I had a truly amazing time in the United States. I spent six months, from July to December 2015, in a training course specializing in cardiovascular diseases at Danbury Hospital in Connecticut. The program was comprehensive. I attended each morning and noon conference, daily teaching rounds, weekly grand rounds and EKG conferences. I learned a great deal from the attendings who shared interesting cases and their experience-based insights about the best clinical practice strategies. I learned that the healthcare system is truly amazing.
Physicians do everything they can to give the most effective treatment for their patients. Access to all kinds of data using computer systems, including information about drugs, diseases, guidelines, and updates, helps save human resources and time while maximizing treatment and minimizing risk. Patients are given comprehensive care, from hospital admission to treatment, discharge, and follow up. There are detailed schedules for patient examination and consultation, as well as for inpatient care including medications, meals, exercise, and mental well-being. These components of patient care are lacking in developing countries.
During my trip, I worked with cardiology fellows and attendings in the cardiology department and critical care unit every day. I gained a variety of clinical experience in cardiovascular diseases, including chronic heart failure, coronary disease, chest pain new onset, valve diseases and arrhythmia. The patients at Danbury Hospital are often in less severe condition than those at Cho Ray Hospital because good primary health care brings patients to the hospital in early stages of illness. For instance, I had never seen a patient with myocardial infarction admitted in the first twelve hours following chest pain.
A disease specific to Connecticut that I learned about is Lyme disease. I also attended a presentation about aortic valve stenosis cases, and observed a Transcatheter Aortic Valve Replacement procedure, which is a new progression in interventional cardiology that has not yet been integrated into clinical practice at Cho Ray Hospital. The critical care unit is spacious and first-class, with top organization and management. All equipment is provided: telemetry, mechanical ventilator, defibrillator, infusion machine system, emergency aid and a wide array of medications and fluids to treat the primary conditions. The equipment helps maximize effective treatment and minimize cross infection. Each patient has a detailed treatment plan, including nursing and preventive complications. This explains a decrease in in-hospital mortality rate as well as duration of hospital stay. When I return to work at Cho Ray Hospital’s interventional cardiology department, I will apply these clinical practices and expect that they will improve patient outcomes.
My mind has been completely opened, not only in my knowledge base but also in the way I will work in the future. The knowledge I gained will be useful for my work and my patients. This course is a wonderful opportunity, especially for young doctors like me. I hope that many young doctors from Cho Ray Hospital will have this wonderful opportunity to contribute to the improvement of patient care. I am very thankful to all the staff who brought me to the United States, supported me, and gave me a chance to completely open my eyes.
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