Taipei Veterans General Hospital
Due to the lack of exposure to ENT and dermatology in my 5th year, I decided to undertake electives in ENT and dermatology at Taipei Veterans General Hospital (TVGH). This was one of the largest hospitals in Taiwan closely affiliated with the medical college of Yang Ming University. As the name implies, most of the patients in the hospital were war veterans from mainland China who retreated to Taiwan in the 1940s. The hospital was very clean and beautiful. The lobby toilets were extremely clean as a cleaning lady “lives” inside the toilet and keep it clean constantly. The hospital had a large food court as well as a Starbucks, bookshop, and several convenience stores. Furthermore, it was located in the Tien-Mu District, one of the commercial hotspots. Hence there was ready access to food and shopping. It is only ten minutes’ walk away from the Shih Pai MRT station.
First, I spent two weeks in the ENT department. The department was divided into three sub-specialties: the ear, nose and throat. The ear doctors only see patients with ear complaints and so on. I divided up my two weeks so I spent approximately the same amount of time in each of the three sub-specialties. I spent time in outpatients as well as in theatre. I also attended the short ward rounds in the morning where we saw a few pre-op and post-op patients. There were also meetings which were useful to attend.
For outpatients, they saw around 100 patients a day. The doctors were therefore too busy to do much teaching and it was more of a visual experience. I wouldn't have been able to gain such as vast amount of visual exposure in such a short span of time in Sydney. However, being faced with such a huge workload, I saw how doctors were more prone to making mistakes. During my attachment to the ears department, the VS (=consultant/attending) did a myringotomy on a veteran on the wrong ear. This was because veterans speak mandarin with an accent. The VS sat to his left side and asked him which side, and he said "this side" (briefly pointing to his right side, but the VS didn’t see him do that). The way the veteran said “this side” sounded like “left side”. So the doctor punctured the left ear and suddenly the veteran jumped and said "WRONG SIDE WRONG SIDE". The doctor could have avoided that mistake if he had double checked the notes. Most of the patients who came in had petty complaints. However, the amount of patients with nasopharyngeal carcinoma was particularly striking compared with Western countries. Therefore one always has to rule out NPC in a patient with an ENT complaint.
The department had a special weekly meeting where they talked about an interesting topic related to ENT. In one meeting, they talked about “setting up your own ENT business”. In the next meeting, they invited a professional singer to teach us “how to sing well in karaoke”. They said singing was very relevant to ENT, since one needs the throat to make sound, the nose and sinuses for resonance, and the ears to keep in tune!
The next two weeks I spent in Dermatology. The daily schedule included a ten minute ward round and a general dermatology clinic in the morning and cosmetic clinic in the afternoon. I also attended some dermatology lectures with the interns. The doctors saw many patients in the general clinic, around 50-70 patients in one morning! I found dermatology very interesting and became more competent at spot diagnosing common conditions. Some of the common conditions included eczema, acne, psoriasis, scabies, fungal infections and herpes zoster. Some of the doctors quizzed me in the clinics and were quite keen to teach. In the cosmetic clinic, I learnt about some of the non-surgical cosmetic treatments, like laser treatments, chemical peels, microdermabrasion, botox, and hyaluronic acid injections.
During my electives at TVGH, I encountered some doctors who are quite interested about how medicine is like in Australia and had interesting chats with them. I also met some nice interns who helped me out and told me when the lectures were on etc. Some of the lectures were very good! I also had a friend from New Zealand doing an elective in internal medicine. Therefore I attended a few of the meetings in internal medicine when I had spare time. One of the meetings was particularly interesting because they had a very interesting case discussion where this elderly man who lived in the mountains and caught fish for food came in to hospital with abdominal pain. They kept grilling the resident doctors about differential diagnosis etc. The old man ended up a perforated ischemic small bowel. How did he get that? It turned out that he accidentally swallowed this huge fish bone which perforated his small bowel!!
Overall, I enjoyed my electives at TVGH and recommend them to those who want a relaxing visual experience. Those who are looking for a more “hands-on” elective might be disappointed.
Due to the lack of exposure to ENT and dermatology in my 5th year, I decided to undertake electives in ENT and dermatology at Taipei Veterans General Hospital (TVGH). This was one of the largest hospitals in Taiwan closely affiliated with the medical college of Yang Ming University. As the name implies, most of the patients in the hospital were war veterans from mainland China who retreated to Taiwan in the 1940s. The hospital was very clean and beautiful. The lobby toilets were extremely clean as a cleaning lady “lives” inside the toilet and keep it clean constantly. The hospital had a large food court as well as a Starbucks, bookshop, and several convenience stores. Furthermore, it was located in the Tien-Mu District, one of the commercial hotspots. Hence there was ready access to food and shopping. It is only ten minutes’ walk away from the Shih Pai MRT station.
First, I spent two weeks in the ENT department. The department was divided into three sub-specialties: the ear, nose and throat. The ear doctors only see patients with ear complaints and so on. I divided up my two weeks so I spent approximately the same amount of time in each of the three sub-specialties. I spent time in outpatients as well as in theatre. I also attended the short ward rounds in the morning where we saw a few pre-op and post-op patients. There were also meetings which were useful to attend.
For outpatients, they saw around 100 patients a day. The doctors were therefore too busy to do much teaching and it was more of a visual experience. I wouldn't have been able to gain such as vast amount of visual exposure in such a short span of time in Sydney. However, being faced with such a huge workload, I saw how doctors were more prone to making mistakes. During my attachment to the ears department, the VS (=consultant/attending) did a myringotomy on a veteran on the wrong ear. This was because veterans speak mandarin with an accent. The VS sat to his left side and asked him which side, and he said "this side" (briefly pointing to his right side, but the VS didn’t see him do that). The way the veteran said “this side” sounded like “left side”. So the doctor punctured the left ear and suddenly the veteran jumped and said "WRONG SIDE WRONG SIDE". The doctor could have avoided that mistake if he had double checked the notes. Most of the patients who came in had petty complaints. However, the amount of patients with nasopharyngeal carcinoma was particularly striking compared with Western countries. Therefore one always has to rule out NPC in a patient with an ENT complaint.
The department had a special weekly meeting where they talked about an interesting topic related to ENT. In one meeting, they talked about “setting up your own ENT business”. In the next meeting, they invited a professional singer to teach us “how to sing well in karaoke”. They said singing was very relevant to ENT, since one needs the throat to make sound, the nose and sinuses for resonance, and the ears to keep in tune!
The next two weeks I spent in Dermatology. The daily schedule included a ten minute ward round and a general dermatology clinic in the morning and cosmetic clinic in the afternoon. I also attended some dermatology lectures with the interns. The doctors saw many patients in the general clinic, around 50-70 patients in one morning! I found dermatology very interesting and became more competent at spot diagnosing common conditions. Some of the common conditions included eczema, acne, psoriasis, scabies, fungal infections and herpes zoster. Some of the doctors quizzed me in the clinics and were quite keen to teach. In the cosmetic clinic, I learnt about some of the non-surgical cosmetic treatments, like laser treatments, chemical peels, microdermabrasion, botox, and hyaluronic acid injections.
During my electives at TVGH, I encountered some doctors who are quite interested about how medicine is like in Australia and had interesting chats with them. I also met some nice interns who helped me out and told me when the lectures were on etc. Some of the lectures were very good! I also had a friend from New Zealand doing an elective in internal medicine. Therefore I attended a few of the meetings in internal medicine when I had spare time. One of the meetings was particularly interesting because they had a very interesting case discussion where this elderly man who lived in the mountains and caught fish for food came in to hospital with abdominal pain. They kept grilling the resident doctors about differential diagnosis etc. The old man ended up a perforated ischemic small bowel. How did he get that? It turned out that he accidentally swallowed this huge fish bone which perforated his small bowel!!
Overall, I enjoyed my electives at TVGH and recommend them to those who want a relaxing visual experience. Those who are looking for a more “hands-on” elective might be disappointed.
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