Back in Better Form and with a Renewed Interest

Arya Assar, a 4th-year student of General Medicine, spent his summer internship in Kazan, Russia. He sends us pictures and an essay about his experiences.

It was early July at my placement back home in England, where I introduced myself to a Russian doctor and told him I would be travelling to Russia in August on a professional exchange. It only took 5 minutes until he was reeling off a long list of situations to avoid, that I started doubting my decision to accept Russia as my internship! Maybe it wasn't the wisest destination after all, I wanted exposure but also to return home safely!

To say I was apprehensive would be an understatement. Regardless, I convinced myself, visa stamped in and tickets bought – I had no way back!

So, on a surprisingly warm English Summer day my brother dropped me at the airport and I flew to Moscow. It was here that I actually saw how widely the FINA World Championships 2015 were marketed in Russia and my anticipation, peaked. It is also from Domodedovo Airport where, after a seven hour wait, without hindrance I flew another 800 km due East to Kazan, the capital of the Republic of Tatarstan. Although British Airways, this final leg was a code share flight with the notorious Siberian S7 airlines and the aeroplane certainly did fit the bill: long in the tooth with cabin signage in six different languages. Regardless, I was sufficiently tired by this point and safety was blurring into a minor concern and sleep paramount!

On arrival, our baggage was delivered promptly and my contact person greeted me at arrivals. My Russian adventure had started and home was a cool 3400 km away. Excited and nervous to say the least, asking myself over and over: who will be my roommate, where will we be housed, what will the hospital be like, and the Doctors welcoming? Tiredness was really showing as we drove to the flat I was to be staying at for the duration of the SCOPE Exchange, as I eventually fell asleep, in the car! Finally though, we had arrived at Gazovaya Street and I met my flat mate Richard, who was interestingly studying at Charles University in Pilsen. I hurriedly unpacked, to the promise of a quick tour de Kazan from Richard who had arrived a day earlier – although I was desperately still, in need of some decent sleep.

At first glance, Kazan, a city of 1.2 million inhabitants was imposing due to the vast layout of the city and grand buildings. However Kazan pleasantly reminded me of Prague – this reverberated throughout my stay – in many aspects of life, and not just similar population sizes. So my first day was over after an extended walk and a wallet almost 30 Euros lighter but a with a monthly travelcard to hand. My bed although awkwardly situated in the living room of our pokey flat, was a welcome sight and I slept to wake up to a sunny day in Kazan.

Today, I would be going to meet my tutor. A cardiovascular surgeon: Dr Murat, at the ultra modern and prestigious ICDC (Interregional Clinical and Diagnostic Centre) Hospital. What a kind, intelligent and welcoming professional – of whom I cannot sing enough praise. The department's main focus was Valvular disease specialising in replacements and repair, with plentiful CABGs naturally. They say first impressions are important, so I think that – since Dr. Murat said that ‘He was glad I was well educated enough to make this month and further discussions together very pleasant’ – I had made a good one. This was pleasing to hear so early on, in a foreign country, hospital and department. Furthermore I guess, such a compliment is a feather in the proverbial cap of my faculty: 2nd Medical Faculty Motol, Charles University in Prague where I study and attests to the quality to which we are examined.

Every morning from there on in, I was in the Cardiac daily multidisciplinary meetings of cardiac surgeons, cardiologists, perfusionists, anaesthetists and nursing staff discussing the day's lists. The department also had Grand rounds of the wards every Thursday morning, which I was also invited to participate in, an offer I gladly accepted. This was engaging and interesting to examine and especially to auscultate the variety of patients either recently admitted or in various post-operative states.

I was allowed to assist in surgeries and enjoyed this thoroughly because it helps in my learning process when I'm actively involved. With Dr. Murat on my case about how, it is after all, Summer, I should curb my enthusiasm for the field to appreciate the beauty Kazan had to offer, we cut a deal. If I stayed until late afternoon to satisfy my hunger for time in surgery, I would then leave and make the most of the evenings dining and the visiting the cultural attractions of Kazan. So I set a course to attend the majority, if not all of the social extracurricular events organised by TAMSA (the IFMSA organisation of Tatarstan).

On the weekends we visited many different places including Bolgar, a place of rich history and the origin from which Danube Bulgaria was established around 679 AD. As a keen reader of history, I was glad we could visit.

Another weekend, we also visited the Blue Lakes where we swam in three and four degree spring water rising from the ground, continuously maintaining its' near icy misdemeanour. Admittedly, in the following weeks I went back twice more, with a couple of my pals from the exchange to test our endurance, repeatedly bathing in the terrible cold.

One evening we arranged to see a Tatar play about a difficult romance which was highly amusing, especially with the hilarious, slightly lacking in content version that was translated into English through headphones by the theatrical production team to our seats.

The evenings in Kazan were always filled with laughter, with good company and over plentiful food and drinks. As a group, the August Incomings were praised by the TAMSA team as fun, unique and impressive.

I also had the opportunity to visit general surgery in the Republican Clinical Hospital (RCH) – an expansive hospital, just South of the city, which was a lot more chaotic than ICDC. Matched with an equally chaotic emergency theatre complex serving the city of Kazan. Cases would enter continuously, into an operating room where two patients would be operated on, side-by-side. This was a real eye opener and an unforgettable one at that. The temperature was scorching but the skill of the surgeons unfaltering. I found myself in esteemed company at RCH as well because my supervising surgeon here was only recently awarded the prestigious ‘Calling of Russia – Best Surgeon in Russia Award’ in 2014 presented to him by Dmitry Medvedev.

The main purpose of my visit to Kazan was to gain more clinical experience in a completely different environment to what I was accustomed to in Europe – and now I can confidently say my expectations were surpassed and I have returned in better form and with a renewed interest with which to commence my fifth year of Medical School.

In conclusion, I certainly made a few friendships that I will cherish for a long time and hope to visit Russia again.

I would like to thank IFMSA CZ especially Drahomir Kolenčik, the whole TAMSA Team especially NORE Ellina and NEO Alina, and last but not least my parents without which all of this would not have been possible.

Arya sends also a link to an article about his internship in a local newspaper, visit here.