Students’ elective abroad demonstrates ‘medicine is truly a universal language’

Whoever said an elective abroad study programme should be all work and no play?

For two sixth-year University of Cape Town (UCT) Bachelor of Medicine and Bachelor of Surgery (MBChB) students, it was everything – an enriching, transformative experience that taught them so much about their beloved field of medicine. It was also an opportunity to see and experience the beauty of the world, its people and places, and make some lasting relationships in the process.

Late last year, Vukosi Baloyi and Aya Agboola packed their suitcases to board a flight to Austria for an elective at the Medical University of Graz – an opportunity awarded to some of the top students with the finest academic records in UCT’s Faculty of Health Sciences. Both concurred that the trip exceeded every expectation and proved to be an experience of a lifetime.

Since they’ve returned to sunny South Africa from a frosty, winter wonderland in Graz, UCT News sat down with Baloyi and Agboola for some insight into their experience and learnings.

Niémah Davids (ND): Tell us a bit about this elective.

Vukosi Baloyi (VB): I am currently in my clinical years of medical training. So, this elective was a purely clinical traineeship. I was placed at the University Hospital Graz, which is directly affiliated with the university, and spent my time between the Haematology Inpatient ward, as well as the Outpatient Department.

Aya Agboola (AA): Like Vukosi, I am in my clinical years of medical training and for this elective I too was based at the University Hospital. This enriching experience expanded my global outlook on medicine and reinforced my commitment to contributing to a stronger South African healthcare system.

ND: How would you describe your experience?

VB: Eye-opening, life-changing and incredibly enriching. This elective gave me an opportunity to explore the field of haematology meticulously. This was most valuable as medical students in South Africa engage with this subject matter minimally in undergraduate training.

“It was fascinating to see how a different country practises medicine and compare it to our South Africa public health system.”

It was fascinating to see how a different country practises medicine and compare it to our South African public health system. During my nine weeks there, I learned a great deaI. I was exposed to diverse cultures and gained a deeper appreciation for South Africa’s healthcare system. One of the most interesting aspects of my time was realising how well our South African medical curriculum prepares students for global medical practice. Our training is comprehensive and covers both medical and surgical disciplines extensively. This experience reinforced my appreciation for UCT’s medical programme and demonstrated that medicine is truly a universal language.

AA: This was a once-in-a-lifetime opportunity and broadened my perspective on healthcare systems and cultures outside of South Africa. I was exposed to different cultures, new ways of thinking and gained invaluable medical and surgical knowledge and experience. I now understand how factors like language, healthcare infrastructure and medical protocols shape patient care. This elective also gave me a deep appreciation for South Africa’s resourcefulness, adaptability, resilience and healthcare professionals’ clinical decision-making.

ND: Describe a typical day “at the office”.

VB: My day started with a 15-minute walk to the hospital. While public transport was an option, it was safe and easy to get around Graz with a stroll. Once I reached the hospital, we started with a haematology team meeting. What followed was patient reviews, and during this time, we examined them, assessed their progress and obtained blood samples. We’d then analyse these results and discuss the findings with consultant doctors, professors and other members of the multidisciplinary team to optimise treatment plans. Thereafter, we proceeded to carry out various procedures like blood transfusions, administering chemotherapy, as well as blood smears and ultrasounds.

I also participated in specialised procedures like extracorporeal photopheresis and bone marrow biopsies and I had the opportunity to observe, assist, and perform aspects of these procedures under supervision. Teaching was also an integral part of the experience, and I attended regular seminars and case presentations. I presented cases on patients I had reviewed and contributed to discussions while gaining valuable feedback from experts.

My second rotation was spent in the Haematology Outpatient Department. There I encountered a wide range of haematological conditions such as bleeding disorders and other complex blood-related illnesses.

“I also spent some time observing and learning from endovascular procedures in the angiology catheterisation laboratory.”

AA: I was fortunate enough to complete electives in two departments: The Division of Plastic Aesthetic and Reconstructive Surgery and the Division of Angiology. In Plastic Surgery, the day started with a morning meeting during which we discussed the previous days’ theatre cases and presented the cases for the new day. Students would then choose the cases they wanted to assist on (one student was allocated to each operating room) and we’d spend the rest of the day in theatre (unless otherwise required).

Similarly, in Angiology, we’d start with a morning meeting, followed by a ward round and spend the rest of the day consulting with patients. I spent most of my time in the Outpatient Department rotating between the peripheral vascular disease, venous disease and thrombosis and vasculitis clinics. I engaged with a wide range of vascular conditions, gaining exposure to their diagnosis, management, and treatment approaches in an ambulatory setting. I also spent some time observing and learning from endovascular procedures in the angiology catheterisation laboratory, which deepened my understanding of the definitive management of vascular conditions, including minimally invasive treatment options and interventional techniques.

ND: What was your biggest learning?

VB: I gained a deeper understanding of how they develop individualised treatment plans for haematology patients, while strongly considering home circumstances, contextual factors and the latest medical research. This experience broadened by perspective on patient-centred care.

AA: I learned that healthcare delivery is shaped by resources, culture and the structure of the healthcare system. I was exposed to new approaches to patient care, surgical techniques and clinical decision-making in a highly resourced setting. This made me reflect on the barriers we face in under-resourced South Africa and challenged me to consider how I would adapt the knowledge I learned in our setting.

ND: What are some of the differences you observed between the Austrian health system and that of South Africa?

VB: The Austrian health system is very different to ours. It is well-resourced with universal health insurance access, which ensures that all citizens have access to medical care. Hospitals are well-staffed and boast advanced, state-of-the-art equipment. For example, in my unit, a ward of about 15 patients was managed by at least two professors or senior doctors, and two registrars (specialist doctors in training), so responsibility is evenly divided.

AA: Austria has a universal health system which residents and European Union citizens can access for free with an e-card. Most citizens make use of state healthcare because it covers all medically necessary services and medications. People only really use private healthcare to access procedures outside the already comprehensive list of state-issued healthcare services. Austrian public hospitals are well-staffed, and our elective site boasted a very low nurse-to-patient ratio. This was also the case in the general medical and surgical wards. They also have liberal access to diagnostic modalities and routinely do a complete blood workup for all patients, regardless of the presenting complaint, as well as chest X-rays (for all patients excluding children and pregnant people). This is quite different to the selective use of investigations in South Africa, which are guided by the patient’s symptoms and clinical presentation due to resource constraints.

ND: What kind of challenges would you say they face?

VB: From a student’s perspective, medical education in South Africa is more student-centric and students are actively involved in patient care. In Austria, I felt that medical students had less direct patient interaction compared to what we experience here.

AA: Austria has an aging population, and this contributes to their high burden of chronic diseases like cardiovascular disease and diabetes. This increases the demand for long-term care and specialised services, which places pressure on healthcare facilities.

ND: From the list of things that they do well, what will count in our favour if implemented here?

“They make extensive use of a digital medical record system, which ensures efficient and streamlined patient care.”

VB: They make extensive use of a digital medical records system, which ensures efficient and streamlined patient care. This is something we could greatly benefit from.

AA: The hospitals are digitalised and makes sparing use of paper-based records. This makes it easy to access all patients’ medical records and helps coordinate the delivery of healthcare services as patient medical history, investigations and treatment plans are readily accessible across different healthcare providers in different settings.

ND: There must be a few things that they can learn from us too?

VB: Absolutely. Our medical curriculum provides much broader exposure to multiple disciplines and prepares students to be well-rounded doctors, rather than to push early specialisation. South Africa’s medical students also receive more hands-on clinical exposure, which enhances their practical skills and confidence with managing patients independently. Austria can definitely do better in this regard.

AA: South African healthcare professionals are well-versed in the art of resourcefulness, especially in clinical decision-making. We rely on clinical judgement and targeted investigations and order tests based on necessity rather than routine. This optimises cost and maintains high-quality and comprehensive patient care. The Austrian healthcare system could definitely benefit from taking a more cost-conscious and efficient approach without compromising outcomes.

ND: I’m sure this elective wasn’t all work and no play. What else did you get up to?

VB: Definitely not. Aya joined me on this elective, and we made it our mission to a visit a different country or city every weekend. We visited Germany, Spain, Slovenia, Italy, Croatia and France and built a solid friendship during our time. It was wonderful being in Europe over the Christmas season and we got to experience their famous Christmas markets and snow for the first time. It was such a treat. It was an unforgettable experience.

AA: Vukosi and I made every effort to explore Graz and Europe to the fullest. We visited a different city every weekend, ensuring that each trip was meaningful and enlightening. We took walking tours, learned about the history and culture of each country, visited famous landmarks, and immersed ourselves in the local experience by trying traditional foods and learning key words and phrases in each language, making our travels even more enriching.

ND: Any new friendships formed?

VB: I met students and academics from different parts of the world, including Austria, Greece, Australia and Chile. I hope to maintain these connections as I progress in my medical career.

“We shared our cultures with each other, as well as our experience of healthcare and medical training in our home countries.”

AA: I formed many wonderful friendships with students from all over the world. We shared our cultures with each other, as well as our experiences of healthcare and medical training in our home countries. I will cherish the lifelong friendships made during this experience the most.