Chirurgie - SCOPE (Famulaturaustausch) von Mouhammad, Mannheim
Even before I began my studies in medicine I had the aspiration to travel & experience cultures in order to comprehend our world a little bit better. I believe - in a world of growing globalization - it is key that physicians be exposed to different cultures [preferably] prior to their beginning of practicing medicine in order to understand their patient's needs better & thus serve their community more efficiently. It's also important for one to be exposed to different health systems in order to broaden one's horizons in terms of care management with respect to finding solutions based on different perspectives.
South America has been on my list of places to visit for the longest time. As soon as the opportunity presented itself via the IFMSA-Exchange program I didn't hesitate to apply. I chose Argentina simply because it's the largest Spanish-speaking country in South America. Therefore its influence on the region is not trivial and so I figured it also has a lot to offer. I expected to be exposed to a culture I've only experienced in film and hoped to understand more about this country by engaging myself with the locals in their daily lives.
I haven't done anything in particular to prepare myself for the trip. BVMD and IFMSA-Argentina did a great job in communicating with with each other & myself to have everything set and ready for my arrival.
As a Canadian citizen I didn't need to go through a visa-application process prior to my travels. Nonetheless I did contact the exchange organizers in Argentina in advance and they also checked for me and confirmed my status. I solely needed to pay an online fee of about 70 EUR, print the receipt and present it upon arrival at the airport in Argentina. Depending on your nationality you should check the embassy website but also contact the exchange organizers in Argentina if you're uncertain.
There weren't any particular requirements in terms of vaccination prophylaxis that I needed to undertake prior to my travels to Argentina. But please do check if your vaccinations are up-to-date. I was also in a foreign country for an exchange semester directly prior to travelling to Argentina so my vaccinations were up-to-date. My foreign health insurance was covered by my Visa card from the deutsche Apobank and so I didn't have to prepare anything in that regard.
I've learned that the northern regions of Argentina are relatively poorer than their southern counterparts. The corruption within the government also doesn't help to make the situation better. Upon arrival to Tucumán I was informed by many locals that some areas are slightly dangerous albeit depending on time of day, location etc. I've been told certain areas are dangerous late at night and are to be avoided if you're alone. That being said, I was out in the city many times and I haven't experienced anything out of the ordinary. On the contrary, only nice people that are willing to offer help whenever it's needed. Personally I think the safety standards are not the best in Tucumán, but if you keep to yourself, are self-conscious, take care with your actions and are with a group of people, nothing would go wrong. The only precautions I took were to blend in with the locals, so for e.g. I wouldn't wear any fancy watches or do anything that would attract unwanted attention. At the same time I didn't have any fears of anyone or anything because worrying the whole time doesn't help either. Just keep to yourself & enjoy the experience in your time.
In Argentina the main currency is Argentinian Pesos. The currency is represented with a dollar sign. At my time August 2017 each 20 pesos were equal to 1 EUR. (Mittlerweile deutlich verändert durch Inflation; Anm. der Berichtekoordination) You can use your credit card for most essential tasks such as grocery shopping in supermarkets or eating in some restaurants, but I always had cash with me because paper is more dominant than plastic. Bare in mind when I had to pay by credit card I was almost always asked for my I.D. and the number. Since I never carried my passport I always gave my german I.D. and that worked most of the time. Also everything is relatively cheap compared to Germany, so you shouldn't have any major concerns regarding living expenses.
Tucumán has a particular northern accent, but with a sufficient level of Spanish, you can manage. I usually had to emphasize to people that I'm foreign and they would speak to me a bit slower/simpler than their normal pace (their normal pace = pretty fast). I believe B1 level Spanish should be adequate, but even then you will learn many expressions and words unique to Tucumán so at least the experience will be fun!
Transport is usually best per bus (named "colectivo" in Argentina). You need a bus card as the bus drivers don't take cash. The bus card needs to be pre-loaded with money to be used. You can do this at regular corner stores but not all of them offer this service so you need to ask. I would recommend loading it with about 100 - 150 pesos for a couple weeks of rides. Each ride can cost from about 6 pesos to 12 pesos depending on destination within the city. The cards are scanned once you enter the bus and you can also see your remaining credit if you wait a few seconds after scanning, so keep that in mind for future reference.
Traveling by taxi is also possible and relatively cheap compared to European standards. I rarely used taxis in Tucumán and almost always used the bus or drove with friends/locals.
I basically tried my best to communicate with everyone in Spanish. But I am guilty of switching to English more than often since it's my mother tongue, at least with those around me who could also speak English. But to be fair you will find yourself speaking more often in Spanish than English, simply because not everyone speaks English or they just choose not to.
It's also wise to buy an Argentinian SIM-Card just to use for internet. Almost everyone in Tucuman communicates via Whatsapp. Your hosts will gladly help you with this.
Living with an Argentinian family definitely has its advantages. I was able to improve my language skills and experience the daily lifestyle of a typical Argentinian from morning until evening. All the habits, expressions and perspectives they had sooner than later became integrated into my life as well. The family provided everything I needed, took care of my food as well as cleaning (they had a maid who came in every morning) so I only had to worry about my leisure expenses, which was nice.
The family lived in an area called "Yerba Buena", which was an upper-class part of Tucumán. The family was well educated and it was just an absolute pleasure staying with them. They had 4 sons and two dogs so there was always something going on in the house and another unique moment to experience.
On a side-note I only looked up Tucumán on Wikipedia, otherwise I haven't made any special preparations in terms of informing myself of my destination. I preferred to be informed on the spot by the locals :)
Since I was there for only 5 weeks I didn't pack too many things, plus I wanted to leave space in my luggage for things I wanted to bring back with me from Argentina, so don't forget to do that.
Depending on the season you choose to go there your wardrobe may differ, but keep in mind that Argentina seasons are opposite to German seasons i.e. Winter is from June to August/September and Summer peaks in December/January so plan your packing accordingly. Otherwise since it's relatively cheap you can also buy anything you're missing from there. I needed a sweater and jacket - had no problems finding nice ones to buy.
The only thing I missed is Amazon when I needed it. Argentina still doesn't have the service of ordering things online, no Amazon, no Ebay. Otherwise all good.
Reise und Ankunft
I landed in Buenos Aires at around 6 in the morning then easily found a bus connection from within the Airport to the city center. From the city center I had to walk to the main bus station and book a bus to San Miguel de Tucuman. Unfortunately the next available bus was around 1pm so I had to wait a while. The ride was then about 16 hours straight and I arrived to Tucuman at around 4 AM the next morning. Carlos, my host, was nice enough to wait for me at the bus station with his car and drove me home. We did communicate with each other the whole time via Whatsapp to let him know of my arrival details.
My internship began a couple days after my arrival so I had time to rest and get to know my host family, which was very warm and welcoming. My first day at the hospital I met most of the residents in my department.
Tätigkeitsbeschreibung und fachliche Eindrücke
I was appointed in the surgery department of a private hospital. To my surprise I've been told that public hospitals are in fact better equipped and have "higher standards" than private hospitals, at least in Tucuman. Unfortunately I haven't had the opportunity to visit a public hospital to confirm this comparison but I can say the private hospital I was in didn't give me the impression of a private hospital according to European standards. That being said, I had no issues with this. I was there to experience something different and I got what I wanted. Also - regardless of the infrastructure - the medical staff was super nice and considerate. They treated me like one of their own, they joked around A LOT and always had smiles on their faces [with Monday mornings being the exception].
Being in the general surgery department meant I wasn't going to see that much "action". Most of the surgeries were repetitive abdominal operations such as laparoscopic cholecystectomies or removal of stones from the ducts. I had a couple interesting experiences where I was allowed to assist with a tracheotomy and I was allowed to sew a wound after an operation was ended. I also had the privilege of playing my own music in the surgery room during an operation after taking permission from the head surgeon [very cool guy]. Turned out we have similar tastes in music and it was a very funny experience (yes fun exists in the OR in Argentina!). I don't think I've learnt as much as I would've liked to with respect to medicine, but in comparison I learnt so much about Argentinian culture, humane contact with others, different ways of thinking about common issues and how to get along with people from different backgrounds.
One particular experience left me with a lasting impression: the older surgeons were operating on an old friend of theirs who was also a doctor and musical composer. This patient studied medicine and music simultaneously, then after graduation decided to follow his passion for music and became a famous classical music composer in Argentina/USA. He even requested that classical music be played during the operation! After they were finished and he woke up from the anaesthesia, his friends/surgeons stood around him to "welcome him back" and things got a little emotional as everyone was happy the operation was a success, they held hands, smiled at each other... the moment couldn't be described with words.
Once I was sitting in the resident's room waiting for the next operation when a muscular, old, bald man with a big moustache walked into the room and all the residents greeted him with respect. He was another chief medic. He approached me, asked me who I was and if I was enjoying my time at the hospital, then, he asked for a piece of paper and pencil. He sat in front of me and told me to look to the side. He then proceeded to draw a caricature of me on the spot - took him about 5-7 minutes to finish and the result was very impressive! That's definitely a memory/gift I'm happy to bring back with me.
All-in-all the hospital experience was definitely worth the trip. The only 'negative' aspect was the hygiene standards, which weren't optimal compared to 'ze German Way' but everyone there learned how to deal with what they had available to them with the capacity they were able to give. And that was a very valuable quality for me to take with me back home.
Land und Leute
Tucuman is situated in northern Argentina between Cordoba and Salta. There's plenty to discover in the city itself but the more exciting parts are towards the north such as the province of Jujuy. One of the IFMSA-Argentina organizers was from Jujuy and she offered to take us Incomings on a little weekend trip to see the beautiful mountains of the region and discover the little villages in between. The experience was unforgettable. We went up 4000+ m to see fascinating salt plains, we saw magnificent colorful mountains, experienced life in small villages and tried all the local food and treats we could get our hands on, even tried some llama meat in the north. The other incomings also visited the city of Salta while others visited Cordoba. I had a full schedule every week with my host brother and his family/friends so I wasn't as flexible nor did I mind because I really wanted to dive in the culture rather than do touristy things every weekend. I did however visit the waterfalls of Iguazu and spent a few days in the capital Buenos Aires near the end of my stay, which was about 8-9 days.
My stay lasted 4 weeks in Tucumán (total 5 weeks in Argentina) but felt much longer and ended too soon. My cultural experience was very rich. I learned about the smallest details such as clapping outside of houses because many had no doorbells and the fact that in the 1800's Tucumán was an independent state for one year! Argentina's independence was also signed in Tucuman! There were really no bad experiences worth mentioning and a ton of good experiences that I could write a novel about but won't, so don't worry.
I essentially got to know plenty of great people, whether they were friends from weekly football matches, friends from parties, friends of the host-family or people I got to meet on my daily commute. That's definitely something I would recommend you to do; don't be shy, go out there, reach out to people and you'll be surprised at how easy you will be welcomed with open arms.
The Argentinian community is a warm community. Despite the countless beggars on the street, the abundance of stray dogs and the relatively low socio-economic status of the general population - all the people I've met appreciated life and were no different than you & I. I've spoken to many people who either seek change in their country, people who were proud to show you what their culture has to offer and others who just didn't give a shit. I enjoyed all of their company and would visit Argentina again without second thought just to see them again. I had absolutely no expectation prior to my travels and was more than satisfied with my experience at the end. It was even a little sad to leave my host family but I am happy I got to know them.
Finally, I'd like you to know that if you have the opportunity to travel to Argentina - just do it. With the right attitude you'll have an experience of your lifetime. If I were to describe South America to any German or European, I would tell them it's simply another world. That alone is reason enough to motivate you to quench your curiosity and see what this other world has to offer.