From Elective Reviews - Brazil - Hospital Distrital Dr Jose Gomes da Silva and Unidade Mista da Saude, Brazil, 2012 - Phoebe Owen
I got a wonderful full medical experience during my elective. I did seven weeks of work and had two weeks holiday. My seven weeks were split between Ibiara and Itaporanga, spending a week in each, and then alternating. My time in Ibiara was spent working at the local health centres, usually from 9am-12pm, and then 2pm-5pm. These health centres resemble GP surgeries in the UK, but the specialist healthcare is not free, so the state-funded health centres cover a lot of things for free that would be covered by specialists. We did a lot of general medicine, paediatrics, some obstetrics, and even psychiatry as part of the day-to-day consultations. The hospital in Itaporanga was also state funded. This was fast paced. Quick morning ward rounds, then triage of patients, seeing up to 104 patients a day on the busiest days! It is a mix of everything general once again. As an elective student, I shadowed one of the very senior doctors there and mainly did GP style consultations. The final aspect of my elective was working on the SAMU – the ambulance service. A doctor, nurse and healthcare assistant cover 24/7, and so it was great to go out as part of that emergency team. One particular obstetric emergency involved a 12 hour round trip, returning to Ibiara at 2am, just to get this woman some free emergency obstetric care! My hours at the hospital were 8am-6pm Monday to Saturday and on the SAMU you could cover a 24 hour shift at a time. I stayed with my friends, the Prices, and so accommodation was cheap.
I loved the elective. It was very general, which was what I wanted. I saw everything – obs & gynae, paeds, psychiatry, geriatrics, learning disability, general medicine, trauma and everything in between. There were plenty of opportunities to ask questions. It was not really a “hands-on” elective in terms of interventions or procedures, but history-taking, examinations and management were the bread and butter of the elective. The doctors I worked with were excellent. Also, there was the element of tropical medicine of working in Brazil – dengue fever is a huge problem there and something I wouldn't have encountered here in the UK. It is lovely and sunny, so good chance to top up your vitamin D! Also, working in state funded hospitals means that many of the people you are treating are very poor and cannot afford private healthcare. Therefore, their presentation and social circumstances can also be an interesting element of their management. I think the main downside is the lack of intervention if that is what you are looking for. I didn't do any hands on procedures, but for me that wasn't really an issue.
This elective wouldn't suit people who don't speak Brazilian Portuguese. Apart from my host family, everybody else I worked with spoke Brazilian Portuguese alone. Because it is in the rural (sertão) region, people do not speak English. If you want an English speaking elective in Brazil, then I can recommend a hospital called IMIP (Instituto de Medicina Integral de Professor Figuera) in the city of Recife. A lot of previous Nottingham students have done electives there and they have a well-run elective programme, with many staff members speaking English. I organised my elective through family friends.
Itaporanga and Ibiara are in the state of Paraiba in Brazil. The surrounding region is very rural, so you have to travel quite a way to get to the holiday destinations! For the two weeks of holiday time we went to João Pessoa, which was about 300 miles away but is on the coast, with wonderful beaches - a beautiful place for relaxation time after working very hard!
I think an elective somewhere like Ibiara (or probably anywhere) is very much what you make of it. If you have an area of special interest, don't be afraid to express that interest to your elective supervisor. In my experience, they will bend over backwards to make it interesting for you so don't be shy!
Approximate cost £1500