Electives are an integral part of medical education, but choosing and organising an elective can be a major source of stress for students. For this reason I am doing a series on electives of various specialties and cities. (Technically, this series began more than a year ago with Nabeela’s post). If you are student in healthcare and would like to do a guest post about your elective, feel free to contact me.
Today I am so excited to talk to Lin, a South African medical student about to enter her sixth year. She did her elective in Plastic Surgery in public and private hospitals in Cape Town. Her school allows a four week elective period at the end of the fourth year and the middle of fifth year, and she has also had an elective in Radiology. Lin is a sparkling personality who is incredibly passionate about every rotation, and I am so honoured that she agreed to this post!
1: Before your elective, what was your experience with Plastic Surgery in Medical School?
Extremely limited, I had one lecture on wounds and healing patterns and two tutorials before my elective, none of which included anything practical.
2: Why did you decide to do plastic surgery for your elective?
In Grade 11 I was up late one night flipping through the channels on TV. I eventually settled on Dr. 90210. During this episode they went to Mexico with the Hirsche Smile Foundation and offered free reconstructive surgery to one of the poorer communities there. There was a little girl with a nasal deformity who was lucky enough to receive surgery during this mission. After seeing herself in a mirror post-operatively she said that she hopes her mother in heaven is proud of her. To see a child whose deformity has affected her life so much that her only concern was making her deceased mom proud of her appearance, immediately brought me to tears. I woke up the next morning and told my mom that I wanted to become a plastic surgeon. I fell in love with medicine that evening and I never looked back.
Since I started medical school I knew I wanted to do an elective in Plastic and Reconstructive Surgery. I decided to save it until 5th year as I thought that would be the year I needed to feel inspired the most.
3: Was it difficult to organize a site and supervisor for this elective?
My elective was relatively easy to organise. I contacted the Prof in Plastic Surgery at the University of Cape Town at the beginning of 2013 and asked if I would be able to spread my elective between Groote Schuur Hospital and Red Cross War Memorial Children’s Hospital. He agreed to allow me to spend two weeks at Groote Schuur and one week at Red Cross. I then went to the Stellenbosch University Plastic Surgery Department and asked them to recommend a private plastic surgeon who would be willing to have me observe for a week. They recommended Dr van Deventer who has his private rooms next to Louis Leipoldt Hospital. This was also very easy to organise as he is very keen to have students observing; he absolutely loves teaching.
4. Which skills and knowledge did you gain through this elective? Was the elective enjoyable, and which aspects of it were the most enjoyable?
I didn’t set out to learn much on this elective, I just wanted to see every aspect of the field of Plastic and Reconstructive surgery. I was completely surprised with how much I actually leaned. Plastic surgery, like every surgical discipline, is based on basic anatomy and like the majority of medical students, my knowledge of anatomy needs a lot of work. This elective was a wonderful refresher of the basics. I also didn’t realize how closely dermatology and plastic surgery are linked. It was also great practical exposure to dermatological malignancies. I spend quite a bit of time in maxillofacial surgery. This was really wonderful because we don’t get much exposure to this at medical school. I always felt like this was a ‘dentist’s territory’ as I have never seen any maxfax surgery before.
Being in theatre was the highlight of my elective. In four weeks I saw 48 surgeries and assisted with 30, as I was not allowed to assist in private practice. This was just amazing to see. Every surgery was different and each more skillful than the last. It was just incredible. I was allowed to prepare and give the local anaesthetic for some of the hand surgeries I assisted with and I was allowed to do the fat grafting for an operation. The most fascinating operation I saw was a free flap for a base of mouth squamous cell carcinoma. We used part of the patient’s fibula to replace the jaw that had been attacked by the cancer. It took six hours, but it was just incredible. The days were long and extremely busy, but I loved every second of elective. I didn’t want to leave in the end.
5. For which kind of medical student would you recommend an elective in Plastic Surgery?
Any medical student who has an interest in surgery, dermatology or anatomy and anyone who would like to see something different to what they learn at medical school.
6. Do you think a sound knowledge of plastics is important for a future general practitioner, or only for certain prospective specialists? Which aspects of Plastic Surgery do you think need more emphasis in our medical training?
I really wish more emphasis would be put on Plastic Surgery in our training. Many of the surgeons on my elective expressed that they feel most doctors outside the field of Plastic Surgery think that it is limited to what they see on TV. The field is far greater than that. We are given a wound and healing lecture as well as a lecture on flaps and grafts during our 3rd year, but I did not understand exactly what they were referring to until my elective when I got to see how wounds heal and the scarring that can occur and assisted with skin grafts and flaps in theatre.
I think it would be an asset to our training to spend some time seeing the practical aspects of the field, just to improve our basic understanding. This will help with GP referrals as well as cater for students who have a keen interest in the field.
7. Can you tell me a bit more about the experience with Operation Smile?
This year I was fortunate enough to be one of the founding members of Operation Smile Tygerberg Society. We became the biggest society on campus with over 200 members. Our aim is to raise awareness and funds for Operation Smile South Africa. As my entire career was directed by a mission similar to those done by Operation Smile, I have always had a special spot in my heart for this organisation. After an incredibly successful year, raising about ZAR10 000 for this organization I was lucky enough to be asked to join the student team on their mission to Mbombela in November. This mission was life-changing. I met the most amazing team from around the world, we brought new smiles to 34 wonderful patients, and I spent time going to the local schools, including a farm school and a school for mentally and physically disabled children where I taught them basic healthcare and hygiene skills. I would encourage anyone with a passion for helping people to apply to go on one of these missions. It is the most amazing experience you will ever have in your life; it is food for the soul.
My dream has always been to work with Operation Smile and I am so grateful that I have been able to be involved with them so early in my career. This mission has left me so inspired and motivated to finish my degree and continue following my dream of becoming a plastic surgeon, so that years from now I will go on one of these missions and be able to use my skill to create more beautiful smiles.
For anyone interested in getting involved with Operation Smile South Africa visit: www.operationsmile.org.za