Ospedale Policlinico San Martino – Genova, Italy
September 1 to November 30, 2019
Having trained in anaesthetics and intensive care in a small country, I always intended to spend some time abroad to extend my experience, learn new techniques and see how things can be done differently. To this end, I applied to participate for the ESA Trainee Exchange Program, a program which organises attachments in European centres of excellence for a period of up to three months. Moreover, this is fully-funded by the European Society of Anaesthesiology, and I was sure not having to deal with the taxman in a new country would make the transition much easier!
I was thrilled to be selected and given a placement at the Ospedale Policlinico San Martino in Genoa, Italy, and my host was none other than Professor Paolo Pelosi.
My reaction to the news was a mix of excitement and apprehension, which I think is normal. I was particularly looking forward to attending a hospital organised differently to my own, with a larger caseload and where patients are offered more treatment options.
Now it was time to organise the familiarisation visit. Prof. Pelosi welcomed me and showed me around both the university department and the intensive care unit and I was immediately impressed with the layout, the organisation and the scientific activity that goes on. We agreed on a program for my time there and arranged the dates of my stay. Everything was set.
I arrived in Genoa at the end of August and started attending the intensive care unit straightaway. I spent my first month in the ICU. The day would start off with the night and day teams discussing all patients, going over the history, their management, progress and further treatment required. Then each doctor would be assigned a few patients to examine, present the case to a senior intensivist and together formulate a plan. Here I had the opportunity to learn particularly on the care of the critically ill trauma patient, neuro-intensive-care and lung-protective ventilation strategies.
I attended the ORL and head and neck operating theatre for the subsequent two months. I chose this subspecialty of anaesthesiology because the practice is very varied, both in terms of patient characteristics and surgeries completed, and allows the anaesthesiologist to become proficient in the management of the difficult airway. During this time, I had the opportunity to participate in the care of patients undergoing complex and extensive surgeries, laser surgery, and surgery requiring the use of jet ventilation. In fact, I had the opportunity to discuss, learn and use this ventilation technique and other advanced airway equipment which I was not as familiar with. Additionally, I gained a better insight into total intravenous anaesthesia, which is fast becoming a technique of choice in many settings, and I learnt about drug agents not yet available at home, especially different sedatives, analgesics and medications to modulate blood pressure. I also had the opportunity to observe highly sophisticated surgical equipment, including navigation systems and robotic-assisted devices.
During my time at the San Martino, I also dedicated some time to research, in which I participated in a project involving several teams working in different university hospitals. It gave me an insight into how modern medical research works, especially the extensive professional networks involved and how increasingly important advanced computer software has become in analysing data and coming up with meaningful results. I also attended multidisciplinary meetings at the ICU, journal clubs organised for trainees and industry exhibitions at the hospital.
I must add Genoa is a very nice place to stay: close to the sea with a quaint historic centre, many opulent palaces, multiple attractions and food to die for.
The ESA TEP was an enriching and learning experience which I would highly recommend. Leaving your home hospital to work and observe other working environments is always an excellent way of broadening your knowledge, understanding and networking, and ultimately, becoming better clinicians.