their expert guidance in practical handling. My expectations to learn Transesophageal Echocardiography for the cardio-anaesthesiologist were fulfilled. Now back home, I use these skills daily and I feel how much it enriched my professional skills.

The ESA grant covered my accommodation, travel expenses and some pocket money. Thanks to this generous grant  I could afford to rent an apartment and live in Germany without any concerns so I could completely dedicate myself to work in the hospital.

In my opinion, the most valuable thing that this program can offer is being able to see how the work is done in other specialised centres and then compare it to work in the hospital at home, and hopefully bring some of the best tips into your daily practice. There are numerous tips and tricks and know-how that cannot be learned simply just from reading literature.

But there are also other benefits that Trainee Exchange Program  can provide:

Building a professional network across the countries, sharing current knowledge,  experiencing different working environments and healthcare systems,  improving language abilities and so on.

In conclusion, I would say Trainee Exchange Programme is a unique opportunity and I would like to encourage everyone who is considering to enrol in Trainee Exchange Program to take this opportunity as it is worth experience in many ways.