Montreal
Report 1
Reporter: Melpomeni Kountouri, 4th yr medical student, Birmingham University Medical School
Year of visit: 2006
Country: Canada
Region: Montreal , Quebec
Institution: Jewish General Hospital (JGH)
Contact at destination: McGill University is the Anglophone university of Montreal and the variety of electives on offer can be found at http://www.medicine.mcgill.ca/undmededuca/ The electives coordinator is Ms Mary Cecere who can be contacted at electives.med@mcgill.ca
Once you know you have been allocated to JGH the elective coordinator for electives there, is Ms Shana Szikman emacademics.jgh@mail.mcgill.ca. Both are very helpful.
Department: Accident and Emergency
Work / Study undertaken:
The “rounds” start at the beginning of new shifts i.e. at 8am , 4pm and 11pm when there is a handover from one team to the next. The attending (Consultant), resident and/or student, nurse in charge, pharmacist, social worker and department coordinator from both teams attend these. The students do not need to be present at the first handover instead they clerk in new patients. On the contrary, at the end of the shift they have to present their patients to the next team. The shifts are invariably the same: clerking patients, formulate a plan and present it to the attending to finalise it. Teaching usually depends on the attending and how busy the shift is. There were occasions when I stayed for almost a 2-hour one to one teaching after my shift (and my attending’s!). In terms of practical procedures nurses did bloods and ECGs however I was offered to do a lumbar puncture (!) and insert an endotracheal tube. Unfortunately, I could only do the latter.
Description of the service and department:
JGH has an extremely busy minors and majors department with trauma being catered by the nearby Montreal General Hospital . My shifts included both minors and majors and they were lasting from 8 to 10 hours varying from morning to afternoon and evening shifts. Teamwork is a key aspect for the efficient running of the department and no day is the same. Surely no one gets bored there!
Description of the destination:
The city of Montreal is based along the sides of the hill that the locals prefer to call the “mountain” Mount Royal . It is a city with a European air and attitude making you feel at home. The transport system is very efficient and there are at least 2 buses from downtown serving the hospital as well as two metro lines. The only downside is the weather. I was there throughout May and it was raining most of the days…
Were the local people friendly?
Montreal is a multicultural city and the locals have blended very well with each other making the city very welcoming to its visitors. Everyone was very helpful and accommodating, although if you don’t realize that tip is not included in bar(!) bills they can, very embarrassingly, let you know.
Did you feel safe and if not why not? I felt safe enough to use the bus at the end of afternoon shifts ( 1 - 2 am ). The bus driver are obliged to stop when requested as long as it is safe to do so, in order to reduce walking distance during night time.
What did you do in your spare time? Spare time was limited. I was working 10 hour shifts for two out of four weekends… However, during the off days (1 in 3 usually) it was nice to go to the waterfront and the Old Montreal, the historic centre of the city. Also, the views of the city from St Joseph ’s Oratory and a walk up the “mountain” are a must. I also went to Quebec City , which is truly breathtaking.
Is there anything that you would particularly recommend others to do? Other than walking up Mont Royal, enjoying the view from there, and strolling along the narrow roads of Old Montreal there is the amusement park “La Ronde” which is very similar to Alton Towers . A great stress reliever. Also, don’t leave without having tried smoked meat and maple flavoured ice cream and biscuits: delicious.
What time of the year were you there? What was the climate like? I was there in May and it was mostly raining and cold. However, I was working most of the time so I didn’t mind! The weekends I had off, somehow the weather changed to being hot-almost 25C, and humid, something like a sauna.
What was your accommodation like? I found my apartment from the University’s accommodation listings on the internet. I had my own room and the girl who was subletting the place was usually offering to cook for me. Internet was provided (I had my laptop) but there was only one phone line which I had to share with the other girl.
Was it provided? No, it was arranged by myself, a month before the rotation started, through the internet.
How much did it cost? $390 (£205) for four weeks.
Did you enjoy your visit? It was a very good educational experience blended with a nice holiday. An excellent combination.
Did you find it useful medically? - in what way? Absolutely. I was responsible for my patients which meant that I had to be knowledgeable. This level of responsibility is lacking over here although we do get more exposure to practical skills, something that the nurses have taken over in Canada
Has it improved your French? Absolutely, especially medical terminology. Almost one in 4 patients would speak only French.
How has it increased your knowledge of French culture? The entire city is bathed in French culture: from its architecture and history to language and music. It is inevitable to escape this especially when you live around the student areas. In addition, the “metro” daily newspaper is in French and two of the free channels on TV are Francophone.
If you went back would you do anything differently? I would have extended my stay for one more rotation as four weeks may not be enough to fully appreciate this rotation. Also, I would choose to go there in June-July if I had the option.
How did you get there? Flight from London Heathrow to Montreal Trudeau Airport.
What was the approximate total cost?
Travel: Flights & Insurance - £599, Transport - £150
Accommodation: £205
Other: Living costs - £200, Study Permit -Medical Examination - £184, Application to McGill Medical School - £230
Total: £1,568
Is there any other information that you think may be useful? I would thoroughly recommend a clinical elective in North America as it prepares students from the UK very well for final year.
Report 2
Reporter: Alison Munro, 5th Year Medical Student, University of Leeds
Year of visit: 2004
Country: Canada
Region: Montreal, Quebec
Institution: Hôpital Général Juif
Contact at destination: Electives are arranged through McGill University because it is a teaching hospital. Email electives.med@mcgill.ca or visit their electives website at http://www.medicine.mcgill.ca/undmededuca/
Department: Emergency Medicine (A&E)
Work / Study undertaken:
I was included on the doctor’s rota and worked a mixture of earlies, lates and night shifts over six weeks. I was expected to carry a similar workload to a first year resident, which was a lot more responsibility than I am used to in the UK. I would take a history and examine new patients who came to A&E, come up with a differential diagnosis and order any necessary tests. Each patient would then be presented to the Attending (Consultant), who would check over and modify the plan. It was then my responsibility to keep checking on the patients I had seen including blood results, imaging and consults until they were discharged or transferred from the department. At the end of each shift there was a round where patients were handed over to the next team, where a brief summary of each patient would be presented. This did wonders for my confidence and presenting skills, as there was no opportunity to be unprepared or shy.
Description of the service and department: JGH is a non-trauma centre, adult, general hospital in the Jewish area of Montréal. All paperwork is done in English but there is a mixture of French and English speaking patients, along with a bit of Yiddish, Polish, Italian, and many others!
Description of the destination: Montreal is a very European North American city. It is extremely multicultural and thrives on these influences. There are very distinct areas such as the Jewish area, the Italian market, China town which you can hardly believe are all part of the same city.
Were the local people friendly? Very friendly – the Canadians have a more moderate version of the American ‘Have a nice day’ culture.
Did you feel safe and if not why not? Montréal was a very safe city. People still leave their houses and cars unlocked and there is very little crime. I felt safe as a single woman walking around on my own and using public transport, even late at night.
What did you do in your spare time? I visited all the ‘must see’ tourist sites, but also just did regular things to really get a feel of city life. I also visited Quebec City (the capital of the province), Toronto and Niagara Falls.
Is there anything that you would particularly recommend others to do?
In Montréal
Go cycling along the canal and get a picnic from Atwater market
Make the most of any outdoor festivals that are on: for example, the film, comedy, jazz and art festivals.
Walk to the top of Mont Royal – the hill that the city is named after. It’s really not very high, but nothing is allowed to be built higher than it in the city – therefore you get a good view!
Go to the baseball. Even if you don’t like sport, go for the atmosphere. It is very confusing because they try to do all the commentary in English and French, but you will be entertained by the performance from the people selling hotdogs, crackerjack, beers and barbe au papa! Oh, and there’s some people batting a ball around. . . .
Out of town
Visit Quebec City. It is a very quaint walled city where the parliament for the province is held. There are lots of beautiful buildings to see, for example Chateau Frontenac. It is a grand hotel built in the age of the railways and you can have a guided tour with a bellboy from the 1800s, which is well worth it!
Take a trip to Toronto. It is about 4 hours away by train but is definitely worth the journey. The CNN tower is the ‘must see’ attraction, especially if you go right up to the skypod at sunset – it’s beautiful.
What time of the year were you there? What was the climate like? 1st August - 26th September. It was a ‘bad’ summer and the weather was still fantastic – temperatures reached 30 degrees C. However, it can be very humid in the city, which is not very pleasant.
What was your accommodation like? I stayed in an Apartement-hôtel as my elective was during Canadian University term time and there was no space in their halls of residence. It was a 20 min bus ride from the hospital, in the down town area which was perfect for my time off.
Was it provided? No, I had to arrange it myself through the internet. No one at the University or Hospital was able to help.
How much did it cost? £200 per week
Did you enjoy your visit? Very much, I am already considering going back there to work in a few years time.
Did you find it useful medically? - in what way? Yes, I saw a wide variety of patients and practiced all of my history and examination skills. I now feel much more confident about being a house officer next year. On the downside, there was little opportunity to practice practical skills, because the nurses do all the bloods/venflons/nasogastric tubes etc. In the minor injuries unit there was always an opportunity to practice suturing though!
Has it improved your French? Absolutely.
How has it increased your knowledge of French culture? It increased my knowledge of French-Canadian culture. I learned a lot about the history of the area and how people feel about the French/English divide.
If you went back would you do anything differently? I don’t think so. I had a great time – it would just be nice to have been there for longer!
How did you get there? Flew from Manchester to Paris, CDG and then to Montréal
What was the approximate total cost? Around £3000 altogether. It sounds a lot of money, but I was kindly given some money from university trusts and educational charities. The main costs involved were:
Flights
Accommodation
Immigration medical (must be done several months before by a specialist GP) ~ £150 including blood tests and chest x-ray
Fees to the Canadian University ~ £250 to arrange an 8 week elective
Travel insurance
Metro travel passes ~ £25 per month
Spending money
Is there any other information that you think may be useful?
Monthly metro passes are great value and can be used without restriction on the underground and buses. However, you can only buy them in the first few days of each month, so don’t miss out.
You do not need any kind of permit to do an elective in Canada, but you do need to deal with Canadian Immigration. You must do this early as they only correspond in writing, by post. It is impossible to contact them by phone or email or fax! You will require a letter from them that says you are a healthcare student on a temporary visit to the country. Before they give you this, you will have to have a full medical with one of their registered GPs. For more information see Immigration Canada website http://www.cic.gc.ca/english/
Report 3
Reporter: Shazid Karim, 5th Year Medical Student, Guy’s, King’s and St Thomas’s School of Medicine
Year of visit: 2004
Country: Canada
Region: Montreal, Quebec
Institution: Montreal General Hospital
Contact at destination: Electives are arranged through McGill University because it is a teaching hospital. Email electives.med@mcgill.ca or visit their electives website at http://www.medicine.mcgill.ca/undmededuca/. The elective co-ordinator is a very helpful lady called Andrea McDaniel
Department: Trauma Surgery
Work / Study undertaken:
Work begins early at with a 7am ward round which everyone attends. This takes about 1.5 hours at which point the team has breakfast together in the canteen. Then we present to the Staff (Consultant) and he decides what jobs need to be done for the patients on that day. During the day if a trauma occurs everyone in the team is bleeped and there is a mad rush to get to the trauma bay where the patient will have arrived. It can be very exciting and busy or very quiet depending on the time of day and whether it is a weekend or not. I observed the management of traumas at the start but as my confidence grew I was allowed under supervision to be in charge of traumas which was fantastic. There were also daily scenario sessions which were good for learning. In terms of surgery, you can scrub in whenever you like but the mcgill medical students get priority and hence I only got to see basic operations like hernias but I did manage to suture a bit.
Description of the service and department: MGH is a level 1 Trauma Centre near the downtown area. I was attached to the Trauma Team who work in conjunction with the general surgery team and share the same offices and common room. Patients speak French and English and it is only rarely that a non-Enlgish speaking patient presents.
Description of the destination: Montreal is a beautiful city with a good mix of European and North American influences. It is very hilly but the good metro and bus system make it is easy to get around. It is as you would expect cheaper than London.
Were the local people friendly? They were very friendly and as soon as they find out you’re from England they become even more so. My accent was amusing to them and hence I had no problem making friends.
Did you feel safe and if not why not? I felt very safe much more so than I do in some parts of London.
What did you do in your spare time? The only spare time I had was on weekends but there are plenty of things to see and do from the common tourist attractions to some hidden treasures like playing petanque (French for bowls) with the locals in the park. The casino is also amazing!
Is there anything that you would particularly recommend others to do?
Mont Royal is a must as is walking through Vieux (Old) Montreal and sitting down to have a coffee to take in the atmosphere. Montreal also has a great nightlife with many clubs and bars including 737 which is a club that is situated on top of a skyscraper building giving fantastic views of the city.
Out of Montreal there is also lots to do. Cities like Toronto and New York are under 6 hours away and it’s a good idea to take a weekend trip. Toronto has lots to see like the CN Tower and New York is fabulous.
What time of the year were you there? What was the climate like? I was there in August which meant the weather was great- hot and humid- definitely T-shirt and shorts weather.
What was your accommodation like? I stayed in halls accommodation for 2 weeks and then with my aunt for the rest. It was pretty basic but it meant I got to meet other students.
Was it provided? No, I had to arrange it myself through the internet.
How much did it cost? £100 per week
Did you enjoy your visit? I had a great time and hope to return one day
Has it improved your French? Without a doubt
How has it increased your knowledge of French culture? Certainly. Some parts of Montreal are distinctly French and English is barely spoken and it was from these areas where I learn the most.
If you went back would you do anything differently? I would probably prepare myself a bit better as they expect a lot of medical students!
How did you get there? Flight from London to Boston. Coach from Boston to Montreal..
What was the approximate total cost?
· £150 for the medical
· £400 for the elective
· £200 for accommodation
· £400 for flights
· £100 insurance
· £400 living
· Total = £1650
Is there any other information that you think may be useful?
As with any elective in North America, plan early and book early as places get taken quickly. Use the website as it very useful and get the compulsory medical done early and everything will run smoothly.
Report 4
Reporter: Frances Slatter, 5th Year Student, University of Leeds Medical School
Contact at destination: Electives at Royal Victoria and many of the other anglophone hospitals need to be arranged through McGill University. This is easy to find out about on their website, there’s loads of information although there are also lots of forms to fill out.
Year of visit: 2006
Country: Canada
Region: Montreal, Quebec.
Institution: Hôpital Royal Victoria (RVH)
Department: Emergency Medicine (A&E)
Work / Study undertaken
I spent one month in the emergency department, medical students are basically rostered onto the junior doctor schedule, doing 4-5 8 hour shifts per week, a combination of days, evenings, weekends and night shifts. It seemed like I was there an awful lot! It was great because it means you get to work directly with the attending (consultant) on shift, clerking patients who come in then presenting them and working out a management plan with their supervision, basically getting one-to-one consultant teaching for eight hours. At the RVH they don’t get many medical students so they seemed quite keen to teach, although while I was there, there were 2 McGill students on their elective and one other British student. There was an hour’s teaching every week day for students and junior doctors which you were expected to attend and there was quite a strict system of attendance and feedback on your performance. There was also grand round monthly which was a morning of lectures.
Description of destination
The Royal Victoria Hospital (http://www.muhc.ca/pfv/rvh/) is an English speaking, state-funded hospital affiliated with McGill University. The hospital fairly large; it is one of 4 McGill University hospitals in the city, and the emergency department sees around a hundred patients each day. The trauma centre for the city is located at a different hospital, but the Royal Victoria ED sees a wide mix of cases including more complex cases due to the number of specialties housed within the hospital; patients are frequently transferred to the Royal Victoria from other emergency departments because their consultant is based there. The hospital itself is about 10 minutes walk from McGill university, in what looks like an old castle on the side of Mont Royal, the hill from which Montreal gets its name.
Montreal is a fantastic, unique place to spend 2 months. Imagine French cafés, bars and patisseries on big American style boulevards, where people switch from French to English and back again mid-sentence. It’s unlike anywhere in North America or Europe and has a brilliant relaxed feel. I was there in August and September and there was a heatwave when I arrived, but by the time I was leaving the leaves on the trees were starting to turn. The city feels safe at anytime of the day and the metro system is cheap and easy to use, although you can walk almost anywhere you’d need to go.
Were the locals friendly? Everyone was really friendly and helpful.
Did you feel safe and if not why not? I always felt safe, using the metro and walking around at night. Montreal has very little crime compared to the UK. My flatmate used to go out leaving her windows open and doors unlocked.
What did you do in your spare time?
I went to a French language school which was brilliant as I made loads of friends and got an instant social life! I went to the cinema, out for meals, bars, clubbing, to see the ice hockey (a BIG deal in Canada), and Canadian football, hung out in Mont Royal park. I also hired a car and travelled around Quebec; to Quebec City (the province capital) and north up the St. Lawrence river, seeing some amazing scenery and going whale-watching.
Is there anything that you would particularly recommend others to do?
In the summer, hang out on Sunday afternoons at Piknik Electronique, a weekly dance music festival in the park on Jean-Drapeau island just south of Montreal. Or go to the Tam-Tam in Mont Royal Park where people go every Sunday to play music, relax and dance around.
Climb the steps to the top of Mont Royal for an amazing view over the city.
Get all your food from Jean-Talon Market, a huge Quebec-produce fruit and veg market with its own TV programme.
Go and see a hockey match at the Centre Bell. Montrealers support the Canadiens (the “Habs”). We only saw a pre-season match but the atmosphere was amazing!
Go to Schwartz’s deli for smoked meat and cherry coke - a Montreal touristy must but definitely worth it.
Get a coffee in Old Montreal and pretend you’re back in Europe.
Go whale-watching (and get soaked) in Tadoussac.
You can also visit Toronto, Niagara Falls and New York fairly easily from Montreal.
What was the climate like?I was there August to September and didn’t need to wear a coat until the last 2 weeks of September when we went further north.
What was your accommodation like? Great. The first 2 weeks I lived with a Quebecois girl, arranged through my language school, the rest of the time I lived with a French couple in downtown Montreal.
Was it provided? No.
If not who arranged it?I arranged it all myself. The University and Hospital were not very helpful with arranging accommodation. I found my first two weeks accommodation through my language school as a “homestay” to practice my French and then organised the rest by contacting people of the housing list sent to me by the university.
How much did it cost?The home stay was included in my language school fees; the rest of my accommodation was £50 a week.
Did you enjoy your visit?I loved it, and didn’t want to leave!
Did you find it useful medically?I had plenty of opportunity to practice my history taking, examination and presenting, get experience at suturing and see lots of different cases. Unfortunately the nurses in the emergency department did all the bloods, cannulas and ECGs so I found it difficult to get to practice these.
Has it improved your French?Definitely, I spoke French to the people I lived with, and although the hospital was all English speaking, as it was the emergency department French speakers would come in very often and I got the opportunity to speak French in the hospital. When I ran into language problems almost all the staff is bilingual.
How has it increased your knowledge of French culture?I know a lot more about Quebecois culture and history and the Anglophone/Francophone divide.
If you went back would you do anything differently?I might have gone for a different rotation because my knowledge of general medicine at the end of fourth year was quite good enough to get the most out of the experience, although I did learn things that have helped me in fifth year.
How did you get there?British Airways, London to Montreal.
What was the approximate total cost?
v £400 for flights
v £80 for BMA medical and travel insurance
v £300 for accommodation
v £250 for the immigration medical exam blood tests and chest x-ray
v £230 for McGill application and tuition fees
v £600 for language school 2 week intensive course and accommodation (a lot but this made my trip)
v £400 living and spending money
Total = around £2600
Is there any other information that you think may be useful?
Sorting out the temporary student visa from the Canadian embassy took quite a long time. It needs to be done quite a few months in advance as requires going for a medical examination with an approved GP - there’s only one in Leeds. This was very expensive but I can recommend getting hold of the list of approved GPs from the embassy and phoning those in your area as they charge different amounts and you may be able to get it done cheaper if you are willing to travel.