Student Reflection by Damaris Ndambuki

Overview of elective in obstetrics – gynecology with University of Toronto’s School of Medicine

The elective period is part of the curriculum in 5th year for medical students at the Moi University School of Medicine. It lasts for 6 weeks and a student can do their electives within the country or oversees. I was selected to do mine at the University of Toronto. The 21st day of April was the onset of the cascade of the events that followed during my elective period in Toronto, Canada.

Arrival
We arrived at Toronto airport at 3pm on Monday the 20th April. Rachael Spitzer picked us up from the airport, dropped us in the place that was going to be home for the next 6 weeks (the nurses residence-93 Gerrard), we went for shopping for some final household goods and then went for dinner. Our had the first dinner in Canada was at College Park. I had chicken and French fries after which we went back to our home. This marked the end of the long first day.

Orientation
Toronto is a town full of roads streets, avenues and the like and for a stranger it’s a big deal to master directions. It was good that the first day was left for introductions to the many places and infrastructure. It began on Tuesday at 9am with Aaron Yormoshuk picking us up from our `home’. First we went to the Department of Obstetrics. Next we proceeded to the public health building where we met David Zakus. Then to Aaron’s office. There we did some internet browsing, got our Toronto phones and then the day really began.

Erin Mcfadden a second year medical student who had been in Kenya during the summer of 2007 came to pick us up for hospital orientations. We went to Mt. Sinai then to Women’s College and met the relevant clinicians.

Women’s College Hospital
I did the first half of my elective at Women’s College. My supervisor was Dr. Janet Bodley. She was a great teacher to me and organized that I was able to attend other clinics with other staff who deal with different things in obstetrics and gynecology.

The clinical work included:

  • Labour and delivery suit
  • Clinic
  • Operating room
  • Fertility clinics
  • Sonohysterograms

My experience in labour and delivery was fantastic. One of my elective objectives was to learn monitoring of labour and compare it with the practice in Moi teaching and Referral hospital back in Kenya. Labour monitoring is electronic in Toronto unlike at home. An ultra sound for monitoring the fetal heart rate is attached to the mothe’rs abdomen and together with this a tocometer for monitoring the contractions is attached. This machine system is accompanied by regular Vaginal Digital exams to make a comprehensive report of the labour progress.

I also had a good time in the fertility clinic up in York Mills. It was incredible the way infertile couples can be made happy once again by proving that their problem is not beyond control.

Mt. Sinai Hospital
Mt. Sinai was my location for the last 3 weeks of my stay in Toronto. I got to work with Dr. Elyse Levinky as my mentor.

I worked in the following subsections:

  • Obstetrics clinic
  • Gynecology clinic
  • Operating room
  • Ultrasound
  • Labor and delivery

The operating room was a new experience for me. I got to observe a laparascopic oophorectomy, myomectomy and loop electrocauterization of endometriotic tissue. This was a very new experience for me – having not had a chance to see one laparascopic procedure back in MTRH.

Sight seeing in Toronto
This was done in a little proportion of the time in Toronto but nonetheless formed a very important part of the elective period. In the whole elective period we managed to tour the following places:

  • Toronto island
  • Lake Ontario beach
  • Chinatown
  • Niagara falls
  • CN Tower

Dinners
Our busy and tight schedule was punctuated by many dinners in our supervisors` houses. We had several dinners and it was great fun.

Conclusion
It was very importance that this elective period came in my clinical training. It has been a great experience and was very necessary. I have a lot to take home and hope that Moi University and Kenya as a whole will benefit from what I gained here.