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Hey guys,

I recently completed an international elective in Alexandria, Egypt, and thought I'd share my experience with you.

First off, I specifically wanted to do an elective in Alexandria (as opposed to Cairo) because I have family in Alexandria, and it's a much nicer, relaxed atmosphere as when compared to Cairo (it's like comparing a resort city to downtown New York, with it's hustle & bustle). The ONLY program I could find that had connections in Alexandria was George Washington University: http://www.gwumc.edu/imp/education/intlclinic.cfm (with a listing of their international sites here: http://www.gwumc.edu/imp/education/isgws.cfm).

As you can see, they have Peds, Neuro, OB/GYN, and Ortho as available rotations. I chose Ortho since I'm going in Surgery, so I figured I'd do something with as much surgery in it as possible.

The GW staff took the time to answer all my questions and put me in contact w/ the ppl I need to be in contact w/ in Egypt to get everything situated. So a big thank you to them (esp. Ms. Dobbs :)). Also, GW requires a $500 application fee (payable only if you qualify and are accepted) for all NON-GW students (I presume it's free if you go to GW). All expenses (living, food, flight, etc) are on you, although I heard from the fellow US student who went with me that his school has a little-known allowance/reimbursement policy for those choosing to do international electives...so visit your local Student Affairs Office and find out if you can get reimbursed for your costs abroad!

We were assigned to El-Hadara Hospital, which is the primary Orthopedic and Trauma hopsital in Alexandria (throughout the rest of the world, Traumatology is a subdivision of Ortho, not Gen Surg, as it is here in the US). We were the first exchange students they ever had, so they were still learning along the way. But I must say, they went WELL overboard to ensure everything was taken care of as best as possible.

- We had a contact (the son of the Chair of the hospital) who answered all of our questions prior to us arriving to Egypt, including arranging a hotel (for about $10/day, a very nice one, with an excellent view of the beach, in the very heart of Alexandria... Al-Raml).
- We had someone ready to pick us up from the Airport
- Almost every day, transportation to and from the hospital was provided by one of the doctors
- Some of the doctors even took us on tours of certain highlights in Alexandria during the week
- We ROUTINELY had doctors, Head Departments, Chairs, and the Chair of the hospital meet with us to ensure everything was ok, we were being treated well, the accommodations were ok, we were seeing & learning enough, and that basically that everything was going smoothly.

So in short, hospitality is a very strong point. Nothing to be worried about here.

As for the hospital experience itself, if any of you are gung-ho about doing Orthopedics, THIS IS THE ROTATION FOR YOU. See, El-Hadara is a government-subsizided hospital (ie like a "County" hospital), so all the ppl who can't afford to pay for their medical expenses come to this hospital. As a result, you see an INCREDIBLE amount of super late presentations as well as quite complex injuries. The one thing I can *guarantee* you'll get from this rotation is exposure (and depending on your experience & confidence) possibly even some experience in managing these extremely complex and often rare presentations. I saw late bilateral ostesarcomas, a few disease processes I still can't remember the name of (had never heard of it before), giant cell tumors, floating knees and floating elbows (rare stuff for you orthopods), Talipes equinovarus, etc etc. There's also a bunch of very complex pelvic and long-bone fractures (tons of car vs. pedestrian accidents due to ppl attempting to cross the Corneish Street, which is essentially a 8 - 10 lane highway on the coast), as well as your Colles' & humeral fractures, IM nailing, ex-fixing, DCS, DHS, etc etc...basically the bread & butter of Ortho. In short, you'll get to see EVERYTHING.

If that wasn't enough, you'll get to assist and participate in reductions, fixations, splinting, casting, clinic, and essentially making the best with what you have...we're talking some of the simplest and most cost-effective solutions to the health problems they see. Bottom line, the hospital isn't exactly well-funded, so if all you're concerned with is the prim & proper environment, with the most up-to-date, expensive equipment, this place is NOT for you. BUT, if you wanna really get your hands dirty and get IMMENSE exposure to stuff you probably won't even see until your 3rd or 4th year into your residency, this IS the place for you.

Also, plz don't mistake second rate finances w/ second rate medicine. One of the doctors I spent a good deal of time with had just returned from Germany, specializing in Arthroscopy, specifically Shoulder Arthroscopy - which to my understanding is still quite a relatively new technique. And they also have another doctor who is THE pelvic fracture guy...he LOVES handling them, no matter how complex. And another guy specializes in the Al-Nizaar External Fixators (dunno what they're called here; the elaborate and huge circumferential structures that surround a limb with a ton of fixators, essentially building a complete frame around the limb). And I saw very skillful joint replacements, ACL & rotator cuff repairs laparoscopically, etc. The head of Trauma there is rated as the best Trauma doc in all of Alexandria. And most of the Orthopods that work at El-Hadara also work at the fancy-shmancy up-town well-funded hospitals. So you're still working with the best docs & brightest minds...in fact, I'd say it takes more smarts and skill to still bring about positive results with less funding and sub-par equipment & supplies. I think you get the point ;)

The doctors are all SUPER warn and welcoming. In fact, they made sure whenever others were talking, they spoke in English (although this is a country where the primary language is Arabic, they are taught the sciences in English). So much so, that we got to attend 2 large conferences between Cairo, Alexandria, Tanta, and a few other cities in Egypt, and they made sure ALL the presentations were done in English, simply out of respect for myself and the other US student with me.

The residents are SUPER cool too. They literally live in the hospital, and love to ask questions about America, medicine in America, etc... They're very warm and friendly, and invite you to come and join them in Trauma Call, the Reduction rooms, surgeries, the whole 9.

Ummm...I don't think there's much left to say. All in all, although I spent a little bit more time in the hospital than I had anticipated (until I told 'em we need some time off to relax and sight-see etc, to which they happily obliged), I had an EXCELLENT time, and I learned an ENORMOUS amount about Ortho, as well as many basic principles & procedures.

If I left something out, or if anyone has any questions or concerns, plz feel free to ask, and I'll do my best to answer 'em. I definitely STRONGLY recommend this rotation to any and all who are interested in learning as well as visiting a very friendly nation with an enormous amount of history and points of interest to visit, and I'm sure you guys won't forget the experience anytime soon ;)

PS: For those who are serious about going, if you want to go on any tours in Cairo or Alex, let me know; we found an AWESOME tour guide for a VERY reasonable price, that'll take you on a personal tour (no group; just you and whoever is with you), transportation included.

PPS: I didn't address cultural norms/values/etc when visiting Egypt because that's not specific to this program; that's more general/broad, to be aware when you're visiting any country overseas...but I'd be happy to answer any questions/concerns about that too.
 

Archer

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Thanks so much for writing this! It was really intriguing and someplace I had never thought about going for a rotation.
 

MSHell

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...Al-Nizaar External Fixators...
I thought they were Ilizarov External Fixators.

Your experience sounds fantastic. I had never thought of doing an elective there.
 
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Glad you guys found it useful.

And MSHell, you're right, they're called Ilizarov External Fixators. I didn't see it written anywhere; I was going on what it sounded like haha. Sorry; I'm not an ortho guy!
 

MSHell

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I hate ortho. I hate myself more for remembering this crap!
 
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Hahaha. To each his own, I guess.
 

Darksmurf

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The ONLY program I could find that had connections in Alexandria was George Washington University.The GW staff took the time to answer all my questions and put me in contact w/ the ppl I need to be in contact w/ in Egypt to get everything situated. So a big thank you to them (esp. Ms. Dobbs :)). Also, GW requires a $500 application fee (payable only if you qualify and are accepted) for all NON-GW students (I presume it's free if you go to GW).
Thank you for posting about your experience: very helpful to the rest of us.

One question: could you describe how you originally got into contact with GW about the program and what the application process was like?

Thanks,

DS
 

travoltage

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you think thats cool? rotate through barts and the london...ull be treating members of the royal family :D
 
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Thank you for posting about your experience: very helpful to the rest of us.
NP :)

One question: could you describe how you originally got into contact with GW about the program and what the application process was like?

Thanks,

DS
Sure! I think this is the application form I had to submit: http://www.gwumc.edu/imp/downloads/ICEPApp_Intl_Students_08.pdf, some of which must be completed by your school's Dean. Also, as it says at the bottom of the application, you'll need to supply them w/ your Curriculum Vitae; Personal Statement outlining goals and objectives; Two Letters of Recommendation; Letter of Good Standing and Unofficial Transcripts. So depending on your school, some of those documents could take a while to get. So I'd start early.

For me, that was pretty much all it took, as I had already spoken w/ their International Department for quite a bit prior to this, so they knew my application was coming. A bit later I got an email confirming that I was accepted (unless you're doing poorly and you're not in good standing w/ your med school, I don't see why you wouldn't be accepted), and I had to provide 'em w/ some info & documents (passport, etc) to get the process moving along.
 

ralphjan1

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Hello, FDNewbie
Ran across your interesting May post on Alexandria. Could you let me have your Alexandria guide's contact info as my wife and I are docking there in January.
Thanks,
ralphjan1
 
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Hello, FDNewbie
Ran across your interesting May post on Alexandria. Could you let me have your Alexandria guide's contact info as my wife and I are docking there in January.
Thanks,
ralphjan1
Hey Ralph,

Prob is, I had no guide in Alex; I'm an Alex native ;) I used a guide only when going to Cairo... But, I think my guide does Alex at times as well IIRC. I'm @ work rite now, so I don't have her info, but I'll try and get that info for you within the next few days. If you don't hear back from me by Mon/Tues, plz make sure to drop me a PM.
 

ralphjan1

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Hey Ralph,

Prob is, I had no guide in Alex; I'm an Alex native ;) I used a guide only when going to Cairo... But, I think my guide does Alex at times as well IIRC. I'm @ work rite now, so I don't have her info, but I'll try and get that info for you within the next few days. If you don't hear back from me by Mon/Tues, plz make sure to drop me a PM.
Thanks Newbie,
We would like 1 day in Cairo and 1 in Alex so you guide might be interested if he/she is available Dec 11 & 12.
Thanks,
Ralph
 

beastmaster

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What a great experience!
 

nilla_wafer

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Thank you for sharing such a great experience and giving me enough inspiration to consider pursuing such a rotation. Could you please give an estimate of the fees you had to pay to GWUMC and to the hospital in Alexandria. Did you have to pay a great deal in international health insurance / malpractice insurance?

Also, did you observe any cultural differences in how women doctors/students are treated, in the hospital in general and for Ortho specifically? What cultural norms are important to having a collegial experience?

thank you!
-V
 
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Thank you for sharing such a great experience and giving me enough inspiration to consider pursuing such a rotation.
My pleasure :)

Could you please give an estimate of the fees you had to pay to GWUMC and to the hospital in Alexandria.
Sure. $500 flat fee, payable only AFTER you are actually accepted by GW to pursue the elective.

Did you have to pay a great deal in international health insurance / malpractice insurance?
I didn't pay anything; my med school's policy covers us internationally while on approved rotations. Yours should too.

Also, did you observe any cultural differences in how women doctors/students are treated, in the hospital in general and for Ortho specifically?
If you mean in terms of respect etc, no...there are a lot of stereotypes re: women in the Middle East. I think you'll find the world is a very small place, and just like here in the US where you'll find ppl highly respect one another, there will also be those individuals who don't. But in short, no I didn't notice any difference.

Having said that, males predominate in terms of physicians, and females predominate in terms of nurses, given the cultural lifestyle roles which emphasize family as the primary responsibility of the female and provisions as the primary responsibility of the male.

What cultural norms are important to having a collegial experience?
Keep in mind you're going to a predominantly Muslim country (95%+). So dress appropriately. Ie for women, NO tight clothes, cleavage, short skirts, etc. Watch your inter-gender interaction, as culture and religion don't promote such a touchy-feely type of interation as is common here in the US. Ie, I'd know some basics about the religion and culture of where you're visiting prior to visiting. Any good travel guide/book should cover the major Do's and Dont's. But overall, it shouldn't be much of an issue at all.

Oh, and keep in mind that the Middle East is EXTREMELY frustrated w/ the bad rap they get in Western media, so they'll take EVERY opportunity they can get to talk to you about 9/11, Islam, terrorism, etc...to set the record straight. So be prepared for that convo, cuz it's inevitable ;) I think you'll quickly see that they're simply trying to show you that they're normal human beings just like the rest of us, not blood-seeking savages that the media often portrays them as.

thank you!
-V
No prob. If you have any other specific questions, feel free to ask :)