Medicine @ Catz: Elective experiences

St Catharine’s has a proud history of educating exceptional doctors and 59 of our students are currently studying medicine. Undergraduates study the medical sciences first (years 1, 2 and 3), before learning to apply that knowledge to medical practice as a clinical student (during years 4, 5 and 6). 

During the summer after their fifth year of studies, students complete what is known as the Elective Studies Student Selected Component – a 7-week placement that students organise at home or abroad to pursue a clinical or research area of their own interest.

Professor Stefan Marciniak (2011), Director of Studies in Clinical Medicine at St Catharine’s, explains:

“In addition to Cambridge being one of the leading hubs for medical teaching and research, Catz students also benefit from rotations across the whole of East Anglia. By the end of their clinical studies, it is essential that they have experienced day-to-day medicine in District General Hospitals as well as the cutting-edge approaches being pioneered at hospitals like Addenbrooke’s, the Rosie and the Royal Papworth. On top of this, we encourage our students to make the most of their elective placements to broaden their horizons and experience a wide variety of clinical, research and industrial settings in the UK and around the world.”

We caught up with medical students and alumni now practising medicine to find out about the opportunities and insight they gained from their elective placements. Read on to find out about each of their experiences. 

Clinical experiences in London, UK and Addis Ababa, Ethiopia

Helen Alemayehu has just started the final year of her medical studies at St Catharine’s. This summer, she spent 4 weeks at Great Ormond Street Hospital (GOSH) in London and a further 3 weeks at the Tikur Anbessa, the largest specialised hospital in Ethiopia.

Helen’s time at GOSH was spent on the cardiac intensive care unit, where she observed how a high-performing team managed newborn infants and children with heart diseases (mostly common congenital conditions) and cared for these young patients before and after surgery.

“I developed an interest in Paediatric Medicine during my placement in fifth year so I chose to spend a month at GOSH. I saw patients presenting from their first day of life right up to a 16-year-old heart transplant patient, and had the chance to see cases that rarely present at other hospitals. I was amazed by the quality of care, shown by the GOSH team’s expertise, careful communication with parents, and ability to make on-the-spot decisions when assessing a patient whose condition is worsening. In addition to learning about cardiac physiology in greater detail, I was able to take histories from the parents of four patients, and learnt how to examine babies and even some ultrasound techniques." 

Later on, Helen’s time at the Tikur Anbessa, a public hospital in Ethiopia, was split across different specialties: 1 week covering paediatrics, general medicine and oncology, and 2 weeks spanning the breadth of internal medicine. She found it eye-opening to experience back-to-back placements in two very different healthcare systems and cultures:

 “My three weeks at Tikur Anbessa reinforced to me the immense value of thorough history and examination – the foundation of modern medicine – which were often relied on more where patients were unable to fund specialised investigations. It was encouraging to see that patients were always surrounded by their family, though upsetting to see many people severely unwell with otherwise preventable diseases. One example of this was a 12-year-old girl unwell with the consequences of a congenital heart condition, in contrast with my GOSH placement, where many infants were recovering from the surgery that she was unable to afford.”

Clinical experiences in Mumbai and the Spiti Valley, India

Alumna Shivani Manoharan (2017, Medicine) is now a qualified doctor and has recently started a radiology rotation in Manchester. During her elective in 2022, she was initially based at the Tata Memorial hospital, which is the largest cancer centre in Mumbai and one of the top cancer hospitals in the country, and then joined a group from Himalayan Health Exchange who provide medical care in remote settings like the Spiti Valley in the northern Indian state of Himachal Pradesh.

“When shadowing clinics at the hospital in Mumbai, many patients had travelled for days and presented with advanced cancers because the care they needed was not available locally. This meant I observed often very difficult conversations, particularly in the paediatric cancer clinic where a father who had to be informed that there was nothing that could be done for his son. However, it also meant that I saw innovative procedures for the treatment of rare disease, such as the nuclear medicine department using antibodies labelled with radio isotopes to image and treat specific cancers. In addition, with smokeless tobacco products being popular in India, I learnt about head and neck cancers that I wouldn’t expect to see in the UK.”

“Then it was on to the Himalayas! I observed how the environment and distance from healthcare centres can affect a population: there were eye issues caused by sun damage from working outside without eye protection, thyroid issues because the soil is low in iodine at altitude, and dental problems because the water isn’t fortified with fluoride and it isn’t easy to access a dentist in remote regions. 

“While there were some patients we couldn’t help, the team made an immediate difference to the communities we visited. We had a mobile pharmacy dispensed sunglasses and glasses of different strengths, as well as a one-off treatment for worms that would otherwise stunt the growth of children. We also had a dentist travelling with us to perform extractions and fillings, who donated their kit to the local dentistry school at the end of the expedition. There were also unexpected moments like using our mobile ultrasound machine to do quick scans on the motorbike rider after an accident and before he travelled to the nearest hospital, and stopping to enjoy the views from the monastery where we were based one day. The experience convinced me that I want to continue to be involved in expedition or outreach medicine in the long term.”

Clinical experiences in Athens and Lesbos, Greece

Alumna Rhiannon Osborne (2016, Medicine) is also now a qualified doctor and has recently started a hepatology rotation in Liverpool. She made the most of her elective by building on existing connections and experiences gained during 2019–20, when the College helped to secure the agreement of the Clinical School to postpone the clinical phase of her education so Rhiannon could devote a year to working in global public health, including providing emergency relief to migrants on the Greek island of Chios.

For the first part of her elective in 2022, Rhiannon travelled to Athens to support the work of Médecins du Monde (MdM), an international humanitarian organisation. MdM has a permanent clinic in the city for people who cannot access the Greek healthcare system, mostly asylum-seekers, undocumented migrants and people experiencing homelessness.

 “It was a great opportunity to shadow doctors during examinations in the clinic. I rotated across several specialties (from paediatrics to mental health) and saw first hand how essential care such as vaccinations and diabetes medication was systematically denied to people and how organisations such as MdM try, but struggle, to fill the gaps.”

 “When I arrived, there was a campaign underway in response to the eviction of people from a migrant camp in Athens (the last in the city area), which was located on land earmarked for a new shopping mall. As well as working in the clinic, I joined this campaign, led by members of the camp, to halt the eviction."

Rhiannon’s final week involved shadowing medics at a clinic in a migrant camp in Lesvos.

"There is increasing militarisation of Europe’s borders, including the creation and expansion of prison-like closed detention centres and the intensification of violence against migrants in the Mediterranean region. At the time of my elective, Lesvos was in the process of finalising a new closed centre. The existing camp was partially closed and heavily guarded, and I witnessed people being held in shipping containers for months. We saw patients with injuries such as fractured patellas, consistent with being beaten. Visits to hospital could not be arranged by the clinic but required approval from the camp management, which was often denied."

Since her elective, Rhiannon has plans to support similar clinics in the future and has started to get more involved in causes supporting migrant justice, such as the Patients not Passports campaign in the UK.

Innovative experiences in Cambridge, UK 

Praharsh Babu has just started the final year of his medical studies at St Catharine’s and is also serving as Co-President of the Middle Combination Room (MCR), having been re-elected to represent the College’s 370+ postgraduate student community, which includes medical students during their clinical studies. Praharsh sought exposure to the different career paths available after a medical degree through his elective, which enabled him to focus on fostering innovation within the life sciences. He was based at Innovia Technology, a global innovation consultancy in Cambridge, where he supported the delivery of four different projects for Innovia’s clients.

Project 1

“In this typical Innovia project, we helped a client in the healthcare space to understand the current views on certain emerging disease landscapes that are expected to have a large impact on healthcare systems worldwide in the coming decades, with the aim of identifying areas for potential intervention – it was important and exciting work that was right up my street! Throughout this project, I reviewed clinical literature and constructed frameworks to understand the key connections between emerging fields which were then used to identify promising opportunity areas.

“Unsurprisingly, I felt this project helped me to further improve my literature evaluation skills, but the most valuable outcome from these projects was a new ability to quickly understand, extrapolate, and summarise the key concepts of a paper. I have a tendency to get sucked into details when reviewing literature, but due to the time constraints of these projects, I learned to be more efficient and prioritise which information would be the most relevant to the project’s goals. Similarly, when presenting these findings, I had to adapt how I presented the information depending on the content and audience. I am sure that the improved critical appraisal and presentation skills I gained will be very valuable going forward.”

Project 2

“The next project drew directly on my medical background to refine scope; I joined a team in the thick of it, working to identify novel intervention agents for certain actively studied disease processes. As part of a specialised sub-team, I rapidly evaluated the evidence basis for a broad range emerging interventions, prioritising and de-prioritising agents based on critical appraisal of the clinical literature to narrow our scope. It was satisfying to know that my work helped guide the project’s next step and I felt my contribution was highly valued even as an intern. As I finished up my elective, the work was still ongoing – I wish I’d been able to stay longer and see where things ended up!”  

Project 3

“This project was a little different, quite creative, and very interesting! It focused on improving quality of life parameters for subpopulations with certain health issues. I got to use my medical background in an unexpected and incredibly creative way! As a team of behavioural scientists, designers, chemists and medics, we brainstormed solutions to long-standing challenges, and we all brought our unique perspectives. There was a flurry of post-it notes of some amazing ideas, lots of great and a few not-so great ideas, but in these ideation sessions, nothing was off the table. The creative environment at Innovia helped me to develop new approaches to problem solving and sparked lots of great ideas – it was so fun!”  

Project 4

“The final project had a very different style of project, we were working for a Fast-Moving Consumer Goods (FMCG) client looking to connect with a target demographic. It relied on behavioural science and design rather than the biomedical principles that I was familiar with. I felt a bit out of my depth, but working in a generalist capacity was actually a refreshing change of pace and it gave me a foundational understanding new disciplines and filled gaps in my knowledge of the world around me. In addition, thanks to the amazing support at Innovia, I was able to learn the basics of coding in Python, a skill I’d been wanting to learn for years.”

Find out more about studying Medicine at St Catharine's.