Clinical clerkship in Oulu
Week 2/4
Please note that most of the information is anecdotal and not double checked. Some things might have gotten lost in translation. Please also excuse me for all of the grammatical mistakes, I am writing this during nights as our days are fully packed with adventures.
The vibes
I just cannot believe how fast the time is running here. I really try to do as many things as possible and that is quite a pace to keep up with. But more on that later.
I like that everybody is cycling, Oulu is rated as one of the friendliest cycling cities in the world! It feels to me similar to Amsterdam or Kranjska gora nowadays, with more and more separated cycling paths popping up everywhere. I also like the cycling etiquette here, seldom can one see people crossing whilst the lights are red and everybody uses hands to signal their next turn.
The public transport is cheap (bus is 1,2 EUR per ride), frequent and usually punctual. You can buy a ticket within an app (for 3,2 EUR), so it is cheaper to just use a credit card when you are getting on the bus. You can also buy a monthly ticket for around 42 EUR, but in the end it is just better to cycle. To get around on bus you can use Google Maps, everything is put in. Alternative to google maps is a specialty app, called Mobiililippu — unohda kolikot!
When going around town you can talk English everywhere and you will be able to strike a conversation with all generations, from juniors to seniors. In Finland they, besides learning English from 1st grade, also learn Swedish. Everybody is interested in talking to foreigners and always keen to help when you get lost.
Regarding the local language (also called suomi; Suomi is a country), I found it really unusual and interesting how they pronunciate "Joo”, which means yes. To say it, one has to INHALE. At first I figured they just want to tell a lot of words in one breath and this is the most effective way to do that — speaking when the air is travelling in and out. What I found out is that some words are correctly pronounced like that. Once you hear it, you cannot miss it. They have something similar in Swedish language, where they just slurp the air in.
It is also really funny how the hospital is sooo big and grown people use scooters to get around. Some more fancy than the others. There is probably more scooters than bikes and cars on the parking lot combined.
Another thing I like very much are these cups that have holders built into them.
Inclusivity
The country is really inclusive. Everything is wheelchair accessible. Additionally the toilets are for all genders, they do not have the usual women and men stickers but this infinity sign.
People are also really open about these topics. You can see pride flags everywhere and it is just a norm.
Ending the clinical rotation in plastic and reconstructive surgery
This past two weeks were one of the best clinical experience to date. I am trying to love every moment. All of the doctors and nurses are so nice. They are always open to answer my (sometimes obvious) questions and trying to accommodate my thirst for new experiences and knowledge.
I have had so many firsts happen right here. First incision, first vessel ligation, first drain placement and many more. If there is one most important thing I have learned and is also applicable to everyday life is:
If you do not ask, nobody is going to offer!
I wake up happy to go to hospital and come home content with the day I have had.
What I like the most is doing a lot of assisting and learning new things. There is no crowd, I can easily scrub in for every surgery they have on programme. I did not have one mentor, but rather the whole department of doctors giving me their time and attention. I feel so privileged and thankful for that.
They are all very busy so catching them for a quick picture was somewhat hard… But here are all of the pictures I managed to snap.
I will be forever thankful to Tinna. She was the first resident that introduced me to everybody. She was very nice to talk to and asked me to assist right away. She personally made this experience even better.
Danger of breast implants
Breast implants have been a staple in plastic surgery for such a long time. But they do not come without their risks. Breast implant ilness (BII) is a collection of symptoms that may be related to breast implants. BII may be related to autoimmune or inflammatory responses.
The complications can occur and that is why here they prefer to do flaps. I have assisted on a few mastectomies with primary reconstruction (meaning they reconstruct it in the same surgery). They find it gives good results and seldomly use implants, maybe a handful of those per surgeon in a year, and in my experience they really have a lot of breast cancer surgeries.
The rough steps procedure can be seen bellow.
Another thing I found interesting was the breast tumorectomies (excision of only tumor with a safety margin). If the cancer is classified as DCIS or LCIS they usually just excise the tumor and not the whole breast. Leaving aesthetically and medically sound results for the patient.
What I have been up to
My schedule
I start my days at 7 AM and I try to get to the hospital ASAP. I takes some time as I have to cycle for 15 mins. I usually arrive at the hospital at 8 AM and it’s feels impossible to be earlier, even if I wake up at 6.30, I’ll get there at 8.00.
The clerkship usually takes about 8 hours. I want to show my interest in the field and my mentors are giving me the ability to try more and more new things. I am really grateful for that. I end my day usually around 4–5 PM, then I have to cycle home.
When I get home there really is not much time for anything. I feel lucky if I can take a short power nap or do a quick workout. Keeping everything tidy and clean also takes some time.
After clerkship we usually meet with our IFMSA family over here. Sometimes all of us and other-times, just a small subgroup. We are all trying to make the most of our visit.
After I get home, usually around 11 PM — the time really flies away when it’s bright all the time, I usually attend to the projects at home. We are working very hard to do everything necessary to launch SiOHCA x EuReCa 3 study.
After all the meetings are done I usually try to get myself to write, at least a tinny tiny little bit. I have got some positive feedback on my first post and it pushes me to carry on, thank you!
Day 8 (Monday)
Monday started early, after a fun Sunday and sauna before sleep, I was energised to take the week head on and do everything that was available to me.
It was a really beautiful day (which are not that often here) so we decided to go SUPing.
We rented SUPs for 2 h in Oulun vesipuisto. It costed us 35 EUR.
Oulu is such a beautiful place, you can really appreciate when crusing around on the water. It was also really really cold (15 ºC), and of course I hit a stone with my SUP and fell in.
Afterwards we left and treated ourselves, hardcore sportspersons, with a tasty pizza in La Festa. Which costed 11,90 EUR.
In the evening we got an app alert about possible Aurora borealis in our location. It had an about 30 % chance of actually materialising. So we said our goodbyes to a well night’s rest and went to the Nallikari beach.
Because of the winters’ eternal darkness, the streetlights are very well placed and everywhere. This is good for getting around in the pitch dark, but bad for catching northern lights, as it makes the city quite polluted with light.
We sadly risked our sleep for nothing, as it was too bright to see anything. But it was a very pleasant experience catching a beautiful sunset and keeping good company.
On the picture bellow is something that might be a tinny little northern light, but probably not.
Day 9 (Tuesday)
On Tuesday I found this poster, which looked quite interesting to me. It’s about osteoporosis and promotes healthy living and taking care of your bones, so you can live without complications as long as possible. For translation I use the Google Translate app, it really gives you good results, just point and translate.
I took some pictures, with permission of my attending, of the hospital.
Bellow are the nurses quarters. I find them somewhat similar to those in University hospital of Maribor.
What was interesting to me, was the surgical materials counter. In Slovenia I have only saw the system of hand&paper or scanning the bar codes of each individual item. Here they have it all digitalised and made easy for use. Under each item there is a button — similar to that for ordering Amazon items, before you take the item you just press the button and it automatically logs to the list.
What is more, they use this system to update surgery prices — they are dynamic! So if a certain type of surgery has average cost of A and over time it gets more expensive, it compensates for that and charges the Health care the new price B. And this is done automatically!
After getting home I wanted to play some beach-volleyball. We met on this nice beach near the river called Tuiran uimaranta. We met a Czech PhD student who came here on Erasmus, fell in love with this country and decided to continue his studies here and stay in Finland.
Later we met for a movie night. We also had an opportunity to eat some candy, carefully curated for us by our Finnish hosts. Our friend from Tunisia also brought special type of pistachio candy for us to try. It was soooo good, I love pistachio.
We watched The Incredibles 1, it is still fun to watch even after so many replays.
Day 11 (Wednesday)
I assisted on 4 surgeries and then rushed home, it was Sauna day!
First we met in a coffee shop — Makia, I have never been and I really wanted to see what do they have to offer and how terrible will the prices be.
The prices were not that bad. You can get a piece of cake for around 7 EUR.
I took cake + black tea and it cost me around 13 EUR.
We then headed to our Kummi for a sauna evening. We were doing sauna at 70 ºC, followed by a short dip in the lake. It was very fun and relaxing. We put beer in the sauna stove for a nicer smell — did not know you can do this and it makes the experience much better. We also drank beer during sauna, also a novelty for me — I thought you drink only after you get out, but here it is a custom.
Day 12 (Thursday)
My last day on Plastic surgery ward. I am so thankful for the time and attention I got from then and hope to maybe even circle back in the next two weeks I’ll be on Hand surgery.
Thursday was also the first day of school for the freshmen. The local student organisation tries to make it as much fun and special for them as possible. And we, the exchange students, had an opportunity to try ourselves with fun games on the beach…
We came to the beach around 6 PM and the students were already there. You could tell by the enormous number of bikes parked (did I already say that everybody rides a bike here).
Because of the trip to Helsinki the next early morning there were only three of us participating — team kung-fu Walrus 🦭.
We then started participating in the games. There were around 17 checkpoints that a serious medical student should do. The games were really fun. The rules were simple, in front of the judges for every check point you first to put up a little play. I’ll let you guess what we tried to act out. Leave a comment and see if you got it.
Then a game followed. A few of the tasks were: spinning around a stick and trying to hit bottles with a football, dance-off, another act to play out, tick-tack-toe with beer and running and just having a fun afternoon for yourself.
Later even a few Erasmus students came to keep us company.
Another thing I really liked, and is missing in Slovenia, are the guild pants. They actually have working pants of white colour (engineers have red) on which you collect patches. The more patches you have, the more senior and active you are. You can get patches for different tasks performed — like scouts, or just buy them when travelling around. It also makes it easier to find other medicine students when doing a social event and the dress code is much simpler, also your other clothes do not get dirty.
As you can see I am really having a nice time here. I am travelling Helsinki & Tallinn this weekend.
Read more about my journey on the blog from week one.
Also here are other parts:
Thanks for giving my writing your time and attention 🥰
