First week realizations

My mid morning snack today :)


So Ive been here for 1 week now and everyday I´m getting a little more comfortable! I´m finally seeing my own patients and its awesome! I spent the first 2 days more or less shadowing the docs and "interns". I was really frustrated at first because I wanted to have the same productivity and initiative that I usually have but I didnt really feel comfortable´presenting a patient with the proper medical terms, nor did i even have the slightest idea of how to use the computer system. I didn´t really get an orientation or at least a "this is how things work" talk lol. I showed up, everyone said hello and welcome, and i was just ready to go :) Im getting the hang of everything though, even the crazy confusing program they use for notes lol. I made myself a little template of the proper ways to present a patient and write a progress note, without sounding like a gringa (aka white girl) Also, its tough to understand people because they speak SOOOOOO FAST!!! I can understand 99% of spanish but when they speak so fast I just stand there like, "ummmm.....huh???" But its going really well overall.

After 3 days of taking an hour to catch a taxi, fighting wiht people over taxis, getting ripped off by taxi drivers (they like to drive in circles to charge me more because they know im not from here and have no idea where im going), and getting lost in said taxis (here you have to tell most of them exactly where to go, the address isnt really enough for the ones ive been in), I decided to walk home everyday! :)  My family told me it was pretty far but when I walked it a couple fo days ago its pretty close! Its only about a 25 minute walk at a godo pace...but it takes 40 mins for me because I take pictures of everything. Its even nicer for me because I dont mind walking through the city and I can stop and get coffe, shop, etc on the way home.

I was talking with a couple of the interns today about the differences in their school vs. ours. I´ll try to explain. They go to high school, and go straight into medical school. The medical school is 6 years, the first couple being classroom oriented, and the last years are rotating in hospitals. Then they do 1 year of internship, which also consists of rotating through all of the specialties. After internship, everyone who wants to practice medicine in Colombia MUST do 1 year of rural medicine in a small town. This is required to get liscensed in Colombia. After that year is when they can apply for residency here. SO, eventhough they dont do college, it ends up being pretty much the same amount of time spent to become a doctor, excluding residency. One huge difference here is that they have to pay for internship and residency themselves! So basically, they dont get paid until they become attendings...i found this crazy at first.  How on earth do they pay for school and residency without ever getting any type of salary or anything?? There are some ways to get loans but basically, you have to have money to become a doctor plain and simple. When I first heard this I thought: In the U.S, NOBODY (well not me anyway) would be a doctor if we had to pay our own way through med school PLUS residency!!  The difference is this: the cost of their entire training, including residency, comes out to be approximately between $80-90K. That is less than HALF of what med school costs for us!! SO, in actuality, its not that bad. I just cant imagine working for a hospital, with intern hours and the 36 hr shifts they pull here (and in the US, despite new rules limiting hours) and not gettign paid. It seems like the hospital is totally taking advantage of the interns and residents, its crazy. But that's the system. Some people love it and stay, and some get leave to the U.S or other countries.

Here are some more random things I found to be really interesting:

- Metronidazole and other heavy anti-parasitic meds are given out like water here! A parent can actually call a pediatricians office and say, "my kid has belly ache and diarrhea"...and they will give you Metronidazole without even seeing the kid. Reason: Amoebiasis is rampant here! In fact, tons of people walking around here have E. dispar (the asymptomatic amoeba). Its so common that people just go to a parmacy and by metronidazole and abendazole and use them at the first sign of a stomach ache. I just thought that was pretty interesting.

- They RARELY use CT scans in the ED. We've had at least 5 kids this week who 100% wouldve had CT scans in the U.S. to confirm appendicitis. They use ultrasound in 95% of cases in the ED. The only times they do CTs are when the surgeons demand it. Which surprisingly, itsnt very often. BUT, its possibly a good thing in peds since CTs are waaaay over used in the US and ultrasound saves the kid the radiation.

- There is one day every 3 months whare cars are prohibited and only taxis, busses, and handicap cars are allwed on the road. There a really big emphasis placed on improving the air quality, the environment, and healthy lifestyle. So, that one day every 3 months is very cool because everyone either walks, rides a bike, or takes taxi/bus. My cousin said that just 4 days per year of eliminating cars has improved the air quality by something like 20%. As cool as it sounds, I doubt the states could ever do that because its so big and spread out. Bogota is big, but everything is fairly close.

- New mom´s are give 3 MONTHS of maternity leave. I think thats pretty awesome.

Ok well, more stories to come soon!

Heres a picture