Alexandra Crisan, MD, from Gheorgheni, Romania
Term of the stay: 16.07. – 27.08.2018
University of Debrecen, Department of Neurology,
4032 Debrecen, Móricz Zs. krt. 22, Hungary.
Supervisor: Prof. László Csiba
First I would like to start thanking EAN for having provided me with this wonderful opportunity to participate in the Clinical Fellowship Programme, 2018. Thanks to the award I was able to spend six valuable weeks in the Department of Neurology, University of Debrecen, Hungary.
The experience I have gained under the precious guidance of my mentor, Professor Csiba László, in the field of cerebrovascular diseases, have led me to one of the most memorable and fruitful experiences in my professional career.
During my stay in Debrecen, I had participated in their daily activities such as morning reports, hospital rounds, out patients management, meetings, medical topic discussions and teaching. Every morning after the morning reports, a chosen medical article was presented and discussed with trainees and medical students. Unusual cases were presented, so I was able to observe how senior experts approach a challenging case. Furthermore, every Wednesday, there was a meeting with colleagues from other Neurology Departments from different towns in Hungary, where novelties in many neurological diseases where presented and discussed. I recall some very interesting presentations providing up-to-date information about cerebrovascular diseases, polyradiculopathies, miastenia gravis and multiple sclerosis.
As I am interested in vascular neurology, I have participated as an observer to many intravenous and intraarterial thrombolysis, step by step, starting from the arrival of the patients, directly to the Radiology Department, for the head CT, where they were consulted by a neurologist, to the ICU Compartment of the Neurology Department, where blood tests were taken and Actylise was given. Considering the high prevalence of stroke in Romania, and the importance of thrombolysis and thrombectomy in these patients, for a better outcome, this programme has fulfilled the mission to bring me a better understanding in stroke medicine. I had the opportunity to have an insight on how stroke units work, and how to minimize the door-to-needle time in thrombolysis, which is vital for patients outcome. I intend to share my experience with my colleagues in Romania, so we can offer a better management for stroke patients, integrating the strategies learned into clinical practice.
I also had the opportunity to broaden my knowledge in neuroimaging, particularly in Doppler ultrasonography, where thanks to the kindness of Associate Professor Dr László Oláh and to Borókné Ildikó I had participated in more than one thousand carotid and vertebral ultrasound examinations, and around thirty microemboli detections using transcranial Doppler. After these, I also had some practical hands-on scanning lessons for which I am very thankful.
Furthermore, I was excited to see how team work has gone to next level, and how well doctors, nurses, speech therapists and physiotherapists collaborated together on creating a strong healthcare support for every patient, tailored to reflect an individual’s particular needs, based on their pathology and symptoms.
I am pleased to say that my experience was well above my expectations and I am very grateful to EAN for this generous support and to Professor Csiba László, my mentor, and all the staff from the Department of Neurology, University of Debrecen, who were very friendly, helpful, and made my stay most enjoyable.
Nika Kvernadze, MD, from Tbilisi, Georgia
Term of the stay: 14.07. – 24.08.2018
Department of Neurology 2, Kepler University Klinik, Linz, Austria, (Med Campus III, Kepler Universitätsklinikum, A-4020 Linz, Krankenhausstraße 9)
Supervisor: OA Dr. Milan R. Vosko, PhD, FESO
First of all, I would like to express my gratitude to the EAN organization, which gave me the opportunity to obtain the excellent experience and knowledge. This is a most important program for young neurologists.
I spent six remarkable weeks at the Kepler University Clinic in the city of Linz, Austria, which is one of the leading hospitals in Austria. The Neurology Department included the Stroke Center, General Neurology Department and intensive care unit. My working day was starting at 07:00 with a morning conference, where the newly-hospitalized patients and interesting cases were discussed. Every day I was actively attending patient rounds, where I was explained the interesting cases in detail and in addition, I was actively involved in the exchange of viewpoints. It was very interesting and exciting for me, because I felt as a full member of the team. My main workplace was the Stroke Center that was equipped with all the necessary services, staffed with high qualified medical personnel and instrumental and laboratory equipment. Systemic intravenous thrombolysis and thrombectomy were performed actively, which was my main goal, in order to obtain the adequate experience and knowledge. The process of the patients’ rehabilitation was actively performed and in the patient’s treatment were actively involved: ergotherapist, physiotherapist, logopedist, social therapist, etc. I will never forget the patient who after multiple injury suffered from tetraplegia, contractures, facial nerve paresis, speech disorders, and how the rehabilitators worked and how the patient’s condition was improving day-to-day. Undoubtedly, that was the result of an invaluable work. The CT and MRI examinations were important in terms of interpreting of cerebrovascular diseases, as well as Doppler examination of intracranial and extracranial arteries, and now I am mastering this method actively.
The Head of Stroke Unit, Dr. Milan Vosko, who was also my supervisor, was actively giving me the detailed explanations and allowing me to be actively involved in patients’ daily management. The patient rounds of the Head of the Department, Professor Gerhard Ransmayr were interesting, who personally explained to me each patient’s history and current methods of management, shared interesting cases and paid attention to important aspects from his personal practices. Intensive care unit was also interesting, where I attended Dr. Milan’s patient rounds and current methods of management of intubated patients with neurological diseases.
The duty days at the hospital were particularly interesting and busy. I saw all the stages of management of the patients with stroke since the Emergency Department. The management specifics and amazing promptness was astonishing and interesting for me. MRT Perfusion, angiography was carried out with amazing promptness, by highly qualified radiologists and thrombolysis was started at the very Radiology Department, in order to save the time. At the Emergency Department it was no less interesting to work with patients where differentiation and ruling out the stroke was needed, when distinguishing and diagnosing of other neurological diseases was necessary.
I did not want to miss even a single thrombolysis, and therefore, in addition to duty days, I worked on-call as well and my colleagues were actively engaging me in each case.
In addition to the work, I also tried to get acquainted with the city of Linz and Austria. I met interesting friends and young colleagues there. After the working hours, I tried to relax in Linz streets and with my colleagues I was riding a bike along the beach of the Danube, enjoying that much. I am delighted with the amazing cultural life of Vienna where the old and modern architecture is combined. I saw a lot of places of interest.
After returning to Georgia, I made an interesting report for my colleagues, where I presented all the necessary and important information in detail, not only in the management of acute stroke, but in general neurology and intensive care as well.
The National Center of Surgery, where I am working, is one of the leading and innovative clinics in Georgia. The knowledge and experience I obtained in Austria have been very supportive and helped me to develop a Stroke Center in my clinic with my colleagues and friends. Today, thrombolysis and thrombectomy are actively performed at my Clinic, both separately and in combination. We were the first clinic in Georgia to perform the thrombolysis and thrombectomy in combination with the amazingly successful outcomes. I am happy to be a member of this team.
I would like to express my gratitude to my supervisor Dr. Milan Vosko, Head of Stroke Unit, as well as the Head of Neurology Department, Professor Gerhard Ransmayr, and senior doctor Roland Reach and junior doctors.
This program is a very good opportunity for young neurologists to get acquainted with innovations in foreign countries, to get acquainted with colleagues, to exchange opinions, that are necessary for development and achieving the success.
Raushaniya Latypova, MD, from Ufa, Russia
Term of the stay: 03.09. – 16.10.2018
Hosting Department: the Neurological Clinic of the 2nd Medical Faculty of the Charles University and Motol University Hospital, V Úvalu 84 150 06 Prague 5, Czech Republic
Supervisor: MUDr. Ales Tomek, Ph.D. FESO
Report from Dr. Raushaniya Latypova, from the Republic of Bashkortostan, Russia, visiting the Neurological Clinic of the 2nd Medical Faculty of the Charles University and Motol University Hospital, Prague, Czech Republic from September 4th, 2018 to October 16th, 2018 under the supervision of MUDr. Ales Tomek, Ph.D. FESO
It was a great experience in a great place! I would like to thank the European Academy of Neurology for giving me the opportunity to have this great educational experience.
I would like to express my deep gratitude to prim. MUDr. Ales Tomek, Ph.D. FESO, prof. MUDr. Petr Marusic, Ph.D., MUDr.PaulasovaSchwabovaJaroslava, Ph.D., Dr. Michaela Dankova, Bc. Gabriela Krizkova, secretary, Magda Dohnalova and all the team for kindness, warm welcome, support in everything.
I was well received and integrated into all daily activities. I had six amazing weeks in the Czech Republic. Prague is a great city with unique cultural and historical attractions.
During my 6-weeks clinical fellowship, I was able to dive into work in the Neurological Clinic of the 2nd Medical Faculty of the Charles University and Motol University Hospital.
I was observing in all parts of neurology department, i.e. in the emergency, outpatient clinic, all the specialized centers (cerebrovascular, MS..), the standard ward and in the neurointensive care unit. I encountered the full spectrum of neurology, especially in a petting of comprehensive cerebrovascular centre.
I had the opportunity to see patients with rare problems that are rarely seen in our clinic, which allowed me to learn and master the most important points of the differential diagnosis.
Every Thursday I attended a neuro-radiology meeting with a review of difficult neurology cases.
I not only was engaged in neurology, but also actively took part in a public life of the hospital: participated in a run in honor of fight against epilepsy «EpicRun», visited a concert in honor of fight against a stroke «Benefice Mrtvice», discussed distinctions of medicine at joint lunches and dinners. I also had interesting and useful night shifts in emergency with Dr. Michaela Dankova. Every Tuesday and Thursday I was with MUDr. Paulasova Schwabova Jaroslava in outpatient cerebrovascular clinic, discussed diagnostic and treatment of the patients after stroke especially in difficult cases.
At the end of my practice I have made the report about my clinic and distinctions.
Overall, it was rather a fruitful stay as a learning opportunity, and an amazing experience from a personal point of view. MUDr. Ales Tomek created a very interesting and productive plan for me, I will highly recommend his team and his department to next winners of this exchange program. EAN Clinical Fellowship inspires to the next steps in professional growth.