Lee Jun Keong and Tay Ru-Fang with the Head of Department of Emergency Medicine, Dr. Andrew Maclean

Box Hill Hospital at Melbourne, Victoria, Australia

Introduction

Our elective posting took place at Box Hill Hospital which is located in Melbourne, Victoria, Australia. Box Hill Hospital is a teaching hospital affiliated with Monash, La Trobe and Deakin Universities. It is one of the seven hospitals that are governed within the Eastern Health network which provides health care services across the Eastern metropolitan area of Victoria. Box Hill Hospital was established in 1956, and admits more than 48,000 patients each year. The hospital provides a wide range of healthcare services including: emergency care, general and specialist medicine, intensive care, mental health services for children, adolescents and adults, maternity services, post-acute care programs, surgery, teaching and research.

Elective Placement

We applied through the Eastern Health Elective Programme which is administered by Monash University. We chose to spend our 4 –week elective in the Emergency Department (ED) in order to have a broad spectrum of exposure to clinical cases which include medical, surgical, and orthopedic amongst others. Not only were we able to practice history taking and physical exam skills, but we were also able to expand on concepts taught in the lectures or seminars. We were placed under the guidance of two different consultants whereby LEE shadowed Dr Liam Walsh and TAY shadowed Dr Anita Liu.  Reporting directly to the consultant who supervises the departments facilitates 1-to-1 teaching of cases.

 Elective students are expected to attend a minimum of 3 x 8-10 hours shifts each week. The 1^st week of elective was allocated for orientation and familiarisation with the workings of ED. 2^nd week onwards, we had to clerk patients, perform physical examinations and present the results to our consultant or registrar. This experience enhanced our confidence that we are able to present and make valuable contributions during ward rounds. Additionally, we were allowed to do procedures like cannula insertion, venipuncture, suture and so on. This turned out to be a golden opportunity for us because we have hardly have opportunities to perform procedures back in our own setting.  By being pro-active, doctors and the nurses were ever ready to give us a hand when needed.

Emergency Department Setting

The ED is divided into various streams which include Red Stream (High Acuity), Yellow Stream (Low Acuity / Complex), Purple Stream (Fast Track), Pink Stream (Paediatrics) and Short Stay Units. The hospital aims to attend to and admit patients within the stipulated targets set by Department of Health; current targets include transferring admitted patients to the ward within 4 hours of presentation to ED, admitting the patient to the ED short stay unit or discharging those going home within 4 hours of presentation. In addition, Symphony is the ED electronic medical record system used at Eastern Health. This is in contrast to HSNZ whereby they use both hard copy case notes and electronic medical records.

In A Nutshell          

Our practical and theoretical experience at Box Hill helped us to become more confident and we hope to emulate all the good practices we have seen and observed. We were also exposed to a different health care system, different working culture and different way of life which has certainly broadened our horizons and made us more knowledgeable about health care systems in other parts of the world. This elective is definitely a valuable learning experience and we are grateful for such a positive experience in our final days as medical students. We would like to express our sincerest gratitude to UCSI University for giving us the chance to experience this awesome elective posting in Box Hill Hospital and to all staff for their hospitality and teaching wisdom. Thank you for an inspiring and eye-opening experience that we will value immensely for years to come.