A majestic neurological month
By Tobias Álvaro Thomsen, Madrid, Spain
Visiting the department of Neurology, Rigshospitalet, Copenhagen, Denmark in July 2022
Opgang 9, 7 sal, meaning ‘stairway 9, 7th floor’, was the place I had to meet up Monday, 4 July, 2022, the day my insight into the neurological department of the Hospital of the Kingdom, as it is called, started. I was positively impressed by how they had planned my stay for this EAN Student Teaser Fellowship, assigning me to different areas of subspecialty and with different doctors every day. They gave me login details, showed me the uniform shop, showed me the locker room, and made me an ID card; overall, very welcoming. The true fellowship started the next day, in the ward talking to and examining patients.
In the following days, I followed the on-call neurologist and stayed mostly in the ward so that soon after my start I was already writing notes on patients on my own (subjected to posterior control by a doctor). During my stay, I had the chance to work in the subspecialised departments of neuromuscular diseases, epilepsy, and dementia and to follow the neurologists in charge of thrombolysis and thrombectomy, respectively. In the clinic for epilepsy, I learned a lot about seizure classification and antiepileptic drugs and when evaluating patients on the ward with suspected epilepsy I also got the chance to learn about electroencephalography. When it comes to invasive procedures, I had seen lumbar punctures before, but here I had the opportunity to observe muscular biopsies for the first time as well as thrombectomies and carotid artery stentings.
I took part in every morning conference between doctors, in each of the two daily conferences with other healthcare professionals (nurses, physiotherapists, etc.), and, with special interest, in the daily neuroradiology conference, where cases were discussed with radiologists subspecialised in neuroimaging who showed the possible correlation between clinical observations and imaging results. I learned how important teamwork is both with other healthcare professionals and medical specialists, mainly neuroradiologists, neurointerventional radiologists, neurophysiologists, and neurosurgeons but also cardiologists, infectious diseases specialists, endocrinologists, etc. — but even more among neurologists. Most of the doctors in the department were always open to listening to ideas and considering other possibilities and I really liked the working atmosphere in which no questions were deemed as dumb, and everyone had the right to speak and participate when discussing cases. On one occasion one of the doctors brought in a patient to the morning conference who had the opportunity to be questioned and examined by the whole team, bringing together the minds of all the present neurologists and thereby enhancing the chances of finding the right diagnosis and treatment. Though some could say it requires quite a lot of courage from the patient to stand in front of so many doctors, it is set up in a way so that it does not seem like that at all, and patients seemed to feel comfortable and listened to. This way of discussing unusual cases was very inspiring, and I would like to suggest that we do something similar at my hospital in Spain.
I have only had this one fellowship abroad before so there is not much to compare to. Nevertheless, I must say that I missed some kind of ‘out-of-work’ closer relationship that I would like to have built with the youngest oncoming neurologists. My expectations though were not very high either since I already know a bit about the Danish culture of socialising. I might not have built an extraordinarily strong network of contacts during my stay, which I would have liked to, but time may prove me wrong.
Report from 4 weeks in MS Center CEMCAT
By Nicolás Morato Martín, Madrid, Spain
Visiting the Multiple Sclerosis Centre of Catalunya (CEMCAT), Vall d’Hebron University Hospital, in Barcelona, Spain in July 2022
I am glad to report on my experience during my four-week EAN Student Teaser Fellowship in Barcelona.
The Multiple Sclerosis Centre of Catalunya (CEMCAT) is an international reference centre for the diagnosis, treatment, education, and research on multiple sclerosis. They manage over 3,000 patients using a multidisciplinary approach: not only can these patients receive medical attention, but they can also benefit from physiotherapy, neuropsychology, neurorehabilitation, and art therapy sessions; everything in the same centre. Thus, each person can follow tailored treatment, fitting their specific needs, and even participate in any of the several clinical trials conducted at the CEMCAT. In addition, there is a close collaboration between the neurology team and the neuroradiology service. This alliance of experts in the diagnosis of neuro-immunologic diseases improves the management of a wide variety of patients, most of them suffering from multiple sclerosis, but many others from more rare demyelinating and autoimmune disorders. That is why many international doctors from all over the world choose this centre to carry out their fellowships, making the CEMCAT an international meeting point.
As a student rotating at the CEMCAT, I have been able to take part in the intricate process these patients go through: from the very first consultation, where they receive the diagnosis, to the consecutive follow-up. I assisted the physicians during their consultations, rounds and discussion sessions (where they share the results of their research or debate the management of complex cases). I was also able to visit the strong laboratory associated to the CEMCAT, where they process biological samples for diagnosis and carry out avant-garde research projects. I also participated in the different neurorehabilitation sessions and in the OCT retina-scan section. Moreover, CEMCAT invited me and the rest of the fellows, along with the whole neurology service of the hospital, to a conference where they debated some of the most controversial neuroscientific topics. This has allowed me to learn a lot about neurological exploration, neuroimmunology and neuroradiology in general, but particularly about the complex management of multiple sclerosis. Most importantly, I have had the chance to discover how varied this disease is and how it impacts on patients’ lives.
For this complete experience I have had the privilege of, I want to thank the EAN Student Teaser Fellowship programme for giving me this opportunity, the whole CEMCAT team and especially the teaching department, who meticulously organised our schedules, and my supervisor, Dr. Celia Oreja-Guevara, who made everything possible.
Visit the Student Teaser Fellowship website to find out more about this interesting opportunity for medical students. Interested applicants can get information about eligibility and how to apply, with useful tips and FAQs, and find out how to become a student member of the EAN and get additional benefits.
New application deadline: March 31, 2023
Fellowship period effective from April 1, 2023 to January 31, 2024.