Recently, I was fortunate enough to travel to Istanbul. Istanbul’s extensive history, rich culture and uniqueness in being a crossing point between Asia and Europe, were what attracted me to this city. The north-west of Turkey shares a border with Bulgaria, this also happens to be Bulgaria’s shortest border. So when I saw an opportunity to visit yet another country which borders Bulgaria I leapt at the opportunity.
Turkey is a country with a colourful past. Istanbul, Turkey’s biggest city although no longer its capital today, was once the capital of the Byzantine (Roman) Empire, known as Constantinople during this time. Its salience continued into the Ottoman Empire which came to an end in the 18th century and in 1923 when the Turkish Republic was declared.
Here is a short photo diary of my stay!
Istanbul is not a city to be missed! It truly has something for everyone, from its more historical side in the Sultanahmet area, to the vibrant area of Taksim Square. You can also choose to visit the eastern side by taking one of the many ferries which leave hourly, marvelling at the spectacular views as you do so.
I started this blog back in 2017 to give those people who were slightly skeptical about studying abroad, particularly in Bulgaria, some insight into what it’s really like to study here.
As some of you might already know medicine is a six-year long course in Bulgaria, compared to the standard five years in the UK. In Bulgaria, the course the is split into two years of theoretical study and four years of clinical practice alongside the never-ending theory. Having made it into my fourth year, I am now in my clinical years of study and thought it would be useful for those interested in this topic to share my experience.
So how hands on is the clinical practice really?
Truth be told, when I started in first year I had much higher expectations in regards to how much clinical work I would be doing when and if I finally made it into the fourth year. However, the reality is slightly different, clinical work consists of shadowing a doctor in his or her speciality e.g cardiology as they teaches you the basics, the more complicated and how to avoid the easy to make mistakes. You are usually allocated a patient for whom you are responsible, you must take their patient history, and determine through your set of skills what might be the matter with your patient. Your professor usually a specialist in their field, will then evaluate what you have discerned through questioning and inspection of the patient. They will quiz you on the reasoning behind your diagnosis and in my opinion, this is the most effective way to learn.
What if I haven’t learnt Bulgarian by the time I am in my clinical years?
This was probably my biggest concern in the build up to my clinical years. However, I soon realised that despite not being fully fluent I would still be able to cope. I set off by learning basic phrases which are required to take patient history and then by learning the most common answers. I also went about learning the organs of the body, and some other key phrases, such as, ‘I have a sharp/dull pain’. It is also uplifting to know that several patients do in fact speak English, and in the worst case scenario the doctor whom you are shadowing will step in to translate.
Do you know enough by your 3rd year to start clinical practice?
One thing I have come to realise during my time studying medicine, is that you are constantly learning and building upon your knowledge. The body although it is composed of several organs and systems, each of them with their own function, are intricately inked. Therefore, when you learn something in relation to one part of the body you can link it to another, your knowledge overlaps and you know more than you think. Through my own experience, I believe that the key to being prepared for your clinical years is having the confidence in yourself to make these links and trusting your judgement in doing so. This being said, your decisions should be backed up by logical reasoning.
Will I my clinical years leave me well equipped to go directly into FY2?
The answer to this question is not so black and white as one would hope. On one hand, studying in Bulgaria gives you exposure to a variety of medical cases that you might not see in the UK. It also gives you an insight on how to assess and treat your patients under the burden of a much more restricted budget, and sometimes limited resources. This teaches you how to work more effectively and efficiently, an invaluable lesson, which more likely than not you would not benefit from whilst studying in the UK. It is however, a consequence of this that I personally do not think it would be wise to enter directly into FY2. Hospitals in Bulgaria do not work by ‘NHS guidelines’ and thus getting used to an entirely different medical system whilst being new to the job would not be an advisable decision to make.
What sort of things do you get to see?
During only my two years of clinical practice I have seen a range of medical cases, from the less extreme to those requiring immediate attention. During most practicals we observe patients in a stable condition, suffering from conditions such as bronchial asthma, psoriasis and neuralgia. However, as our teachers are themselves practising doctors, if one of their patients requires immediate attention and care whilst we happen to be in the hospital, we have the opportunity to observe these situations first hand. The most recent and memorable are an emergency ENT surgery to remove a malignant tumour from the right nostril, or a 68-year-old man undergoing defibrillation to shock his heart back into its normal rhythm.
If anyone is looking to study in Bulgaria or is currently studying here, I hope this post was useful. If you would like me to touch upon any specific topics, please let me know!
Waking up to the sharp shrill of my alarm clock at 6AM does not invoke the most pleasant of emotions within me. I roll over and burrow my face further into my pillow, as though doing so will take me far away from the endless check list of things to do today. As the realisation dawns that this is nothing more than mere procrastination, I haphazardly rise from the haven that is my bed and trudge through the cold, into the shower.
As the individual beads of water make their way distally towards the tiled floor, they accelerate losing their parallel flow and merge to form the puddle in which I stand. I absent-mindedly forego the essential components of my bathing routine, my mind meanwhile is planning which jumper might most suit my recent purchase, a pair of beige corduroy trousers.
As I stand before the mirror, I run my fingers through my tangled hair whilst using my right hand to swing my back-pack onto my vacant shoulder. It fits snugly into place, causing my shoulders to hunch slightly, as they accommodate to the weight. I slot my earphones into place and find myself soothed by the mellow notes of todays soundtrack. Perhaps today won’t be so bad.
Time races ahead and as usual I find myself adjust somewhere half way between a jog and a fast-paced walk. As the cars stop at the traffic lights I take my cue to cross the road and enter the hospital in front of me. I make an immediate left towards the cloak room, where a young girl no older than six is perched on her father’s lap. Her head leaning limply against his chest, her skin flushed by invading infection in her body. I laugh inwardly. I reminisce at the naivity that is so obvious in her demeanour, she believes her father to be her saviour, her doctor a miracle maker.
Stethoscope draped around the neck of my scrubs, I once again walk past the little girl towards the lifts. I watch her eyes attentively follow me down the corridor. I feel an inner relief that her perception of the truth, her fantasy, will not be distorted anytime soon. As the lift doors part and I step into the ward, I leave behind me the invention of her innocence.
I head straight for Marie’s room. Will she I wonder, still be here today? Sure enough lost somewhere within the sheets she is bundled up shivering. It takes one look into her hollow eyes, her frail frame, the bruising decorating her thin paper-like skin, to know that her body will not and can not support her any longer. The sharp contrast between both the young girls perception and the harsh reality leave me subdued. Time however is not my friend, without the luxury to dwell on this moment I move onto the next patient.