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amormehta
07-31-2004, 10:06 AM
Hey everyone,

So I'm in Prague now, coming back home tomorrow. Just wanted to share some of my thoughts regarding the Prague selective (which is offered to all SGUSOM students as well as students from US medical schools). I really enjoyed my 3 weeks in Prague, it was an experience that I'll always remember. Some of the things that I learned will be with me for my career.

I think it is really good that we SGU students do get to appreciate the differences in the health care systems of countries other than the US. In the Czech republic, there is universal coverage as the citizens all hold a national health insurance policy (that they pay into with taxes, etc.). From an American capitalist's perspective, I came to the Czech republic thinking that the standard of medical care would be subpar; the physicians would generally be unhappy with their profession and the patients would suffer as a result. Boy was I wrong.

First of all, I have never seen such reverence towards physicians as some of the Czech people had towards their respective ones. Some of these doctors are practically worshipped by their patients. The physicians that I was able to shadow were, mind you, of the best and brightest in the Czech republic, if not the world. So my take on the Czech healthcare system is a little skewed, as I was witnessing everything through a rosy lens. But generally, I felt that the physicians seemed to spend more time with their patients, had undeniably exceptional rapport with their patients and made their patients feel comfortable. The patients, for the most part, were very satisfied with their physicians. I can go on and on, but I'll just be brief and say that I felt that physicians were generally happier than their American counterparts and the patients were less apt to blaming their doctors for any complications.

I've also started to revise my view on universal healthcare. As the idealist I am, I feel that everyone deserves a right to healthcare, but the practical man in me knows that in the US......this ideal clashes with the free-market system we have in place that is so distinctly American. Even hints at making American healthcare "universal" would edge the conservative hawks of American society to cry foul, alleging that we'd be going one step closer to "Godless" red socialist society that would be the downfall of our nation as we know it. So I don't think that universal healthcare coverage is feasible in this time of American history. BUT......and mind you, I'm thinking out loud on this one......what if there was a universal plan where yes, if you could afford private insurance, you could get it, but if you couldn't afford private insurance, there were a national plan that you could pay into (through income tax, whatever). I don't know much about healthcare policy and insurance and health law so all of you policy wonks, don't shout me out, because I'm ignorant on those matters.

I do think that eventually US must go towards some sort of universal system, however the only way that could happen is if the bottom line is not the biggest concern in healthcare. I do not believe that physicians, or any health professional can run their practices in the traditional business sense, if their objective is to provide the best possible care for the patient. I also don't believe that massive amounts of income will guarantee physician happiness. The fact is, some of the doctors I met here in the Czech republic seem to be the happiest people in the world regarding their profession and they don't make even a quarter of what the average US doc makes. I think true happiness in the field stems from the atmosphere in which one works. More time with patients, less bureacracy, less paperwork more clinical work.....these are the things that need to be resolved for US physician satisfaction to improve....I think.

Anyway, not to start an opinion-laden diatribe.....I'll just talk more about Prague. So the city is now one of my most favorite cities in the world. The people all have been really nice, even though I am at a loss due to the lack of knowledge I have in Czech language. The city is beautiful, filled with buildings that are much older than the oldest of old building in the US. For example, buildings that were erected in the 15th century are commonplace and not that old according to locals. Prague also was one of the few major cities in Europe that was not destroyed in a war. The Czech people, although sometimes are criticized for never fighting, did manage to save their cities in all their grandeur due to that trait. Invading armies never had to destroy the city to quell a violently resistant people.

The Czech people are very proud of Prague. I would be too if I were a local denizen. Every block you walk there are beautiful baroque and Art Nouveau buildings. The city is very easy to get around thanks to a stellar public transit system. The food is wonderful and served in LARGE portions....if you're a meat and potatoes lover this is your place to be. The beer.....let me tell you about the beer; MY GOD, the BEST I've ever had. And soooooo cheap. You can get a lot for a dollar here.

Anyway, to anyone thinking about doing the PRague selective in the future, I would highly suggest it. Not only do you have a lot of time to just travel around central and eastern Europe and see a lot of what Prague has to offer, you also gain keen insights into the practice of your future profession. Yeah, the flight over here was kind of expensive, but I view it as an expense worth it for sure.

Sorry for the long post.

neilc
07-31-2004, 10:37 AM
dekuju mockrat!

glad to hear that you liked prague...i wasn't around this time, but if any SGU folks come over when i am there, i would be happy to show you around the town...it would be great to see more of you over there! pass my name, contact and email list along to other students that may not come to this board, as well, if you feel it will be helpful.

neil
ncor33@hotmail.com

tak, na schledanou

libowski323
07-31-2004, 03:19 PM
Even hints at making American healthcare "universal" would edge the conservative hawks of American society to cry foul, alleging that we'd be going one step closer to "Godless" red socialist society that would be the downfall of our nation as we know it. So I don't think that universal healthcare coverage is feasible in this time of American history.




Does the Czech Republic have the same problem of illegal immigrants sucking up a lot of the health care funding that is found in the US?? So i guess in your mind if you say that you are not in favor of socialized medicine then you are a Bible Thumping Pro War Conservative??? Interesting assumption.

stephew
07-31-2004, 05:02 PM
I thank the poster for his/her impression of the prague selective. I will also state right now that if this turns into a socialized medicine versus private medicine debate or anything near to it, its going into the lounge. And certainly, no flaming or personal insults of others will be tolerated, a warning that unfortanately experience has taught needs to prelude any vaguely political thread.

snitzle
07-31-2004, 07:35 PM
If the system works in Prague, then great. On the other hand, I personally have known more than a few Canadians who hate their country's version of socialized medicine. I think the issue is a little more complicated than one faction or another "squaking" about it.

Ronu
07-31-2004, 08:23 PM
Would I be able to do the Prague Selective after 4th term, which for me would be after 5/2005? I want to know whether I would have the chance to do it or if there would be too little time.

stacy_de_lin
08-01-2004, 11:04 AM
Does the Prague selective substitute as one of your clinical rotations? I am concerned about making sure all my rotations are ACGME approved so that I can practice more widely in the states.

Thanks for your help, and for your interesting thoughts on different versions of healthcare. I think that we can all agree that US medicine is entering a difficult period right now, so we can probably learn from how others practice around the world.

neilc
08-01-2004, 11:29 AM
Does the Prague selective substitute as one of your clinical rotations? I am concerned about making sure all my rotations are ACGME approved so that I can practice more widely in the states.

Thanks for your help, and for your interesting thoughts on different versions of healthcare. I think that we can all agree that US medicine is entering a difficult period right now, so we can probably learn from how others practice around the world.

all rotations done in teaching hospitals abroad count as ACGME.

stephew
08-01-2004, 12:47 PM
Does the Prague selective substitute as one of your clinical rotations? I am concerned about making sure all my rotations are ACGME approved so that I can practice more widely in the states.

Thanks for your help, and for your interesting thoughts on different versions of healthcare. I think that we can all agree that US medicine is entering a difficult period right now, so we can probably learn from how others practice around the world.no i belive its separate. However remember: you do UK rotations if you like as well and they by definition are not acgme as they are not American. THe acgme is for us rotations only. The rotations you do in the UK (or grenada or svg if you wish) are approved as they are approved in their country.

mortigitempo
08-01-2004, 02:26 PM
the prague selective was one of the best things ever in my life. i didnīt know what to expect going into the program, but i could not have dreamed about ever doing the things i did. one student in the program put in a central line unassisted while another placed a NG tube into a patient. we learned how to perform digital rectals to a complete workup of a infant.

with that being said, it is a program that also rests on how motivated you are. if you want a nice vacation, then the program isnīt for you. there were students who were there for a vacation and didnīt like the program.


i met a few doctors here in prague who i will be in contact about coming back again in december to rotate through their hospitals for 4 weeks again

and if you like exquisite food for cheap, cultural activities, and hot slavic women with pouty lips and the nicest gastrocnemius muscles, prague is it for you!

emt036
08-01-2004, 02:44 PM
Sounds like a great program -- learning to work-up patients and doing procedures... Looking forward to going next summer.

Though I don't think this counts as a rotation, it is just extra, right?

seagoddess
08-01-2004, 08:21 PM
The Prague Selective was excellent. The organization of the selective was also excellent. We rotated through two or three different hospitals (one each week). Every week at the beginning of a rotation we were taken to the respective hospital from Dr Stransky's office if one wanted to know how to get there. Public transportation is very good and the subway system is very easy to understand - everything is color coded. One can get almost anywhere by train, tram and/or bus.

The 1st week I rotated at Motol. I was under Dr Bojar, a very well known neurologist and former minister of health. He was truly an inspiration in that he has excellent bedside manners and he is revered by patients and staff alike. He is a very good teacher and very patient. It is said that he has never been seen either angry or visibly tired. We look at a lot of X-rays and CT scans. Several diseases were common theme this week: strokes, multiple sclerosis, lyme disease, carpal tunnel. We also saw some brain tumor patients. We didn't spend the whole day with him. We met some of his colleagues and we "affectionaly" called one diazepam because though an excellent teacher he was also monotone.

The 2nd week I rotated at Homolce (pronounced Homolka). Here we had one good rotation then bad; it changed from day to day. The 1st day we went to Cardiology and saw a couple of angioplasties. Here the nurses were somewhat rude. The day we were supposed to rotate through surgery, half of my group was sent to urology outpatient where the doctor translated the clinical scenario of the 1st patient and never bothered to talk to us again. Eventually we were sent home. Their attitude was more like, oh we're too busy. The problem with Homolce is that it isn't a teaching hospital. Then after that we went to vascular surgery where we saw a femoral bypass and that was really exciting. Finally, we rotated through internal medicine and that was also good. The internal medicine professor spoke English very fluently.

The 3rd week I went back to Motol but this time to rotate through Pediatrics. The 1st two days I went to Pediatric Neurology. We saw a couple of cases of cerebral palsy. The last three days we rotated through Pediatric Gastroenterology. We also went to pediatric diabetology/endocrinology and nephrology.

In general rotations are from 8:30-12:30. Twice a week there are afternoon sessions where the czech healthcare system is introduced and there are also patients to take a history kind of like the SGU clinical skills.

The healthcare system in Czech republic is good in that it ensures care for everyone. However, doctors are not paid very well, about 1000 USD a month. People are very happy with the care they receive. However, I noticed that doctors don't wash their hands as much and that sanitary conditions are not so good. I think the system works because doctors and staff are paid very little and such a system would never work in the US. In my own very biased opinion, the US is the best country to live in even if our healthcare isn't the best. The Czech system didn't surprise me very much because it is very similar to Cuba's. Whereas communism teaches that "everyone is equal" in fact the opposite is true. In such a system only the top government officials receive the best medical care. Castro is always boasting about free healthcare in Cuba but why would you want free healthcare if you don't even have access to medications? In the US though one must pay for healthcare there are a lot of choices. Whereas in Cuba one is always poor in the US one can obtain better insurance as our means increase. The price for "free" care in Czech republic is the low payment of medical professionals among other factors that we don't know. It is very easy to admire such a system but in the end I come to the same question: Who will be willing to pay more taxes to have care for everyone? I do not intend to provoke a political discussion here. You can address me individually by PM. However, I felt I had to express how I feel.

Now about Prague I must say it is an amazing city. It is very beautiful and very romantic. The view at night from Charles Bridge is something everyone should see. Food is great. Beer is cheaper than coke. Then there is also Absinth... (70% alcohol by volume, illegal in the US and most European countries, responsible for blackouts and numbness of the upper and lower extremities). Great clubs. Great people. Very good looking men and women. I swear they must be selected for. However, most locals don't speak English. I became extremely good at pointing...hahaha. I would also recommend going to Cesky Krumlov, a medieval town outside of Prague. We rented a car but one can also go by bus.

I strongly recommend the selective :)

snitzle
08-02-2004, 03:18 AM
http://www.msnbc.msn.com/id/5538833/?GT1=4529

I guess you guys were lucky, huh? :lol:

doc5544
08-02-2004, 01:35 PM
do you all get some time to travel around, like go to other countries, during the selective on weekends?

seagoddess
08-02-2004, 01:46 PM
A lot of people went to Austria. I know of somebody who went to Amsterdam while other people went to Munich.

I personally didn't travel to other countries but it is very easy to. Just hop on a train...

seagoddess
08-13-2004, 09:22 AM
I forgot to mention that I strongly recommend staying in Prague longer than the Selective period. There is a lot to see in Prague and sometimes I was so tired after going to the hospital that I couldn't go out.