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Clinical Electives in Pakistan

AKU, SKMCH , SIUT and PIC are considered the best hospitals to opt for when considering electives in Pakistan.
Read up on the reviews and decide which one might suit you best!





Hospital : Aga Khan University Hospital, Karachi
Specialty : Obs n Gynae
Elective student : Amna Khalil , King Edward Medical University, Lahore



Application and fee

You will find everything you need to know on 
https://www.aku.edu/

The form for this year's clinical electives in as follows:
https://www.aku.edu/mcpk/Documents/elective-application-national.pdf

AKU conducts electives all year around, just be sure to apply two months in advance!
I was fortunate to be accepted for an elective placement in the speciality of my choice but in the application form you apply in order of preference, so if your merit doesnt fall into your speciality of choice, they will place you into your second option, choose wisely!
There is a mere Rs.2000 application fee and then a processing fee of another Rs.2000, and thats that.

Accomodation
You can apply for accomodation and it is at a very reasonable Rs.15,000 for a month in either the on-campus or the off-campus hostels.
I was adjusted in one of the off-campus hostels, which are fully furnished, with attached baths and a tv room and a kitchen on each floor and ironing, washing and pick n drop facilities around the clock.

Afternoons at hostel


Daily routine 
You basically rotate with the consultant you get assigned to.
On our first day, we were given a basic orientation of the hospital and sent off to our respective specialities where we recieved our schedules for the month.
I had clinic almost everyday, expect for Wednesday which was elective OR day and the day usually started off with morning rounds, followed by either morning, afternoon, or evening consulting clinic and then I was free to go to labour room if I wanted or just relax and head to the pool.
Weekends are off but since I was super enthusiastic about the whole thing, I would go to clinic on Saturdays as well.
The students, the faculty, the staff , everyone was super friendly and helpful and none of my queries would ever go unentertained.

Clinical experience
My experience was extremely stimulating and it has almost made me seriously consider pursuing a career in Obs and Gynae , which is the specialty I did my clinical electives in.
I had plenty of time to  brush up on my  history-taking skills as we would see almost 20 - 25 patients in the clinic everyday and then the best part was following some of those cases to the very end Post-op days.
Other than history taking , I would perform PVs and speculum examinations routinely, take HVS samples and pap smears.
Its amazing as you get a lot of practice in terms of what labs n radiology investigations to send for and when and then interpreting the results in both antenatal follow ups and gynae cases.
But my favorite gadget was the sonic aid and the highlight of the day was making moms-to-be listen to the heartbeat of their babies, absolutely miraculous!

I also had the opportunity to observe and wash up on a number of procedures like numerous cases of LSCS, EnC , insertion of IUCD, Hysterectomy, Hysteroscopy and endometrial biopsies , laparotomies including a very interesting case of  bilateral ovarian cysts!


Counselling
At AKU, patient counselling is at its finest and I learned a lot in terms of how to patiently counsel and explain to the patients what was happening to them and why and discussing what options they had.
 It was a stark contrast from government hospitals as the pateints at AKU were inquisitive and almost authoriatiave about the treatment and had already read up a lot on their conditions! 
Each consultant had their own way of counselling, some would draw doodles, some would explain it in detail, and I tried to absorb as much as I could.

Tuitioning during the elective
In between clinics, or afterwards there were plenty of opportunities to discuss the cases that presented and their management and differentials.
With my consultant, the amazing Dr.Azra Amerjee
Also my consultant would give me topics to read up on after every clinic which we would discuss subsequently e.g I distinctly remember a case in which there was evidence of ARPKD on the fetal anomaly scan and I spent hours in the paediatric nephrology section to read up on its mortality, so it was invigorative studying and i really enjoyed that.





Perks lalalala
The elective card around your neck gives you access to the library and the doctor's cafetaria and you can pay and utilize the sports facilities whenever.

Iftari for two

I am a water fanatic and the one thing I fell head over heels for was the pool and thats where I spent almost all of my Sundays so yes! a great place to head to , to relax.

 The library is pretty amazing; a little too well air-conditioned, with a great assortment of books , and comfy well lit corners to hide in ; it served well as my hideout spot for the month.

My spot

Also, AKU has seminars and workshops going on around the year, we ourselves were lucky enough to catch a CME Seminar on neurology, neurosurgery and psychiatry and listen to the expertise talk about the subject and earn ACCME credit hours as well.


An inspirational experience
All in all I would highly recommend an elective at AKU ,it is an excellent learning experience and a potentially rewarding time for anyone willing to throw themselves in.

AKU nights 
By the end of the month you will be walking out with an evaluation form, an LOR from your consultant and if you are lucky a number of credit hours but most importantly a lot of experience and some great memories and new friends!

Hospital : Sindh Institute Of Urology and Transplantation, Karachi
Elective student : Sumbul Andleeb, Sindh Medical College

Application and fees


Application procedure is pretty simple .
All u have to do is write an application and attach NIC with it . 
But you have to submit it at least 12 months before , they get a lot of applications and they select on first come first served basis.

Clinical Experience

It was an experience of a life time. Everyone from the janitors to the senior doctors were super helpful and nice. From day one we were treated as doctors and not students. We were given the opportunity to run the OPDs  and be the first assistant in surgeries. It was an exhilarating experience.
Our lack of experience and knowledge never came in the way of their teaching.Daily we were rotated in different wards and were assigned a mentor for the day ,who would ask us questions about stuff we already knew and teach us about the cases he was dealing with. I learned a lot and not just the medical stuff but also about empathy and  human suffering. 







Personally,I think every medical student should do electives or some sort of volunteer work in SIUT.
It will change your perspective about medicine and life ,in general.
The environment is so positive and the chance to meet the most humble person you will ever meet in your life Dr. Adeeb Rizvi should not be missed. 


Hospital : Shaukat Khanum Memorial Cancer Hospital , Lahore
Elective student : Fatima Qamar , King Edward Medical University, Lahore


Application and fees
SKMCH has limited slots. So apply a good few months in advance. It's always preferable to apply in those months when fewer applications are received, like Ramazan for instance.
You've to be in final year for a clinical elective.
For research and other basic sciences you can apply in 3rd or 4th yr.
Application is available online.
Contact their HR coordinator, Novaira Syed. You can reach her via phone or meet her in person. Weekend is off for the HR people so go on any other weekday. Ask her for available slots and only then get a bank draft made. It's Rs.1500/-

Accomodation
SKMCH&RC offers on-site accommodation to elective students.

Clinical Experience
You can rotate for 2 weeks to a month. The thing about electives is, you always have to step up your game.
You ought to have some background knowledge, it leaves a good impression.
You can come early to attend ward rounds although the schedule they provided me mentioned only the OT and clinics. They also had case discussion meetings on days when clinics were short.
The system is amazing and up to date.


All patient information i.e. history is typed directly on to the computer and all previous histories and lab tests etc were accessed the same way.
 I had a lot of fun, scrubbed in on quite a few surgeries.

 Perks

Self service cafe! It is pretty good.
There is a lake around to enjoy and sometimes you can run into celebs haha!( I met Inzi bhai)


With the legend himself
 Also, the FRIENDS cafe is just across the road.
You get to access the library too.

Overall rating

I'd score it a 7/10 mainly because this was my first elective and I was unaware how to go about it.
Remember the key : Step up!
The doctors there did appreciate my work as I got to scrub in otherwise they admitted themselves that more often than not, students aren't given such opportunities.
Therefore, plan your month well.

Hospital : Aga Khan University Hospital, Karachi
Specialty : General Surgery
Elective student : Fatima Qamar , King Edward Medical University, Lahore



Some pointers :

You can do an elective at AKU ONLY ONCE so choose well and prefer the clinical one and wait for it till final year.
Both AKU and SKMCH require you to completely change your clothes. They provide the scrubs themselves.
The first thing to do before it all is to get into the ward's whatsapp group, that's how the residents keep in touch with you.
 It helps to have a friend along though, even if you're rotating in other specialty.




AKU evenings




Daily Routine and Clinical Experience : 

This is an elective I thoroughly enjoyed. It was a great experience overall, from learning to the student-patient interaction as well as student-consultant interaction.
They allot you a consultant themselves and my consultant was a colorectal surgeon.
 So my schedule was something like this :

Monday- Clinic + Grand round ( this was a scary thing, basically all consultants, residents, HOs and students of the ward sat in one room.
2 people gave a case presentation that was thoroughly discussed.
 It was a smashing critique but great learning too. I also presented twice. )






Tuesday/Wednesday- rounds
Your consultant expects you to clerk her patients.
Like, at any time, 3-4 students are under one consultant. They could be phase 1s (3rd yr) or phase 3s (final year). Divide amongst yourselves and ensure you get at least one patient.  Then it's your job to take history and examine the patient.
Their pattern is a but different but not impossible to learn. Also, they rely on lab reports a lot. So once you're done with the history & exam , type the patient's MR (registration )number onto their computer system. (You need a login for their remote desktop connection, sahl. Request a PG or student to lend you their username and password.)
 Go to investigations and note relevant tests.
So after the residents round where you had to know what their next step in management and plan was, and your own clerking, the consultant came around 9 or 10 and did a round. That's when you're supposed to present a patient to her.








Thursday- OR
OT's can last till 4pm to 9pm, starting from 9am., depends on your consultant.
(The system at both AKU and SKMCH is via valid IDs. Elective students have temporary ones that dont work so often you'll find yourself standing in doorways waiting for someone else to let you have access.)
Friday - Clinic
My consultant had a double clinic.
Every patient who registered, their private file was extracted from the hospital.
 And a stack of unattended files were placed at a counter.
We used to pick one, the staff called the patient and we took them to a room to take history and then examine subsequently along with reading the labs.
Clinics were my favorite.
Calls
Since I was living with some relatives, night stay sounded scary.
Emergency nights
But they had a female lounge to crash for the night ,it was carpetted, air conditioned, locked with a passcode. (Ask any student to give you that.)
Emergency worked the same way , the consultant again expects you to have a patient or two clerked because many are admitted later. But they don't keep a close check on you on calls. And therefore I'm guilty of admitting to play tennis on one of my calls.
 Weekends were off.
Evening tennis



Hospital : Punjab Institute of Cardiology , Lahore
Elective Student : Ayesha Shahid , King Edward Medical University, Lahore

Application and fees

You will find all the relevant detail at :

pic.punjab.gov.pk/electives

Take a form from PIC from Maam Afshan and fill it , attach all docs with it including NOC / bonafide.
Jot down due dates on which you want to do electives.
Apply earlier to ensure your registration.

Daily Routine

It mainly started from summer vacations day 1 and was of 14 days duration with Sundays off.
Timing was 9a.m onwards until you get your attendance signed.

Clinical Experience 

You go around in OPDs,  Paeds block, male/ female block, Emergency, and Labs.
No OT.

In OPDs we observed follow up cases mainly .
I observed cases of STEMI ,NSTEMI ,HEART BLOCK, AR, HYPERDYNAMIC CIRCULATION MR, RHD ,IHD, CONSTRICTIVE CARDIOMYOPATHY , DRUG INDUCED BRADYCARDIA.

Other than that we learnt to interpret ECG and observed labs like ECG, ECHO ,THALLIUM SCAN, STRESS TEST ,ANGIOGRAPHY, ANGIOPLASTY, ETT e.t.c and learned about their indications, contraindications and pre requisites.


Overall 

It was a good experience and I think that the best time to do electives in PIC is in final year when you have sound bases.
And those who are interested in cardiology ,electives are best for them as you can revise your CVS system easily!

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