During my time in Scotland working at the University of Edinburgh school of medicine rotation, I was able to identify some major differences between the United States and their system here. I will break them down into three sections:

1. Requirements for medical school entrance:

This topic was particularly interesting to me, as I was able to spend some time with high school students who were eager to enter medical school. They were also spending time in the operating room, trying to get a feel for there true desire to enter such a rigorous course of study. In order to enter medical school, you must have excellent grades during your software Junior and senior years of High School, particularly in the Sciences and mathematics Fields. You must also get Letters of recommendation comma and show that you have a true passion for the challenge which lies ahead. Instead of taking the MCAT exam, they require something called the "UKCAT." I have attached a description of this from the official website:

"The UKCAT is an online test required by medical schools in the UK, designed to test cognitive abilities, attitudes, critical thinking, and logical reasoning. UKCAT is the UK Clinical Aptitude Test meant to select applicants with the right abilities to pursue careers in the health care field. The UKCAT test is not based on a sciences related curriculum; the format of the test covers questions that assess logical skills such as decision making, quantitative reasoning or situational judgement."

It was interesting to see how this test is not based on sciences, but instead focuses on logical skills and more real-life abilities.

It was also interesting to note that an undergraduate degree is not required, and is very much not the norm. Thus, it is very normal to see 22 year old doctors entering their residency.

2. Medical school duration and curriculum:

Medical school in the UK is a combination of what we would consider an undergraduate degree, mixed with medical school. However, instead of having a grand total of 8 years, it ends up only being 5 years long. During this time, they are not exposed to clinical rotations in the same fashion that United States medical students are accustomed to. They are allowed to observe occasionally during their final years of school, but direct patient contact is not allowed.

3. Residency positions and duration after graduation from medical school:

Immediately after graduating from the 5-year medical school course, they are considered "Junior Physicians." At this point, they will begin a two-year program known as the "Foundational Years." It is here that the new doctors will get direct exposure to patients, similar to the third and fourth year of medical school in the United States. A major difference is that they are now considered physicians, and are able to have prescribing and treating abilities, with the appropriate supervision as required. Once these two years are completed, the JR Physicians will find out their Match results into a specialty of their choosing.

Once the Match is complete, they are now considered "Registrars" for the next five to seven years (instead of Resident Physicians). Once they complete this., they will then finish there board exams, and be considered a "Consultant" physician in their field of choice. If they so choose to be a surgeon as their specialty, once they have completed their training, they can then be recognized with the Royal College of Surgeons. If this recognition is achieved, they earn the title of Mister (Mr.), replacing the previous title of Doctor (Dr.).

My experience in Scotland was beyond what I had hoped for, and I really enjoyed learning from the generosity and wealth of knowledge that the different physicians offered me. I gained a great appreciation for the differences  in comparing health access between the UK and the US. While there are challenges within the National Health System (NHS), the benefits were seen daily, and I look forward to seeing how our own health system makes improvements to benefit all.

 

Edinburgh Castle

 

 

At the entrance of the castle

 

 

Entering the castle interior

 



 The view of Edinburgh from the castle

 

 Mosque within the castle walls.

 

 

Mons Meg, the cannon that was hauled around by horses to destroy fortresses and castle walls.

 

The best travel partners, even with the cold, windy and rainy Scottish days.

 



At the beach. It was cold and windy, but the sun was out, so we were.

 



 Had to get our feet wet, but wore a coat.

At a pier and lighthouse

 



 

Our family hike up to the ruins of an old chapel.

 

The surgery department is very strict, as you should expect, with any photography. However, this is a picture of the "anesthesia theatre." Yes. This is the first room that the patient will encounter after being in the pre-op area. In this room, the patient will sit on the operating table. Here, they get their IV placed, receive induction agents, and become intubated and central lines inserted. Everything happens here first, and then they are disconnected from this ventilator, and are pushed through the double-green doors, to then be reconnected to a second ventilator in the operating theatre. Once the patient is in there and the surgery begins, this room is then used as the place to drink tea and coffee and chat, all while being able to peer through the blinds and check on the patient and monitors. 

This is a "selfie" in the anesthesia theatre.

 

The airway cart comes with its' own printed algorithm. It's nice to have as a reference, especially during stressful events. 

 

The double-decker bus that takes me to the hospital each morning. They don't begin surgeries usually until 8:30.

 

The front lobby and information desk.



 

 

They call each nursing unit a "ward." And the operating rooms are called "operating theatres." 

 

Holyrood Park, which is a mere 5 minute walk from our flat, boasts picturesque lakes, rolling hills of freshly cut grass, and is usually lightly covered with a misty fog.

 

 

The Royal Infirmary of Edinburgh is a short car-ride away, but most days, I commute with the citizens and ride two buses each way.

 

 

My scenic view begins with the locker rooms. As you can imagine, the lack of places to store your clothing and valuables is abundant. In fact...

 



 

...we are provided surgery footwear and scrubs. Most of the time I've been able to find a pair of clogs in my size, but they are all well seasoned with blood and betadine. Yes. Betadine is still the solution of choice in most surgeries here. And when you're done with the clogs, you throw them in the barrel to be cleaned.  

 

 





My journey to Edinburgh wouldn't be complete without my wife and two daughters. This is our first picture after walking out of the Edinburgh airport, and we are excited for the next 4 weeks!