Report from Dr Jasur Toshev from Tashkent, Uzbekistan visiting Department of Neurology, Antwerp University Hospital, Edegem, Belgium under the supervision of Prof. Patrick Cras.
It is with great gratitude and pleasure I report back on my training experience at UZA (University Hospital of Antwerp) which commenced on the 2nd November 2016, since the 1st November 2016 was a holiday in Belgium. The first day started with a consultation with doctor David Crosier who is a highly qualified specialist in Parkinson’s Diseases. During the first visit, we observed and consulted patients with Parkinson’s Disease and other movement disorders. The neurological status check vastly differs from the one in my home country with its in-depth test. I learned to apply the methodical approach in conducting neurological status check-up. Other days were also rich in a learning experience. For example, I attended an EMG process and gained some more knowledge in neuromuscular disorders which was especially involving for me as this practice is not established in Uzbekistan well. Moreover, I gained experience in conducting EEG analysis and decoding EEG waves and performing consultations of patients with Prof. Patrick Cras, Dr. David Crosiers, Dr. Massimiliano Montagna, Dr. Ingrid Baar and others. Also, I got to observe emergency patients, saw thrombolysis procedures and thrombectomy procedures. I thought of promoting the establishment and adoption of a stroke protocol with all its related systematic methods in my home country as this protocol is crucial in not only treating the stroke but also decreasing the detrimental after stroke affects of the disease. Learning how to do lumbal punction proliferated the spectrum of my diagnostic procedures. Every day I made rounds with doctors Pegah Masri and Cant Antonin observing patients in the Neurology ward. Thursdays and Fridays at 12:00 there was a staff meeting of Neuroradiologists, Neurosurgeons, Neurologists and Pathology Anatomy, and Tuesdays and Fridays at 12:30 there was Neurologists staff meeting, and I participated in these meetings and observed the work of real professionals. Every Friday at 13:00 there was a Neurology Club, and every doctor and assistant presented their important scientific work and findings in the forms of presentations to us.
The given opportunity helped me to expand my horizon vastly not only in my major, neurology but also in work ethics of different doctor specialists in Belgium. I learned various diagnostic methods and check-ups, keeping and filing medical history and many other aspects.
Report from Dr Alberto Vogrig from Premariacco (Udine), Italy visiting the French Reference Center of Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Bron Cedex, France under the supervision of Professor Jérôme Honnorat
It is my great pleasure and privilege to have participated in the European Academy of Neurology (EAN) Clinical Fellowship 2017. I would like to thank the EAN for giving me the opportunity to be part of this program, for their support and help.
This clinical fellowship allowed me to join an excellent clinical and research center – French Reference Center of Paraneoplastic Neurological Syndrome, Hospices Civils de Lyon, Hôpital Neurologique, Lyon, France – under the supervision of Professor Jérôme Honnorat.
The program lasted for a total of six weeks, from 2nd of January until 10th of February 2017, and focused mainly on the diagnosis and management of patients suffering from autoimmune encephalitis and paraneoplastic neurological syndromes (PNS). The French Reference Center of Paraneoplastic Neurological Syndrome, being France’s most advanced center for these diseases, gave me the rare opportunity to meet with an unusually large cohort of patients. This meant that whilst the placement was at times challenging, considering the rarity of these diseases, I was very fortunate to have been able to learn from the foremost experts in the field in France.
Upon my arrival, Professor Honnorat and all the members of staff welcomed me warmly to the department and introduced me to their research facilities, including a laboratory dedicated solely to the identification of autoantibodies associated with PNS and autoimmune encephalitis. Everything was very well organized and everyone I met was very kind, supportive, and passionate about their work. My work was organized in a way that I could combine both clinical learning and research activities. Monday afternoons were reserved for a collegial meeting in which all the PNS and encephalitis cases were discussed in with neuro-oncologists and laboratory members. In addition, once per month, all the cases referred from all over the country were discussed by looking at clinical presentation, laboratory and neuroimaging data. These meetings particularly were very educational providing me with the opportunity to encounter a great variety of clinical data. Thursday mornings consisted of “le Tour” (patients grand round): I took advantage of the precious expertise of Prof. Honnorat to examine patients with autoimmune encephalitis, PNS, and brain tumours. I also had the opportunity to discuss cases with Prof. Ducray, who is a dedicated physician and was enthusiastic to work together with me.
I would like to particularly mention Dr Joubert, Dr Thomas and Dr Izquierdo: it was a privilege to work with young colleagues as smart, kind and passionate as they are, and it is my great pleasure to call them my friends now. Dr Joubert was my primary reference in the department. He took every opportunity to discuss complex cases with me, and gave me valuable advice for my research activities.
During my stay in Lyon, I was able to complete two clinical studies, and I am very grateful to Prof. Honnorat for this invaluable experience. From him I learned how to organise a clinical study, and he introduced me to scientific approaches which I will be able to use throughout my medical career. I wrote two scientific articles on the two clinical studies that will be submitted in few weeks.
Besides the scientific work, I enjoyed the truly beautiful and charming city of Lyon. Walking towards the Fourvière Basilica from the river Saône, illuminated at night, is a unique experience and the view from its top is amazing. Vieux Lyon (Old Lyon) truly instills a captivating fascination in its visitors.
In conclusion, I had a wonderful professional and personal experience and I believe that my future career in Neurology will greatly benefit from this placement. I have a genuine interest in paraneoplastic and autoimmune encephalitis and it is my goal to excel in this field through hard work, research, the continuous improvement of my skills and perseverance. I am looking forward to future collaborations with Prof. Honnorat and his staff from Lyon, which will enable me to further develop this neurological field in my region in Italy, Friuli Venezia Giulia, for the benefit of my patients and my fellow neurologists at the Udine University Hospital.