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					        MEDICAL SCHOOL




Erasmus for Bristol Medical
       Students –
   Everything you need to know
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Contents
What is Erasmus and why should I do it? ................................................................................ 6
General useful info ................................................................................................................ 7
  When do I apply for the exchange?..................................................................................... 7
  What will happen about my exams? .................................................................................... 7
  Can I afford it? .................................................................................................................. 7
Planning to go ...................................................................................................................... 8
  Accommodation ................................................................................................................ 8
  Finances ........................................................................................................................... 8
  Language courses ............................................................................................................. 9
  Getting there .................................................................................................................... 9
  Health and Insurance .......................................................................................................10
  Indemnity for working in hospital.......................................................................................10
  Contacting home when away .............................................................................................10
  Paperwork .......................................................................................................................11
Where can I go from Bristol? ................................................................................................12
France ................................................................................................................................13
  Paris................................................................................................................................14
  Bordeaux .........................................................................................................................17
  Grenoble..........................................................................................................................19
  Strasbourg .......................................................................................................................22
  Angers.............................................................................................................................24
  What will I be doing on placement there? ...........................................................................25
Spain ..................................................................................................................................27
  Alicante ...........................................................................................................................28
  Granada ..........................................................................................................................30
  What will I be doing on placement there? ...........................................................................31
Austria ................................................................................................................................33
  Vienna .............................................................................................................................34
  What will I be doing on placement there? ...........................................................................37
Units and objectives .............................................................................................................40
  What will I be missing? .....................................................................................................40
  Internal SSCs ...................................................................................................................40
  Exams .............................................................................................................................40
  When will I do the exams? ................................................................................................42
  Help, I‟ll never pass! .........................................................................................................42
MDEMO learning objectives ..................................................................................................43
  Musculoskeletal disease ....................................................................................................43
  Emergency medicine.........................................................................................................44
  Ophthalmology .................................................................................................................46
TUBES learning objectives ....................................................................................................47
  Cardiac system .................................................................................................................47
  Vascular surgery...............................................................................................................48
  Respiratory system ...........................................................................................................49
  ENT and Maxillofacial surgery ............................................................................................49
Language tips......................................................................................................................51
Thanks ...............................................................................................................................67
References ..........................................................................................................................68




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Introduction
Thinking about Erasmus? Considering spending five months of your 3rd year of medicine abroad,
learning a foreign language, experiencing a different health system and style of medical teaching,
immersing yourself in another culture? Or maybe you have already decided to go, and are just
looking for more information to help you along your way. Great! Either way, this handbook is for
you.

Hopefully the information here will give you a bit of a helping hand, whether you are deciding
whether and where to go, or whether you want to know where you could stay when you are over
there, and what to expect! Perhaps it will even give you some language tips.

Whatever you are using it for; I hope that it will give you the information you need. If not, please
help us to update it for future years. The material in here has all come from experiences of
students who have previously been on the exchanges. Your feedback can be of vital use to
students in the years to come!

So, all that remains to be said is enjoy! ….. and of course….




Good luck!



                                             Bon chance!



               Viel Glück!



                                                            Buena suerte!




 This handbook was part written, part compiled by Emma Phillips as part of her 3rd year
 external SSC project. Emma participated in the Erasmus exchange programme in the academic
 year 2005-2006, studying abroad in Vienna, Austria. Information about the other cities where
 exchanges can be undertaken was collected from other students who also took part in the
 exchange programme in this year.




                                                                                                   5
What is Erasmus and why should I do it?
Erasmus is part of the European Commission‟s Socrates Programme, which supports education
throughout Europe, with particular emphasis on bringing a „European dimension‟ to education in
all of its member states. Erasmus loosely stands for the EuRopean community Action Scheme for
the Mobility of University Students. It is an exchange scheme which is the higher education focus
of the Socrates Programme, allowing exchange contracts to be set up between European
Universities, such that students are able to spend part of their course abroad, with the time spent
away being recognised by their home University.

There are obviously both advantages and drawbacks to spending part of your course abroad. Of
course, you will improve your language skills and experience another culture, health system and
medical teaching style, but the exchange is also likely to increase your independence, coping
skills and problem solving, as there are bound to be difficulties which you will have to meet along
the way!

Spending time abroad will probably mean that you will not cover the curriculum as fully as you
would have done had you stayed at home in Bristol, yet you will still have to pass the same
exams as your peers when you get back. This is certainly a challenge, but learning to learn
independently and work things out for yourself is definitely a skill worth having, and you may get
the chance to learn other skills you might not have experienced at home.

Before you go, the University likes to make sure that you are going to be able to cope when you
are away, and that you are not likely to fail when you get back. The current regulations stipulate
that all potential exchange students have to have an interview with the Clinical Dean to ensure
that they are both physically and mentally fit enough to manage the challenge of being abroad.
Students are also expected to have a clean examinations record from the first two years of their
medical study (i.e. no fails or re-sits) and they must also pass the first unit of the third year to be
allowed to go.

Language skills are also clearly important and the Faculty suggests that students should be
approximately A-level standard in the language of the country to which they will be travelling.
Although this is recommended, several previous students have been lower than this standard- it
certainly makes it harder work for them, but coping is not impossible!




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General useful info
When do I apply for the exchange?
Go to the meetings held by Erasmus Co-ordinators which usually take place in the first term of
you second year at Uni (or 3rd year if you are an Intercalator!). You will probably have to apply
formally in the second term of this year. Have a look at the Medici website for more information
(http://www.medici.bris.ac.uk/).

The contacts for the Erasmus exchange are:
Dr Clive Roberts                                    Mr Matthew Ball
Erasmus Co-ordinator                                Secretarial Assistant
Address        Centre for Medical Education         Address        Centre for Medical Education
               39/41 St Michael's Hill                             39/41 St Michael's Hill
               Bristol                                             Bristol
               BS2 8DZ                                             BS2 8DZ
Email          C.J.C.Roberts@bristol.ac.uk          Email          M.Ball@bristol.ac.uk
Phone          0117 954 6518                        Phone          0117 331 1602


What will happen about my exams?
You will take your exams on return to Bristol, so you will need to make sure you keep up with
your learning while you are away. For more information on this, see the „Exams‟ section of this
booklet.


Can I afford it?
The cost of living in Europe is generally a bit lower than here in the UK, and most students seem
to pay cheaper rent whilst they are abroad (that is, if you are not also paying for your rent in
Bristol at the same time!). You will also get a grant worth about £1000 to help you pay for your
exchange from the European Commission. You have to apply for this via the International Centre,
who will provide you with all the information about it at their Erasmus Seminar which is very
useful to attend – the Medical Erasmus Office will let you know about this.

When you take into account the extra costs of airfares and all the new experiences you have to
sample and trips you might want to take, you will probably break even and end up spending
about the same as usual.

The International Centre European Office (http://www.bris.ac.uk/internationalcentre/europe)
contact is:
Beverley Orr-Ewing
Socrates-Erasmus Co-ordinator
Address       University Union Building
              Queen's Road
              Clifton
              Bristol
              BS8 1LN
Email         bev.orr-ewing@bristol.ac.uk
Phone         0117 954 5841




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Planning to go
So, you have applied for the exchange, been to the meeting held by the medical Erasmus co-
ordinator, been to the European Office seminar and filled in all your forms for the Erasmus grant.
What more do you need to do?

Organising all the things you need at the last minute can be a bit daunting, especially when trying
to do them whilst simultaneously coping with passing your AERN (Medicine and Surgery B)
module! However, it is much easier to sort out before you go- your first week abroad will
probably be stressful enough as it is! Some things can (and must) be set up for a while in
advance – applications for halls abroad and language courses for the summer beforehand are two
of these.


Accommodation
It can be nice to know where you are going to stay while you are away. If you are planning on
applying to University halls, then you have a much greater chance of getting a room if you apply
early – preferably start thinking about this as soon as you have handed your form in to the
Erasmus office. Options vary from one place to another, so look at the city guides in this booklet
for more information and tips.

If you also have a room in Bristol which you are going to be paying for while you are away, you
might want to consider trying to rent it out during your exchange. Rooms can be advertised on
the Accommodation Office website (http://www.bris.ac.uk/accom). Alternatively you could try
contacting the European Office or Erasmus Co-ordinator for medicine, to see if they can put you
in contact with any incoming students who need a room. The Galenicals‟ International rep might
also be able to help with this (international@galenicals.org.uk).


Finances
You should have your EC Erasmus grant set up before you go away. As from this coming year,
the grant will be paid directly into a UK bank account, in two instalments. You will receive your
first instalment when you post confirmation back to the European Office in Bristol that you have
arrived (this has to be stamped by your host faculty).The second amount is paid when you
confirm your departure.

When you apply for your Student Loan, tick the box stating that you will be spending some time
abroad. You may be able to get a grant to cover some of your travel costs.

You will probably want to consider whether or not you will open a bank account abroad. Talk to
your bank about charges on a Visa or Mastercard in Europe- some banks do not charge for
withdrawing money abroad (e.g. Nationwide debit cards), whereas with others, the charges can
be as high as £3.00 for one cash withdrawal. A bank account may be useful to reduce costs. If
you are in France, you will also need a French account so that you are eligible for the
accommodation grant (CAF).

Transferring money to Europe can be expensive. World Pay from HSBC and International Money
Orders (from any bank, but Barclays offers a good service) are probably the cheapest way of
getting your money abroad. Transferring money between banks in the usual way can cost up to
£30 for an international transfer, so it is worth looking into this before you go away.



                                                                                                  8
Language courses
You may be reasonably fluent in the language conversationally, but medical vocabulary can be
another problem entirely! If you are not very confident about your skills it is a good idea to do a
language course. It is possible to do this in the second year as your SSC. If you didn‟t do this, or
want more practice, there are also evening language courses run by the University Language
Centre in collaboration with the Centre for Continuing Education. These cost £75 for a term (10
weeks). The Galenicals‟ International Rep is currently working on ways to reduce these costs for
medical students wishing to improve their language skills.

There    are    also    French  courses    run    by   the   Anglo-French     Medical    Society
(www.anglofrenchmedical.org) every year. These are held in Burton on the Wirral in the last
weekend of January. Contact the Centre for Medical Education about these- the faculty is able to
send up to 10 students per year to attend this course and provides bursaries which should cover
most of the registration costs.

Many European Universities also offer summer language courses lasting about a month, which
run in July and August. Students are normally accommodated in halls whilst abroad on the
courses. These are a great opportunity to explore the city you will be living in, as well as tuning
up your language skills. Most of these have specific medical vocabulary options to take.

In addition to the summer courses, it may also be possible to get on a language course whilst you
are abroad on the exchange programme.

The best way to find out about these courses is to contact the International Office of your host
faculty, who can put you in contact with the course organisers. As an Erasmus student, it is
usually possible to gain partial funding of up to £350 for intensive language programmes
undertaken in the host country before the exchange period. Speak to the European Office in
Bristol about these grants.

For emergency language tips, check out the language section near the end of this handbook.


Getting there
If you plan to fly, or go by coach (usually cheaper options than a rail journey across Europe),
booking in advance could save you a fair bit of cash. Look out for the cheap flights with Ryanair,
Easyjet and Skyeurope. The disadvantage of these is that the baggage allowance is quite low and
you may be taking quite a bit of stuff (Kumar and Clark probably weighs at least 5kg by itself!).
Other airlines may have slightly more baggage allowance. Remember though, that you are
allowed to take your laptop onboard in addition to your hand luggage. If you can stuff both of
these bags full of books and then pull off a sufficiently nonchalant look as you swing them onto
your shoulder at the check-in desk and walk away without collapsing under the weight, you may
get away with more than you are allowed! If you want to go by coach check out Eurolines (which
are a branch of National Express).

You might want to consider taking your car with you if you have one. Driving all the way to
Vienna or Granada by yourself is a pretty long distance though!

Documentation and other bits which you need if taking your car abroad includes-
 European driving license (if you are a British citizen, your UK driving license covers this- if not,
   you may need an International Driving permit)




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   International motor insurance (check with your insurance company before you go whether
    your car is covered- you might need to arrange an addition to your policy for the duration of
    your exchange; you should get an International Motor Insurance Card/Green Card which
    certifies this)
   International breakdown cover (i.e. like the RAC/AA in England)
   Valid MOT and road tax covering the whole time you will be away
   Beam benders for your headlights
   GB sticker for the front and the back of the car
   Car emergency kit – hazard warning triangle, jump leads etc.

If the car is not registered in your name, then you need a letter of authorisation from the
registered owner too.

Remember that European countries also have their own laws regarding speeding, drink driving
and other offences! Check out the Embassy websites to find out about driving in your host
country. Both the AA and RAC websites (http://www.theaa.com; http://www.rac.co.uk) have
useful information about driving abroad.


Health and Insurance
You need a valid European Health Insurance Card (EHIC - which has superseded the old E-111
documents), which will entitle you to free urgent treatment for accident or unexpected illness. If
you have not yet received a card automatically, you can get the application forms in a Post Office
branch. The card does not cover all medical expenses, so you should think about taking out
additional travel insurance for the duration of your stay.

Both Endsleigh and STA have good offers on travel insurance. Remember that if you want to ski,
you will need to make sure the policy covers you for this.

In Europe, unlike in England, prescriptions are not generally subsidised by the government, so
can be a lot more expensive than in the UK. It is a good idea to go to the doctors before you go
and try to get any prescription medicines you may need whilst you are away.


Indemnity for working in hospital
It is essential to have proof of indemnity from the MDU or MPS for your placements abroad. Both
of these organisations are free to join for students if you are not a member already, and will
provide certificates of indemnity for you. Contact the local branch, explaining you are an Erasmus
student, and letting them know the dates and location of your exchange.


Contacting home when away
If you have a laptop, it is very handy to take it with you. Most student halls abroad have internet
access, and this is also straightforward to set up if you are living in private accommodation. This
makes it easy to stay in contact with friends, family and university in England. It is also a help for
writing internal SSC projects!

Get your friends and family to download Skype (www.skype.com). With headphones and a
microphone you can then call them over the internet for free!




                                                                                                    10
When you are abroad it is a good idea to buy a pay-as-you-go type SIM card, making it cheaper
to phone and SMS home. You can put this into your English mobile if it is „unlocked‟- something
you can get done at home for about £5 in many phone shops.


Paperwork
Other documents that you might need include –
 Valid passport (always useful for going abroad)
 An attestation of two years study at your University, which will be given to you by home co-
   ordinator (a couple of copies are handy)
 Your original long birth certificate and some copies of this
 Proof that you can support yourself while abroad e.g. Student Loan paperwork, a letter from
   your parents stating that they will support you financially during the year, a recent bank
   statement (with money in the account!)
 Proof of vaccinations required for working in hospital (i.e. Hepatitis B and BCG). You may
   need a chest X-ray to prove you don‟t have TB – check this with your host faculty
 4 or more passport photographs (for sticking onto the variety of new cards and IDs you will
   get when you register)

France is probably the worst for bureaucratic requirements for registration and you will likely
need all of these things if you are going here, but none of them would go amiss at many of the
other Universities!

.




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Where can I go from Bristol?


                        France
                           Paris
                           Bordeaux
                           Grenoble
                           Strasbourg
                           Angers




                        Spain
                           Alicante
                           Granada




                        Austria
                           Vienna




The University also accepts incoming Erasmus students from the following Universities:
    Aristoteleion Panepistimion Thessalonikis, Greece
    Universitetet I Oslo, Norway
    Karolinska Institut, Stockholm, Sweden

However, new exchange programmes have been negotiated in recent years, including those with
Grenoble, Alicante, Granada and Angers. Students should be encouraged to build links- if there is
somewhere you particularly want to go, especially if it is to a University with which we already
have links, with a bit of hard work, it may well be possible to negotiate this option, depending on
whether the correct courses can be accommodated!




                                                                                                 12
France




         13
Paris
The City
Paris is an incredibly vibrant city, standing in a class of its own in the fields
of beauty, culture and sophistication. There is so much to discover, it‟s hard
to know where to start! Paris is the capital and the largest city in France,
with a population of about 2.2 million. It lies on the river Seine in the Île-
de-France region of the country. The city itself is astoundingly beautiful,
renowned for its neo-classical architecture and abundance of monuments
and churches. There are also a whole host of museums and galleries. Its
magnificent wide avenues contrast superbly with cosy little cafés and
winding back-streets, allowing you to discover the Paris that suits you the
best. Of course, the most recognisable symbol of Paris, and perhaps of France itself, is the Eiffel
Tower, standing at 324 metres high near the river. Dubbed in the 19th century La Ville Lumière,
Paris is often considered to be one of the most romantic cities in the world, and is certainly one of
the most popular to visit, entertaining over 30 million tourists per year.


The University and Hospital
       The university we have links with in Paris is the Université Pierre et Marie Curie IV
        (http://www.upmc.fr/FR/info/00). There is information about exchanges in their
        international pages (http://www.upmc.fr/FR/info/Mobilite_et_echanges/010303).


Accommodation
This can be difficult to find, and if left to the last minute, accommodation in Paris can of course
be very expensive. It may be best to try and sort out something before you go. There are lots of
options:
     University accommodation (CROUS) - this may be difficult to get hold of unless you apply
       early, in June/July before you go away. You will need to apply for this through your
       University. Look online at www.crous-paris.fr to find out about the forms.

       Cité Universitaire (Cité-U), which offers accommodation for French and international
        students who have completed the first cycle of their degree (2 years). You can apply
        online at http://www.ciup.fr/room_cite.htm. Rooms vary in price depending on what you
        want, but the basic ones are pretty good.

       CROUS may also offer housing in HLM (council housing). Prices vary depending on the
        standard, but are around €130 for a single room. In these you may also have to pay bills.

       Private accommodation tends to be a bit more expensive than university-managed
        accommodation, where all your bills are included. Expecting to get housing from the start
        is unreasonable, so be prepared to stay in a hostel whilst you are looking.

Tips when looking for private accommodation include –
     Self-contained one-bedroom flats are common; it can be difficult finding an apartment
       with more than 3 bedrooms, so it may be harder to look for rooms with friends.




                                                                                                   14
      There are extra expenses to take into account when renting:
              - a lot of housing comes unfurnished, so you may need a shopping trip just to
                  find the basics
              - Taxe d‟Habitation (Council Tax) may be your responsibility- check with the
                  landlord
              - Remember to check whether bills are included, and get someone to read the
                  electricity meter before you move in
              - The law in France requires that you have housing insurance against any
                  damage to the property you are renting (this is not necessary in Cité-U). The
                  basic rate protects against fire and flooding, but you can get more
                  comprehensive cover. Companies which have been used by students are
                  L'A.G.E.M. (€20 for basic cover plus €6 for each room that is larger than 9m by
                  9m) and L'M.N.E.F. (€32 for a private room or studio per year, €60 for a
                  private apartment). These prices include cover against theft and damage to
                  personal belongings.

      If you are renting accommodation in France (i.e. not living in the Cité Universitaire), you
       are eligible for Caisse d'Allocations Familiales (CAF), a state run organisation which gives
       grants to students to help pay for accommodation. It is worth around €100 per month, so
       it is well-worth applying for, although the bureaucracy involved in getting hold of it seems
       a little over the top! You will need a French bank or postal account for the money to be
       paid into. The CAF forms are available on www.caf.fr, and your landlord will need to fill in
       a part of them. Similar to opening a bank account you will also need proof of address e.g.
       contract from your landlord, proof of student status and student loan/Erasmus grant and a
       photocopy of your passport/birth certificate.

      Estate agents often ask for a finder‟s fee before they will show you any accommodation,
       which can be as much as £90. Avoid them if possible- previous students do not
       recommend them, saying from experience they were not very useful! If you are forced to
       use an agent because you haven‟t had any luck anywhere else, check with the CROUS
       which is the most reputable one to use first.

      Other places to look for accommodation include the CROUS and the Fac office boards, the
       American Church (Quai Branly) which has a board with accommodation listings, the
       CNOUS website and the free magazine FUSAC, which is available in many shops and bars.
       It has English-speaking resources and contacts. Adverts in the newspapers are also
       helpful, although may be a bit daunting to wade through at first.

      The hospital is in the 13th arondissement, but as Paris is quite a compact city, and the
       metro is very efficient, you don‟t necessarily need accommodation in the 13th.



Important information and tips
      If you have an EU passport, you are permitted to live in France for 6months without a
       Carte de Sejour. When applying for accommodation, an Erasmus cover letter should be
       sufficient.

      French SFR SIM cards will work in unblocked phones, and cost about €30. Top-up cards
       can be bought in many shops. Call and SMS rates are much higher than for UK
       companies, but it is much cheaper than using your English SIM card abroad!



                                                                                                 15
      To set up a bank or a post office account, you will need quite a few documents, including
       your passport, proof of address (e.g. letter from your landlord) and your contract of
       accommodation. The minimum initial deposit is usually about €50.

      Restau-U is the University restaurant, which is subsidised by the Government. There is
       usually one at every Cité-U and they are open from 11.30 to 14.00 and again from 17.00
       to 20.30 during the week, and at weekends one Restau-U in each town will be open.
       Access is only with student ID. Food is a bit variable, but can be OK, especially if you don‟t
       have any cooking facilities! Choice is poor for vegetarians.

      Cité-U residences sometimes have a language centre offering free conversation classes.



Contacts of previous students (2005-2006)
      Alison Montgomery – am2900@bristol.ac.uk
      Jess Green – jg2846@bristol.ac.uk
      Kate Myall – km2227@bristol.ac.uk
      Laura Ilchyshyn – li2191@bristol.ac.uk
      Noellie Ramsay – nr2881@bristol.ac.uk




                                                                                                   16
Bordeaux
The City
Bordeaux is a buzzing city in the south-west of France with approximately ¼
million inhabitants. A recent renovation programme has vastly improved the
city, and it now has many pedestrianised areas and a state-of-the-art
tramway. Set onto its background of neo-classical architecture, typically
French wide avenues and many parks and museums, along with a friendly
university population and good night-life, this is a great place to be a student!
It is, of course, famous for its wine which has been produced in this region
since the 8th century. The area is the largest wine region in the world, with
over 100 000 hectares of vineyards and an annual production of over 700
million bottles! The city is a port on the river Garonne, which is large enough
within the city for the harbour to be accessible to ocean liners.


The University and Hospital
      The university in Bordeaux with which we have links is the Université Victor Segalen
       Bordeaux 2 (http://www.u-bordeaux2.fr/index.jsp). Altogether, the four university
       sections in Bordeaux make up a student population of around 70 000 students. The other
       three sections of the university are located out of town on a large campus, but Bordeaux 2
       (medicine, physio, dentisty etc.) remains in the town centre. There are two main
       campuses, one near the hospital (Pellegrin), which is the site of the international office
       and one at Place de la Victoire.
      There are 3 hospitals in Bordeaux where you could be placed. The main teaching hospital
       is called Hopital Pellegrin, which is not far from the centre on the line A tram. The hospital
       is pretty huge, so the best thing to do is to find the main entrance (Tripode building)
       where you can get hold of a map! The other 2 hospitals are smaller - St Andre in the
       centre of town and Haut Leveque which is a bit further out (past students have had the
       respiratory placement here).


Accommodation
It is possible to get a place in the halls of residence at Bordeaux (this can be reserved for you by
the international office at the University, however, these are pretty far out and apparently
somewhat lacking in charm, décor and facilities! Previous students have advised giving these a
miss and looking on the internet to find accommodation. It is not too expensive – sharing a house
will probably cost you around €300-400 per month. There are a good few websites to look at;
included here are the ones which are free to use.

Finding somewhere to live may be tricky as you are not arriving at the beginning of the student
year, but experience of past students shows it is certainly possible to find somewhere great. If
you are lucky you may even find somewhere good, and with lovely people before you even arrive!

Tips for looking include-
     Make sure that what is being advertised is what you are after- e.g. you are not about to
        be sharing a one room studio with the person who is advertising!

      Good locations include Place de la Victoire which is the studenty area (not the most
       beautiful but very friendly); around the Jardin Public just north of the centre (very pretty,



                                                                                                   17
       but a 20 minute walk to town); around the main street – Rue St Catherine (a very long
       pedestrianised shopping street).

      Trams in Bordeaux are superb, running until 2 am, so anywhere near a stop on line A or B
       would also be fine.

      Try to live with at least one French person – especially if there are a group of you from
       England – otherwise it is far too easy to spend all your time speaking English.

      The websites to look at are:
             - http://www.easycoloc.com
             - http://www.appartager.fr/
             - http://www.recherche-colocation.com


Important information and tips
      Apart from the international office you could also speak to Philippe Leicht. His only job is
       organising Erasmus socials (making him somewhat a legend!). He is worth getting in
       contact with when you arrive, as he will be able to put you on the mailing list for the
       socials (if you are not already) and he can also put you into contact with other Erasmus
       students who have been there since the beginning of the year- it can be a bit difficult to
       find them otherwise! His office is in the Uni campus at Pellegrin.

      French lessons are free at the University at Victoire. You can start at a variety of levels, all
       of which are highly attended by Erasmus students. Previous students say that the teacher
       was lovely and enthusiastic and will set up medical French lessons if there are lots of
       Erasmus medics wanting to participate.


Contacts of previous students(2005-2006)
      Sophie Epstein - se2123@bristol.ac.uk
      Louisa Daoud – ld2145@bristol.ac.uk
      Sarah Curtis – sc3214@bristol.ac.uk
      Sehr Bhatti – sb3069@bristol.ac.uk
      Elena Hazelgrove-Planel – eh2765@bristol.ac.uk (Year Programme)




                                                                                                     18
Grenoble

The City
Grenoble, the „capital of the Alps‟ is a city in the Rhône-Alpes region at the
foot of the mountain range in south-east France. The population is around
160 000, and in its situation surrounded by the mountains, the city is a
charming place to live with marvellous views. It is often visited by the Tour
de France, and has a bustling tourist industry during the ski season, with
over 20 ski stations in the nearby area, the closest being only about 15
minutes drive away.


The University and Hospital
      In Grenoble, the university with which we have contact is the Université Joseph Fourier
       (http://www.ujf-grenoble.fr/), which is named after a famous French mathematician and
       physicist (1768-1830) who lived in the city. The original university in Grenoble is one of
       the oldest in France, having been founded in 1339 by Pope Benedict XII! Grenoble is now
       a major scientific centre, and the Université Joseph Fourier is recognised as one of the
       leading French scientific universities.
      There are 2 hospitals in Grenoble – Hôpital Nord and Hôpital Sud. For last years group of
       students, all the placements but one were in Nord, with just Rheumatology happening in
       Sud. Nord is situated on the tramline between the city and the university campus, but Sud
       is further out of town in the opposite direction to the campus, so is a bit harder to get to
       (you have to catch a tram and then a bus).


Accommodation
Accommodation does not seem to be hard to come by in Grenoble. Students who were there last
year recommend applying to stay in University accommodation, at least for the first weeks you
are there, as they found it very relaxed and cheap. It also seemed to be flexible in that it was not
too hard to arrange to leave earlier than stated, without being required to pay rent for this.

Tips include-
     Look at the Crous Bleu website for Grenoble, to contact them for the application forms for
        accommodation (http://www.crous-grenoble.fr/).

      Last year all students applied for the cheapest accommodation, in a place called La
       Tronche, which was the nearest to Hôpital Nord (5 minutes walk) and near the tramline
       between the campus and the city centre.

      It is also possible to live in halls on campus, but this is further from the city centre.

      Accommodation in halls is quite basic – for instance, La Tronche had no fridges – but is
       very cheap and has a good community feel. (On the subject of fridges, it is apparently
       possible to get hold of one very cheaply from the cleaning staff if there were any left over
       from last year. As you are there in winter, it is also perfectly possible just to hang your
       food out of the window- it is cold enough outside!!)

      In France, you can apply to get an accommodation CAF grant from the government to
       help with living costs at university. Applying for this as soon as possible is sensible- if you


                                                                                                    19
       leave it too late, you might never get the money. CAF forms can be obtained from the
       secretary at the halls, or at the Uni campus.

If you are not keen on living in halls, it is probably easiest to find accommodation when you
arrive – that way you will know where you will be living, what it is like and what your flatmates
will be like. Anywhere not too far from the tramline will make it easy for you to get to the
hospitals in the morning.


Important information and tips
      The contact lady in the International Office at the Medical Faculty, Aline Paillard
       (Aline.Paillard@ujf-grenoble.fr), is really helpful with any problems you might have!

      You can set up a bank account which gives you a debit card at La Poste; this is free if you
       only want to use your debit card at La Poste, or will cost you around €8 a month if you
       want use of your debit card anywhere. Credit Lyonnaise was also suggested as a good
       place for an account; last year you could sign up free for 6 months and then cancel the
       account for nothing- it is also helpful having an account with a bank, as it is easier to go
       into a branch and deal with finances than if you only have an account at La Poste. There
       are also deals around whereby if you recommend them to a friend, and they sign up, you
       get free gifts – if there are a group of you, this may be worthwhile!

      Pay-as-you-go SIM cards cost around €30, and may offer €5 of credit in this. Make sure
       you get a SIM card which isn‟t one of the type which allows your credit to expire. With
       some of the packages, any credit you buy only lasts one or 2 weeks before it expires.
       One recommended is NRJ Mobile – you can buy the card at CarreFour, but you do need a
       debit card to top-up the phone.

      Skiing is obviously the leisure activity in Grenoble! It is easy to do it relatively cheaply as a
       student. The best way is to join the University Ski Club – Ecole de Glisse or EGUG, which
       will cost you about €30 and then allows you to get ski passes in a few different areas for
       about €12 at weekends or €10 during the week. Some of the ski areas are not covered by
       the offer, but most also have student offers for passes at around €12 on a weekday with a
       valid Grenoble Uni card. EGUG run buses to skiing at the weekends and on some
       weekdays. These are good if you also want to take advantage of the free ski lessons
       offered at the beginning of the season, which are a good way to get to know people.
       Otherwise, it is cheaper to get the local buses out to the lifts from the bus station by the
       train station- the cheapest way of doing it is to get a pack of 10 tickets at a time, which
       makes it about €2.50 each way (e.g. to Des Alpes resort). Make sure you have a return
       ticket, as they can be tricky to get hold of at the resort! All in all, it is possible to do a day
       of skiing for about €20, especially if you take food with you rather than buy it on the
       mountains. At the weekends, it is possible to get cheap (€15-20) accommodation in the
       resorts for Saturday- ask EGUG for more info.

      Remember most shops are closed on Sundays (even CarreFour, the big supermarket) - if
       you find yourself stranded with no food, there are markets open in Grenoble on a Sunday
       at the St. Claire-les-Iles and Notre Dame tram stops. Trams still run on Sundays, but less
       often than on other days of the week.

      The „Self‟ canteen in the hospital is good for cheap food- you get a card and charge it with
       credit to pay.



                                                                                                       20
      Other stuff not to miss in Grenoble includes-
              - The interne/externe soirées, which you can get in free to as an Erasmus
                  student at least once, where there is sometimes free drink after entry. These
                  happen once to twice a semester.
              - „Beaujolais‟ night, which is shortly after your arrival in November
              - „Luminations‟ in Lyons – after Christmas and good for a day trip to the city.


Contacts of previous students (2005-2006)
      Ahna Allan – aa3746@bristol.ac.uk
      Faith Dyer – fd2874@bristol.ac.uk
      Jess Parsons – jp3872@bristol.ac.uk
      Lauren McCluskey – lm4894@bristol.ac.uk
      Liam Ingram – li0499@bristol.ac.uk
      Lucy Harten-Ash (Galenicals‟ International Rep 2006-2007) – lh2340@bristol.ac.uk




                                                                                             21
Strasbourg

The City
With its name literally meaning „the city of the roads‟, Strasbourg plays an
important role as a meeting point for Europe, being home to divisions of
the European Parliament, the European Court of Human Rights and the
Council of Europe. It is a lively modern town acting a centre for
manufacturing and engineering, but with a beautiful old city of Rhineland
black-and-white timber buildings, home to a sandstone mediaeval Gothic
cathedral and a superb collection of museums. As the capital of the Alsace
region, the city is also famous for a great variety of pubs, restaurants, and
traditional Alsation „winstubs‟ (cafés). It is the 7th largest city in France, having a population of
about 270 000 people. Its situation near the oft-disputed border, means that Strasbourg also has
a large German population, giving the city a very multi-cultural feel. Once home to Erasmus
(1467-1536) himself, this is a great place to experience the benefits of an exchange programme!


The University and Hospital
      In Strasbourg, the host university is the Medical Faculty of the Université Louis Pasteur
       (Strasbourg I) (http://www-ulpmed.u-strasbg.fr/). Strasbourg has a large student
       population – around 50 000 students – split between the three divisions of the university.
       Strasbourg I is part of the league of European Research Universities.
      There are 2 main hospitals in Strasbourg – Hôpital Civil, which is a lovely old hospital right
       in the centre of the city with each of the departments housed in separate buildings, and
       Hôpital Hautpierre, a newer hospital just outside of the city (although easy enough to get
       to on the metro, which stops just outside).


Accommodation
As with the other French universities, it is possible to get either University or private
accommodation.

Tips include-
     For university-run housing it is recommended to check out the CROUS website for
        Strasbourg, as some other halls in Strasbourg have a minimum 9 month contract.

      If you are after private accommodation, search on Google for websites for accommodation
       in Strasbourg, e.g. www.relocation.com.

      Private accommodation costs were around €280 per month, with University housing being
       somewhat cheaper than this.

      If you need to move whilst you are in Strasbourg, the departmental notice-boards at the
       Uni campus are a great place to look for advertisements.


Important information and tips
      Strasbourg has a great tram system that will take you almost anywhere you are likely to
       want to go. If not, the buses are also good and cover the rest of the city. You can buy a
       monthly student „freedom explorer‟ pass that covers both for around £20, although you


                                                                                                    22
       first need to obtain a photo pass costing €4 from the central office; take your student ID
       with you, and a passport photo to get this.

      Opening a bank account is necessary to qualify for CAF. It is best to do both early on,
       otherwise you won‟t get hold of any of your money before its time to leave again!

      Pay-as-you-go SIM cards cost about €30; most offer similar packages- previous students
       have used Orange and had no problems with this.

      Strasbourg is a great location for visiting other parts of Europe- you can easily pop into
       Germany to do some shopping (where it is a bit cheaper) and it is also possible to do
       weekend visits to Switzerland and Luxembourg, neither of which are too far away.

      You will be in the city at the best possible time of year. The atmosphere is amazing
       around Christmas-time and the festival period, with the famous Christmas Market to visit
       and skiing resorts nearby!

      Getting to Strasbourg by plane can be expensive if you fly directly, but cheap airlines (e.g.
       Ryanair) fly to the nearby airport of Karlsruch-Baden in Germany, from where you can get
       a connecting bus to take you directly to Strasbourg.


Contacts of previous students (2005-2006)
      Debbie Linsky- dl2399@bris.ac.uk (or debbielinsky@hotmail.com)




                                                                                                  23
Angers

The City
Angers lies in west-central France, on the banks of the river Maine, about
200 miles south-west of Paris. It is the capital of the Maine-et-Loire region,
also known by its historic name of Anjou, and has a population of about 150
000 people. The city is very old, the area having been settled since Roman
times, and the ancient chateau on the river is one of the most famous in the
Loire Valley. The area around the town is well-known for its agriculture, and
the fresh fruit and vegetables and flower stalls in the city are a common
sight. The oranges also have another purpose- Angers is the only site of
distillation of Cointreau in the world!


The University and Hospital
      We have links in Angers with the Université d‟Angers (http://www.univ-angers.fr/). This is
       one of two renowned universities in the city, which has a student population of around 40
       000. Angers is also the site of the Centre International Des Études Françaises, meaning
       that it is often home to many international students learning French. Apparently, Angers is
       considered an excellent place to learn the language, the local accent retaining as it does
       the aristocratic flavour of the French royals, who for centuries took their holiday in the
       area! This is supposed to make it easily understandable anywhere in the Francophone
       world.



Angers is a new exchange programme and so far no students have signed up to go
there. As yet, we don’t have very much information about the exchange- perhaps you
could be the first to go and bring us back tips for next year!




                                                                                                24
What will I be doing on placement there?

You are likely to have a pretty similar hospital experience at any of the French universities; this
section covers generally what to expect from your placements over there.


The French Medical School System
In the French system, entry to University is not decided on the Baccalaureate marks (A-level
equivalent) but rather any student who has obtained a minimum in their Bac can start a course.
This means that the first year of a typical medical school can take around 1000 students! The
year consists of basic science lectures, and students work very hard and take exams seriously, as
at the end of the year, approximately the top 20% (according to exam marks) will earn the right
to get into the second year of the course. Students in France therefore tend to be very
competitive as they are basically fighting each other for a place on the course. The high
competition in French medical schools does mean that University is much more about learning
and working hard, than about participating in extra-curricular activities, although this is not to say
that French students don‟t have any fun!

There is a definite difference in the learning emphasis between France and England, with the
French system focussing on knowledge and interpretation of results (e.g. ECGs) as opposed to
the English focus on clinical examination skills, bedside manner and communication. Students in
France have no clinical exams like our OSCEs or OSLERs at all, even their final exams. Exams are
all written, based on clinical cases.

The first 2 years are purely theoretical and lectures based, with very limited clinical teaching,
meaning that the French students have usually got a very high standard of clinical knowledge,
but are often unprepared in other aspects of clinical skills. There are 4 clinical years, each split
into 3 month placements in hospital, covering the obligatory specialties and also some rotations
where you can pick a specialty of your own interest. Students are allocated to a ward along with
students from both their own and other years. There are typically around 6 students to a ward,
although this obviously depends on the size of the ward!


Role on the ward
Students on the wards have a more active role than in England, often being expected to take
responsibility for patients. Try to avoid this if possible – especially on the A&E placement.
Previous students suggest trying to stick to a friendly French student- this way you can learn,
without having the stress of having to phone the local GPs for past medical histories!
Responsibilities include clerking, making sure results and notes are up to date and checking up on
patients daily. Other jobs which students tend to do are ECGs, ABGs, taking notes during ward
rounds and other administrative roles, but be prepared for anything- even cutting off plaster
casts!

Your placements on the ward are likely to be between 1 and 4 weeks long. This does not fit
terribly well with the French system of 3 month placements, but on the whole, French students
have been found to be very accommodating and helpful in making you feel at home on your
placement.

It is advised that it is best to be a bit „pushy‟ when on your placements, as long as you are polite
with it- this way you are likely to be able to achieve all your objectives, such as going to theatre



                                                                                                    25
and outpatient clinics, rather than just tidying up folders and chasing up notes, which is
sometimes all the French students end up doing. The best thing to do is simply to introduce
yourself and ask what is possible! Show the head of the department your aims and objectives list,
to see if you can get any help on where to go to achieve them.



When do I have to be there?
Students expected to be on the ward every morning, but also may have to cover weekend or
afternoon shifts, similar to being on-take in England. In many French hospitals, the students are
paid for their work in these tasks. Timings depend on your placement. In general for medical
placements, 9-9.30 is standard, but for surgical placements, 8.00am is the usual start time. You
are expected to stay around until about 13.00, which is when the French students go off for their
lectures, but if you are keen, you can stay longer and try and glean some teaching!


Dress code
Dress code in the hospital is pretty much what you like, the reason being you also have to wear a
long white coat over the top (which, bizarrely, has short sleeves). Most students seem to wear
jeans and T-shirts with their coats over the top.


Teaching
In contrast to the bedside teaching in England, in France afternoon (and maybe even evening!)
lectures continue throughout the clinical years. This leads to a very high standard of theoretical
knowledge – something you may be aware of when you talk to 6th year students! Sometimes
teaching sessions occur during the morning hospital placements, but in general teaching on the
ward is much less structured than in England and dependent rather on the doctors around at the
time. When ward-teaching does take place, it is usually aimed at the 6th year students, and is
therefore of a high standard. You may however be able to persuade the 6th years on the wards to
teach you a lot of things!

If any of the afternoon lectures fit in with the topics you need to learn (see objectives), it is a
good idea to tag along the sessions with the French students. Talk to them to see what they are
doing whilst you are on your hospital placement.




                                                                                                 26
Spain




        27
Alicante
The City
Alicante is a historic Mediterranean port in the southern part of the region
of Valencia. It is one of the fastest growing cities in Spain, with a current
population of around 320 000 people. It is a popular tourist destination,
with the nearby sun-soaked beaches of the Costa Blanca, along with
regular ferry services to the Balearic Islands, drawing in many visitors.
Fortunately during the November-March Erasmus period, the city is not
too swamped by tourists, but does maintain some of its „holiday-feel‟.
Although the place itself is a lovely old port, with a spacious harbour and
a castle (Castillo de Santa Barbara) sat high on the hill above, it is not renowned as a centre of
Spanish culture and some of its 1970s architecture can be a bit depressing. However, there is a
lot to do, it has a busy night-life with lots of cafés and bars, and the weather is always pretty
good- not falling below about 10°C even in the winter!


The University and Hospital
   The link university is the Universidad Miguel Hernández (www.medicina.umh.es),
    commemorating the Spanish poet. It is split into four campuses, each responsible for different
    degree courses. Although the main administrative section is based in a town called Elche,
    about 30 minutes by bus away from the city, the medical faculty is on a campus in San Juan,
    a smaller town about 15 minutes by bus away from Alicante. Lectures are held here, as are
    Spanish lessons, and the ORI (Oficina de Relaciones Internacionales) is based here.
    Unfortunately this campus is small, and there are not many student organisations here. Most
    extracurricular activities can be found at the San Vicente campus of the other university in
    Alicante, Universidad de Alicante (www.ua.es).
   There are three hospitals which take students for practicas - Elche, San Juan, or Alicante.
    Which you choose when you organise your placements (see „what will I be doing?‟ section)
    will probably depend on what is easier and more convenient for you –if you are living in the
    city choose Alicante where possible as it is much easier to get to.


Accommodation
This is generally cheaper than in Bristol. There are several options available:
     The University will link you up with somewhere to live via a company called Houses4U.
        The standard of these is pretty good and on the whole they tend to be in nice, convenient
        locations. The downside is that the houses tend to be full of Erasmus students, which will
        not necessarily help your Spanish, and the company does overcharge, making the
        accommodation more expensive than similar places which you could find independently.
     If you want to stay in private accommodation, it is recommended to stay in a hostel for
        the first week or so, while you look for somewhere to live- perhaps a bit stressful,
        especially if you are on your own, but worth it in the long-run as you can choose your
        housemates and your flat!

Tips when looking for private accommodation include:
     Good places to look for housing adverts –
              - http://cv1.cpd.ua.es/anuncios/default.asp?idioma=es
              - the library in the Universidad de Alicante
              - internet cafés and international calling centres
              - bus stops and telephone booths



                                                                                                     28
      Try to live with at least one Spanish person – this helps your language skills and you learn
       more about the culture
      Ask other Erasmus students if they have any rooms
      Live in Alicante rather than San Juan, as there is far more to do and most Erasmus
       students live here
      Visit the accommodation with a friend before you decide anything; don‟t go alone,
       especially if you are female.
      The best areas, from cheap to expensive are the Plaza de Toros, Plaza de Los Luceros,
       and El Centro.
      Prices are usually around €140 to €250.


Important information and tips
      A good website about doing a medical Erasmus placement in Spain can be found here
       http://www.medvoice.de/esp/curso.htm

      Online listings of stuff going on in Alicante can be found at www.alacalle.com

      A good way to meet Spanish people is to join some groups when you are there. Alicante
       has a thriving base of community organisations such as Medicos Sin Fronteras and
       Amnistia Internacional, which can be found at the Hotel de Entidades de Interes Social
       (http://www.alicante-ayto.es/accionsocial/hotel_asociaciones.html).

      There are loads of places to go out in Alicante – El Barrio and El Puerto are both good
       areas to go to (the latter is a bit more commercial) and then there are various other
       places dotted all over the city.

      It can be hard to open a bank account in Spain as the bureaucracy is quite a struggle. You
       may think it‟s not worth the worry; possibly the best way around this is to open an English
       account where you can withdraw money abroad for free (Nationwide Building Society is
       one which allows this). For this reason, you may want to request your Erasmus grant
       cheque in Pounds, not Euros.

      Hospital placements which you may not be signed up for at the start but are well-worth
       looking into include vascular surgery (Dr Alberto Miñano), thoracic surgery (Dr Paniagua)
       and intensive care (Dr Canovas). The vascular and cardiac surgery tutorials are also highly
       recommended and it is a good idea to ask about these when you arrive in November.
       Other placements which previous students enjoyed include rheumatology (Dr Eliseo
       Pascual).

      If you get to know the residentes (junior doctors) some of them may be willing to take
       you along on their on-call in Urgencias (A&E) or on the wards.



Contacts of previous students (2005-2006)
      Jienchi Dorward – jd2446@bristol.ac.uk




                                                                                                 29
Granada

The City
Granada is the capital city of the province of the same name, in the
Andalusia region of southern Spain. The name actually comes from the
pomegranate - the heraldic device of the city - granada in Spanish! It has
a population of around ¼ million inhabitants and is situated at the
confluence of two rivers and at the foot of the Sierra Nevada mountains.
The city is steeped in Spanish history, and is the point of much important
and beautiful Moorish and Catholic architecture. Famous for its university
and wild night-life, this is a great city to experience the Spanish culture.


The University and Hospital
      The university with which we are linked in Granada is the Universidad de Granada
       (http://www.ugr.es/). Founded in 1531, the university is prestigious within Spain, and is
       said to be one of the three best places in the country to be a student. In addition, it was
       the first university in Europe to receive Erasmus exchange students, so hopefully their
       programme is well-organised by now! The university is split into 17 faculties, of which the
       medical faculty is one.



Granada is a new exchange programme, with the first students going out in the
academic year 2006-2007. As yet, we don’t have very much information about the
exchange- look out for tips next year!




                                                                                                30
What will I be doing on placement there?

The information in this section comes mainly from the experience of the Alicante exchange, as no
students have yet been to Granada. It is, however, likely to be similar in most Spanish
universities. Look out next year for more tips on studying in Granada.

The Spanish Medical School System
It takes six years to complete a medical degree in Spain, with the first three years being pre-
clinical, and the last three clinical. The subjects from our third year, i.e. MDEMO and TUBES, fit
into subjects in their 4th and 5th year. You will soon realise that the courses in Spain are highly
theory-based, not practical like in Bristol – in both the 4th and 5th year the students are expected
to be in hospital doing practicas, from 9-12, after which they have an afternoon (1-5pm) of
optional lectures. As our course here is so practical, the focus of your exchange will be the
practicas, and as you don‟t have to take any exams out in Spain, attending lectures is not
compulsory, although it may be helpful some of the time!


Role on the ward
After a week or so of practicas you will see that being in hospital in Spain is different from back
home in Bristol. There is a lot of time spent just following the doctors around, with little emphasis
on teaching. The largely theoretical focus of the course does mean that students are not always
very enthusiastic about the practicas and see it as something that takes up their time while they
need to be studying for exams! This means it is also rare for Spanish students to acquire skills
independently (taking histories by themselves, venepuncture etc.) although this is very variable
depending on which doctor you are assigned to.

As you will be taking your exams back in England when you get home, it is very important to
make sure you get to do the things that students at home will be doing (see objectives part of
this booklet). Spanish doctors may be a little surprised by you if you take initiative and do things
on your own, but if you have a positive attitude and ask appropriate questions, then they are
likely to help you along. You may even get a chance to see stuff you wouldn‟t get to see at home!
It is a good idea to specifically ask to take histories. In addition, show a doctor, if possible the
head of the department, your clinical skills and objectives sheet which you need to complete (and
get signed) for Medicine and Surgery. If you ask about these things it should be possible for you
to see some procedures, for example angioplasty, or pacemaker implants, which the Spanish
students would not normally go to. This means that the doctors in these areas are not used to
students being around and are therefore usually more friendly and keen to explain things.


Organising your placements
There are two ways you can set up your practicas - either find a group of students doing the
practicas you need and join them, or arrange it on your own. Each year has a delegado or
student rep, who arranges the practicas groups; they can help you to fit in with a group that fits
your timetable and which isn‟t already full. There is always a small group doing a practicas in
each subject every week of the year, so fitting in is reasonably easy! You just have to make a list
of all the subjects you have to cover, work out what order you want to do them in and in which
hospital.

The other way to arrange practicas is to do it yourself. You ask for a letter from the Dean to the
doctor in charge of each department in which you want to study. You can take this letter to the



                                                                                                   31
department head and arrange your placement yourself. Doing it this way means you have to be
in hospital longer, from 9-3pm, but you will get more experience and be allowed to do more.

It is, however, recommended to start with your placements by going with the other students, as
it is far less daunting and a good way to meet people. Then you can stay on in the hospital after
the other students leave if you are keen for more experience!


Dress code
You should wear neatly casual clothes in hospital. Jeans, trainers and T-shirts are all fine, as long
as they are reasonably presentable. Girls shouldn‟t show mid-riffs or wear „provocative‟ clothing.
You will need to bring your own white coat (make sure it‟s ironed!) and stethoscope. When you
arrive in Spain ask the ORI to make you a name badge.




                                                                                                    32
Austria




          33
Vienna
The City
Situated on the river Danube (Donau), Vienna lies only around 40
miles off Austria‟s eastern border, in close proximity to the Czech
Republic, Slovakia and Hungary. The capital city is easily the largest
city in Austria, home to some 1.6 million people. It is home to many
churches, parks and stunning buildings, as well as the renowned
Kaffeehaus culture. Vienna‟s architecture, particularly that around the
famous Ringstrasse, built at the height of Austria‟s power in the 19th century, is both grand and
beautiful. The city has a long artistic and cultural history, especially in the areas of opera and
classical music, fine arts and theatre. There are two opera houses and several theatres in the city,
as well as the Musikverein, home to the Viennese Philharmonic Orchestra and the Wiener
Konzerthaus. There are also innumerable museums to visit, covering art from the mediaeval to
the modern and everything in between. If you are lucky enough to be there during Fasching
(festival period) which runs post-Christmas to the beginning of Lent, you may also be able to
attend a Viennese ball, and learn to waltz!


The University and Hospital
       In Vienna, the host university is the recently formed Medizinische Universität Wien
        (opened in 2004) (http://www.meduniwien.ac.at/), which was originally a faculty of the
        Universität Wien, but is now situated within the extremely large general hospital of the
        city, the Allgemeines Krankenhaus (AKH).
       There are a few hospitals in Vienna, but generally all of your placements are likely to be in
        the AKH, which dominates the 9th district of the city. The AKH is an enormous site, home
        to many different departments. Two large tower blocks, each of 21 floors house the
        inpatient beds for medicine and surgery (one in each block). You enter from the U-Bahn
        on Ebene 5. The outpatient clinics and A&E are on levels 6-9 and the wards start at level
        13 and go right up to level 21! If you are on a placement in Ebene 21, arrive in the
        hospital 10 minutes early as it can take you that long to reach it in the lift!


Accommodation
It is possible to live in halls or in a private flat, and there are advantages and drawbacks to both.
Rent for either is cheaper than in Bristol.

   Halls
     If you apply in time, you are likely to be able to get a room in halls. Information about the
        halls in Vienna can be found at http://www.akademikerhilfe.at or at
        http://www.housing.oead.ac.at/.
     Living in halls can make it easy to meet new people, which is a bonus as the way the
        placements at the hospital work means it is difficult to get to meet and integrate with the
        medical students as a group.
     There is also the bonus of not having to pay bills, although the halls will ask for a deposit
        of a month before you go.
     The hospital is in the 9th district, so recommended areas to live are in the 6th, 7th, 8th or
        9th, but it is reasonably easy and efficient to get around using public transport, and the
        hospital has its own U-Bahn stop (Michelbeuern AKH on the U6), so anywhere in 1-9th,
        17th, 18th or 19th would be ok.



                                                                                                    34
       You can work out the district from the address (the district number has a 1 at the front
        and a 0 at the end, i.e. 8th district is 1080, 19th district is 1190).
       Halls can be pretty basic, but meet all your needs for sleeping, washing and cooking.
       You may find yourself sharing a room- quite common in Austria. This makes the rent even
        cheaper. If you really can‟t stand your roommate, you can apply to have a single room,
        but this decreases your chance of getting a room in the first place.

   Private accommodation
    Although this may be the more stressful option at first, you may prefer to live in a flat with
    other students rather than returning to halls‟ life! It can be difficult to find a flat or room for a
    6 month period, especially as you are coming half-way through a semester. Tips on finding a
    decent room:
     The best website to use is http://wohnen.career.at
     Rooms go very quickly so try to call or email on the day the advert comes out
     You are unlikely to be able to rent a room before you go, but it is worth checking the site
        out the week before you leave and setting up some appointments
     Most landlords will hold a „party‟ to check out any prospective tenants who have applied- it
        can be a bit intimidating, but is certainly an experience and your German will pick up
        quickly!
     When you are filling in the online form, remember to click the möbiliert box so that you
        don‟t need to go out and buy your furniture!
     Be aware of extra costs: ablöse (contribution to recent decoration of the flat- best to avoid
        this); kaution (deposit, normally 3months rent, returnable if the flat is in the same
        condition when you leave); provisio (agency fees- usually 3 months rent for an estate
        agent)


Important information and tips
       Get hold of a map of Vienna – a good A-Z is the Taschenatlas Wien by Freytag und Berndt
        – you should be able to get this at most Tabacs.

       The public transport in Vienna is really efficient and pretty cheap. There is an
        underground (U-Bahn) system, as well as trams, buses and local train (LokalBahn or S-
        Bahn) and the surprising thing is that they all run to a timetable! You can buy a
        Monatskarte or a Wochenkarte at the U-Bahn station which cover all of the transport
        running within the town boundaries (Stadtgrenze). These are cheap compared with prices
        in the UK. If you think you will use the transport a lot, it is just about worth getting hold
        of a student Semesterkarte (costing €117) for the first semester (beginning of October to
        the end of January) if you do it straight away. Although you have missed the first month,
        this card is still marginally cheaper than buying 3 Monatskarte. For this, go to the
        WienerLinien Office in the U-Bahn station at Westbahnhof, taking your Vienna student ID
        with you.

       When you arrive in Vienna, you are supposed to register (anmelden) with the local council
        offices within 3 days. This has to be done for any visit over 60 days. You will be able to
        get the Meldezettel from your halls or a local newsstand. The halls or your landlord have
        to sign it to confirm your place of address, then you can take it to your local
        Magistratisches    Bezirkamt    to    register.  This    can    be   found     online   at
        http://www.wien.gv.at/mba/mba.htm (the nearest one depends on which district you are
        in). Take your passport with you and check out the opening times online before you go!
        You will need your Meldezettel for opening a bank account and registering at the hospital
        library to borrow books.


                                                                                                       35
      A bank account is quite useful, just for the benefit of not relying on your English card. You
       need your Meldezettel to open an account (this gives proof of address) and you will
       probably also need your passport. Make sure you get a student account- this has the
       lowest charges, so you should not be charged for opening or closing the account. They
       may take a few cents off the account every now and again as a cumulative charge for
       using your debit card, but this does not amount to much. Banks that have student
       accounts include ErsteBank/Sparkasse and Bank Austria. There is a branch of Bank Austria
       in the AKH, but this closes at 13.00, whereas other banks across the city stay open longer.

      SIM cards can be bought for about €30. Ask around the students for the best deals – up
       until now, Telering has been the best. A Telering Twist15 SIM gave you texts to abroad
       and within Austria for 15 cents, which is not a bad deal.

      The main shopping street in Vienna is Mariahilfestrasse – this is where you‟ll find
       department stores and large chain stores and is always a good bet for where to look if you
       are trying to buy something „normal‟, i.e. not presents or tourist kitsch! Remember shops
       are shut all day Sunday, so try not to be caught with no food!

      Flying direct to Vienna can be expensive. If you have lots of stuff and it is going to be
       easier to fly directly, the cheapest airlines to Vienna Schwechat airport are usually KLM
       and AirBerlin/AirNiki, flying from London airports. You can then take the CAT (Ciy Airport
       Train) from Schwechat to Wien Mitte Bahnhof, which connects you with the U-Bahn
       network. Alternatively, if you want to fly for cheaper, Ryanair flys to Bratislava Airport in
       nearby Slovenia, and you can get a bus from the airport to Wien Erdberg bus station,
       which connects to the U3 line. This bus costs €9 one way and takes about 90 minutes; not
       bad if you are saving £50 or more!


Contacts of previous students
      Emma Phillips - (2005-2006) – ep2188@bristol.ac.uk (or emma_danescourt@hotmail.com)
      Helen Walters - (2004-2005) – helenwalters@gmail.com




                                                                                                  36
What will I be doing on placement there?
The Austrian Medical School System
Similar to the French system, Austrian students only need to pass their Matura (A-level
equivalent) to be able to go to University. This means that the first 2 years of the course consist
of basic science teaching, with difficult exams at the end of each year getting rid of the majority
of students. Even with these exams, the course in Austria is massively over-subscribed, and even
after the second year, a year group may contain in excess of 1000 students! Recent changes in
the legislature in Austria to come in line with EU requirements, means that other EU students
wishing to study in Austria also need to have only a minimum A-level equivalent to get in.
Previously, students from these countries wishing to study in Austria must have qualified for a
University place in medicine in their own country to be able to get into the Austrian system. This
lack of a so-called „Numerus Clausus‟ (closed number) system, means that the first year of the
course can contain a ridiculous number of students – last year they were taken on a “first come
first served” basis and were camped outside the registration office for days before it opened in an
attempt to get a place! It is hoped that the government will soon change the rules to prevent this
reoccurring.

As in many other European countries, the course is highly theoretical, with students spending
most of their time in „Vorlesungen‟ (seminars/lectures), and a minimum of time in hospital. The
curriculum in the medical school has recently changed; at the moment the students are split into
those following the „alte studium‟ (old system) or the „neue studium‟ (new system). The new
system is much more proscribed and organised, similar to here in England, whereas in the old
system, the students must organise their studies themselves. Once they have completed the first
2 years of lectures, these old system students must apply for the various courses which they wish
to attend during the year. If they manage to get on the course, they must then apply to a
professor to take them for an exam at the end of it. Most of the courses are heavily
oversubscribed, and application for a course is certainly no guarantee of getting on it. This means
that it is not uncommon for students to be in their 15th or 16th semester of study and still not be
finished, simply because they could not organise their courses!

The clinical hospital time they have to do consists of „Praktikum‟, which is compulsory. Depending
on the specialty, this is either a practical based teaching course usually lasting a couple of weeks,
or ward time for „innere medizin‟ (general medicine) or „chirugerie‟ (surgery) where the
placements are a month on each. In addition to these praktika, which are compulsory and have
exams relating to them, the students must also undertake 16 weeks of „famulatur‟ or ward-based
placements. They can choose which to do depending on their interests.

Once a student has completed all the exams for the compulsory praktika, and has done the
required amount of famulatur, then they have finished their degree. There is no final exam in
Austria as there are here in England.


Placements and when you have to be there
Your placements fit in mainly with the old system of praktika and famulatur. At the time of
writing, it is unclear how, in the future, Erasmus students will fit into the neue stadium.

Most of the placements will be on the wards. Timing varies, and you have to stay for as long as
the doctors need you there, but most placements are around 8.00 until 13.00, with surgery
starting earlier at 7.00. Occasionally you may be expected to stay all afternoon. Students are not
free to come and go as you are at home- when you are on the ward, you are responsible for


                                                                                                   37
doing some of the ward tasks (most of which would be carried out by nurses in England). If for
any reason you will not be able to attend a day of your placement, you check with the staff on
the ward first if this will be ok; similarly if you are unlucky enough to be ill while you are away,
then you will need to phone in the morning to let them know you won‟t be there.

The placements that have been done in the past include:
 Famulatur equivalent in
    Respiratory (3 weeks on a ward-based placement in Innere Medizin IV)
    Ophthalmology (one week in the Augenambulanz)
    Orthopaedics (3 weeks in Ortho, attending outpatient clinic and theatre)
    Emergency (one week on Notfall, which unfortunately does not include trauma, as their
       A&E system is split into separate Unfall and Notfall departments)
    Intensive care (3 weeks on Intensivpflege – coronary care unit)

   Praktikum equivalent in
     ENT (2 weeks of HNO praktikum – lecture and practical based course during which you
        are also taught the outmoded use of a head mirror!)
       Rheumatology (4 weeks on a ward-based placement in Innere Medizin III with a one-
        lecture per day course in topics relating to any general medicine, e.g. ECG)


Role on the ward
When you arrive on the ward, you start off by taking bloods, putting up drips, re-siting venflons
and giving s.c. injections of heparin. The students are then supposed to take a complete history
and examination from any new patients who are being admitted. Visite (ward round) usually
starts at around 10.00am, and you are expected to follow this after you have finished your jobs.
Ward rounds may last in excess of 2 hours, and can be a bit dull on occasion! Once a week, there
is the „Chefvisite‟, where the top man comes in to make all the underlings sweat. The hierarchy is
very traditional in Austria, and everyone has to bow and scrape to the Chef, so the Chefvisite will
be obligatory to attend (and you will probably have to drop anything you are doing the moment it
starts!).

For surgical placements (orthopaedics), you have to be on the ward at 7.00, when the Visite
begins. After this, and the case discussion, you will either be in theatre, where you may be
needed to assist, or in outpatient clinics. Theatre can last until 17.00, but if you are not needed,
then you can often leave earlier!


Dress code
You can wear anything sensible in hospital- most students stick to jeans and a T-shirt- as you will
also have to wear a long white coat over your clothes. On some wards, you are also expected to
wear the white trousers and shirt (for men) or T-shirt (for girls) which you can get from the
central stores. These all have to be changed once or twice a week. When you register for your
placement, they will give you a certificate entitling you to these wäscher, without which the ladies
in the central stores will be very mean and won‟t give you anything!


Organising your placements
With the Austrian system of students applying for their own courses, it is important you make
sure that the International Office in Vienna has sorted out your courses for you before you arrive;
otherwise, arriving in November, you will struggle to find any placements at all!



                                                                                                  38
The contact in the international office is:

Dr Human Salemi
SOKRATES Hochschulkoordinator
Address      MEDIZINISCHE UNIVERSITÄT WIEN
             Büro für Internationale Beziehungen
             Spitalgasse 23
             1090 Wien
Phone        0043-1-40160-21023
Fax          0043-1-40160-921001
Email        human.salemi@meduniwien.ac.at

Dr Salemi is assisted in the office by a very helpful lady who will tell you where you need to go
for the start registration of all of your placements.

Mag. Christine Baier
Phone          0043-1-40160-21014
Fax            0043-1-40160-921001
Email          christine.baier@meduniwien.ac.at

Ask her about times, places (make sure you get a floor and clinic number (e.g. the
Studentensekretariat for Innere Medizin III has its office in the clinic on the 6th floor, in area J –
written simply as 6J) and who you should ask for when you arrive! If you can‟t get hold of this
information through the office, you can look it up on the website www.meduniwien.ac.at, looking
under the section on Universitätskliniken & klinische Institute to find the home pages of the
separate departments, which usually has information on where their offices are. Registration for
the placements is usually between 7.30 and 7.45 on the first day- this gives you enough time to
pick up your wäscher from the Zentrallager (central stores) on the 4th floor before you need to be
on the ward at about 8.00am!

You will need to register in the International office on the first day, to get your student card. You
may find however, that they pack your timetable so full that you will also be expected on the
ward at the same time. Go to the ward first (after registration at the Studentensekretariat) and
familiarise yourself with what is going on before you try to go to the office. The office has limited
opening hours (9.00-12.00 Mon-Wed and Fri, 14.00-17.00 Thurs). It is on the ground floor of the
medical building on the Spitalgasse side of the hospital, but can be difficult to get into as
sometimes the outer door leading to the section is locked. Don‟t be disheartened, just bang loudly
until someone lets you in- you are allowed to be there!




                                                                                                    39
Units and objectives
What will I be missing?
Obviously whilst you are away abroad it is important that you cover all of the information that
you would have been doing had you been in England, not least because you will have to do the
exams you missed when you get home!

It is therefore very important that you make sure you are aware of the Units objectives before
you go away, so that you know which placements you should be doing in hospital and so you can
read round the subjects and learn things which you might be missing.

The two units that are usually covered by the Erasmus placement abroad are:
    MDEMO – this includes musculoskeletal disease (rheumatology and orthopaedics),
      emergency medicine and ophthalmology
    TUBES – this includes cardiovascular disease (Cardiology and Vascular surgery),
      respiratory medicine and ENT (ear, nose and throat medicine). TUBES is the „Medicine and
      Surgery A‟ unit.


Internal SSCs and coursework
Both of these units also contain coursework in the form of an internal SSC or other piece of work,
which you will have to complete and submit while you are away. As you may not be doing the
units in the same order as you would be at home, the course organisers are usually reasonably
flexible about when you submit the SSCs, provided both are done and submitted when you
return.

Last year, the MDEMO unit organisers asked for the SSC to be submitted 8 weeks after you had
emailed in with a title and a supervisor, but were very flexible about the start date. TUBES unit
organisers wanted the SSC completed at the same time as if you would have done TUBES at
home; for most of us, this would have been the third unit of the year, so the SSC had to be
submitted midway through March, just as we were returning home.

Finding a title and a supervisor is not too difficult, and you will have probably got some idea of
how this works during your first third year unit in England. For TUBES, the Medicine and Surgery
course book is a great help, providing you with a long list of title ideas and people willing to
supervise these. It‟s a good idea when you email a supervisor to let them know that you are out
of the country and won‟t be able to get to see them in person!

In MDEMO, in past years the unit leader, Professor Kirwan, has supervised all of the Erasmus
student SSCs. Owing to increased student numbers next year (2006-2007), there may be no
internal SSC for the MDEMO unit, however you may be required instead to submit another piece
of work that students in Bristol will be undertaking whilst you are away.


Exams
When you arrive back from your placement, you will have to sit the exams from the second and
third units. For MDEMO and TUBES this involves-




                                                                                                  40
TUBES
     OSLER – long-case exam
     OSCE (medicine and surgery)
You will have had experience of a medicine and surgery OSLER before, after your first unit in
England, so this is nothing new to worry about. It involves 50 minutes taking a history and
examining a patient with a consultant or SpR watching, followed by 10 minutes to present and
discuss the patient with them. For TUBES, the patient is likely to have a cardiovascular or
respiratory complaint, so make sure you know the questions to ask, and exactly how to do the
examination (Beware! Cardiologists are notoriously pedantic about the cardiovascular
examination!!).

The OSCE usually takes place in the clinical skills lab at Frenchay hospital, and you will be doing
this along with half of your year who have done the two medicine and surgery blocks within the
first three units. The timetable will be emailed out beforehand. The unit organisers set up a bus
service to run to Frenchay from the medical school on the day, as parking at the hospital is very
difficult.

The OSCE basically tests any clinical skills you should have covered during medicine and surgery.
There are several stations, some lasting 10 minutes, some lasting 5 minutes. The whole exam is 1
hour and 10 minutes long and includes one rest station. Examiners will guide you around the
stations and give explicit instructions on what you are to do in each one.

It is useful to look at the list of skills which you have to get signed off for the units during the
year. Common stations include-
      Venepuncture
      Taking blood pressure
      Urine dipstick analysis
      Interpretation of ECG
      Interpretation of spirometry
      Interpretation of radiographs

Therewill also be history and examination stations. Past stations have included:
     Communication skills – e.g. breaking bad news, explaining a difficult or chronic diagnosis
     Examination of any system of the body e.g. cardiovascular, neck lumps etc
     Short directed questioning – e.g. confirming a suspected diagnosis of intermittent
      claudication
    Taking a history to elicit a diagnosis e.g. fits/faints, headache, abdominal pain/diarrhoea

In the OSCE, one of the most important things to remember is that you get marks in relevant
stations for introducing yourself to the patient and explaining what you are going to do! Don‟t
forget this most basic of things, and you are already off to a good start.

MDEMO
This exam involves:
     20 minutes to take a history from and examine a musculoskeletal patient
     10 minutes to present and discuss the patient with a consultant or SpR
     10 minutes of radiography with a consultant or SpR
     10 minutes of ophthalmology (fundoscopy using an ophthalmoscope and identification of
       diseases using photographs)

The structure of the MDEMO exam may be changing for the next academic year; however there
are no details for this as yet.


                                                                                                  41
When will I do the exams?
The timing of the exams will depend on whether the course organisers can fit all of the Erasmus
students into the system at the end of the third unit. The likelihood is that you have to take your
TUBES OSLER and the medicine and surgery OSCE as soon as you get back from your placement.
Last year, some students also took the MDEMO exam at this time (i.e. all three exams as soon as
they returned), whilst another group of students took the MDEMO exam at the end of the fourth
unit (i.e. with the June set of exams). This was randomly assigned by the course organisers and
the Erasmus Office, so be prepared for either possibility!



Help, I’ll never pass!
For tips on how and what to learn, look at the course objectives which are written below. The
Emergency Medicine objectives are new for 2006-2007, but others are similar to those from
previous years. All of this information can be found in the Unit course books and on the relevant
section of Blackboard (http://www.ole.bris.ac.uk).

Blackboard is a very useful tool, especially for the MDEMO course, as all of the eLearning tutorials
that students at home will be doing for the Seminars are posted here, as well as many sets of
lecture notes, internet links and other informative stuff.

Before you go make sure you have picked up the MDEMO Logbook, GALS DVD and
Musculoskeletal Book from the Centre for Medical Education. These contain huge amounts of
really important things you will need to know for the MDEMO unit. The GALS DVD is especially
helpful for learning how to examine the musculoskeletal system in the way you will need to do it
in your exam. You should already have the Medicine and Surgery book from the AERN unit.

Try to cover as many of the practical skills as you can during your placements abroad. If the
placement you are on does not do this, show the head of the department over there a list of your
objectives. If you ask politely, it may be possible to organise to see some extra things.

Make sure you have read up on the knowledge-based topics you should have covered – Kumar
and Clark‟s Clinical Medicine, or the Oxford Handbook of Clinical Medicine (and Clinical
Specialties) are useful books to take with you! It is harder to pick up information in hospital when
you are always struggling with a language that is not immediately familiar. Try to do at least a bit
of reading and revision (30 minutes to an hour minimum) every day when you are away. This will
also stand you in good stead when you are revising for the written exams in the summer.

For the clinical exams when you get back, it is important to know how to take a history and
examine the relevant systems in the English (not the European!) way, and how to interpret
results and imaging. Try to go through the examination of systems with a friend, to make sure
you have it in a logical order that will please an English doctor! For ophthalmology it is a good
idea to go and practise on the eye models. There are some in the Eye Hospital and some in the
Clinical Skills Lab in the UBHT Education Centre.

In the end, if you really have done as much as you can, you should be fine.




                                                                                                  42
MDEMO learning objectives
Unit Leader
Professor John Kirwan                                Course Administrator
Email         John.Kirwan@bristol.ac.uk              Ms Suzan Fowweather
Work phone 0044 117 928 2906                         Email suzan.fowweather@bristol.ac.uk
Address       Academic Rheumatology Unit             Work phone 0044 117 928 3364
              The Courtyard                          Address      as for Prof Kirwan
              Bristol Royal Infirmary                Office hours Mon 1.30-5pm
              Bristol                                             Wed 9am-5pm
              BS2 8HW                                             Fri 9am-5pm
Office hours 9am-5pm


Please send any queries or questions about the unit to the Administrator first.


Musculoskeletal disease
The learning objectives for this unit specify the amounts and types of teaching you should be
receiving-

       Ward round with consultant - 1 hour of each ortho, rheuma and trauma per week
       Outpatient clinic attendance – 2-3 hours per week of each ortho, rheuma and trauma
       One weekly tutorial
       One weekly seminar

Also specified are specific practical skills you should try to observe-
     Manipulation and plaster of a fracture
     Surgical fixation of a major fracture in theatre
     Aspiration and injection of a joint
     Arthroscopy of the knee or shoulder joint in theatre
     Any major joint replacement in theatre
     Some rehabilitation work, e.g. physiotherapy, OT or specialist nursing care
     Some experience of reading radiographs and other imaging techniques


Knowledge
   basic anatomy of the musculoskeletal system
     structure of major joints
     neurology of limbs
     anatomy of common injuries to joints and peri-articular soft tissues
     surgical approaches

   major rheumatological conditions
     inflammatory arthritides – rheumatoid and seronegative arthropathies
     osteoarthritis
     crystal arthropathies
     connective tissue disorders
     vasculitides
     polymyalgia rheumatica


                                                                                                43
   other common musculoskeletal problems
     osteoporosis
     osteomyelitis
     septic arthritis
     avascular necrosis
     Paget‟s disease
     Peripheral nerve lesions
     Orthopaedic disorders of childhood

   Principles of diagnosis and treatment of trauma
     Common fractures and dislocations
     Major trauma

   Assessment and management of common musculoskeletal problems
     Rheumatological – monoarthritis, polyarthritis, polyarthralgia, diffuse musculoskeletal pain
     Other – back pain, shoulder pain, hip pain, knee pain


Skills
        Take a relevant history from a person with a musculoskeletal disorder
        Appropriately examine the musculoskeletal system
        Elicit commonly observed signs in the musculoskeletal system
        Record your findings in a systematic and understandable way and present them to
         colleagues and teachers
        Read an X-ray well enough to identify major musculoskeletal pathology
        Control bleeding
        Suture a wound
        Apply bandages, simple splints and plaster casts


Emergency medicine
Within the MDEMO unit, you should also complete an A&E attachment
    36 hours A&E time, including various shifts (e.g. morning and evening)
    some teaching sessions addressing A&E learning objectives


Knowledge
        Define normal physiological parameters
        Understand the significance of abnormal observations in the recognition of a critically
         unwell patient
        Define ABC approach in the context of an acutely unwell patient
        Be able to decide when to use a „focussed history and examination‟ and when to opt for
         the „ABC approach‟
        Be able to assess a critically ill or injured patient using a structured „ABC approach‟

Airway
        Explain why emergency assessment starts with A and B
        List potential causes of airway compromise
        Demonstrate how to assess the airway and recognise signs of airway obstruction
        Demonstrate basic airway manoeuvres (chin lift, jaw thrust)



                                                                                                 44
      Demonstrate how to use suction apparatus
      Demonstrate how to size and insert oro and naso-pharyngeal airways. List occasions when
       it is appropriate to use them
      Be able to define a „protected‟ airway
      Understand indications for LMA, endotracheal intubation and surgical airway

Breathing
      List common potential causes of acute severe respiratory compromise
      Demonstrate how to assess breathing using examination, monitoring and urgent
       investigations.
      Understand the use and limitations of saturation monitoring
      Choose appropriate masks and flow rates for the delivery of oxygen
      Demonstrate effective bag-valve-mask ventilation technique
      List indications for needle thoracostomy and chest drain insertion

Circulation
      Recognise the clinical manifestations of shock
      Explain the physiological mechanisms responsible for the clinical manifestations of shock
      Be able to identify causes of hypovolaemic shock in a traumatised patient from clinical
       examination and basic observation
      Be able to initiate appropriate fluid treatment in a patient with hypovolaemic shock

Disability
      Define coma
      Construct a differential diagnosis for patients with a reduced conscious level, differentiated
       between intra and extra cranial causes
      Describe systems used to assess patients in coma, including the Glasgow Coma Scale and
       AVPU scoring
      Understand the importance of a structured approach (ABC) in the assessment and
       treatment of patients in a reduced conscious level
      Outline the management steps of a patient presenting with a significant head injury

Chest Pain
      Take a focused history from a patient presenting with acute chest pain
      Construct a differential diagnosis for patients presenting with acute chest pain
      Perform a focussed examination to demonstrate clinical signs making a diagnosis more or
       less likely
      Choose relevant investigations of patients with acute chest pain based on history and
       examination, that may confirm or refute a diagnosis

Minor Injuries (Wound Management)
      Take a focussed history from a patient with a wound
      Describe the clinical assessment of a wound, including assessment of surrounding
       structures
      List the different options which exist for treatment of wounds
      Categorise examples of „high risk‟ wounds
      Explain the current approach to minimising the risk of tetanus in patients who have
       wounds
      List factors associated with poor healing of a wound




                                                                                                   45
Communication
        Describe the factors causing stress in the ED
        Understand the style of ED working, including multi-tasking, inter-professional team
         working and flexibility


Ophthalmology
You should also carry out an Ophthalmology attachment
    40 hours of ophthalmology experience
    including practical procedures and teaching specific to ophthalmology learning objectives


Knowledge
   Emergency ophthalmology
     The red eye
     Sudden loss of vision
     Common visual field abnormalities
   Strabismus (squint) in children
   Cataract and the surgical care pathway
   Diabetic retinopathy
   Age related eye disease
     Chronic glaucoma
     Macular degeneration


Skills
   Obtain and record a history from a patient with an eye complaint
   Carry out a basic ocular examination
     Measuring and recording visual acuity (adults and children)
     Measure and record pupil response to light
     Measure and record visual fields to confrontation
     Evert an upper eyelid
     Safely administer eye-drops
     Use the direct ophthalmoscope for cornea, lens and fundus examination




                                                                                                 46
TUBES learning objectives
Unit Leader                                           Unit and SSC Administrator
Professor Karl Karsch                                 Val Newman
Email          k.r.karsch@bristol.ac.uk               Email          val.newman@bristol.ac.uk
Work phone 0044 117 928 3190                          Work phone     0044 117 928 2344
Address        Department        of    Cardiac,       Address        as for Prof Karsch
               Anaesthetics and Radiology
               Sciences
               Level 7
               Bristol Royal Infirmary


For any queries about the unit, please email the Administrator in the first instance.


Cardiac system
Knowledge
   Key points
     Risk factors for cardiovascular disease
     Myocardial infarction
     Heart failure
     Ischaemic hear disease
     Cerebrovascular accident/transient ischaemic attack
     Hypertension
     Hyperlipidaemia
     Valvular heart disease
     Pulmonary embolus
     Tachyarrythmias (SVT, VT, AF)
     Bradyarrythmias (1st, 2nd and 3rd degree block, bundle branch block)

   Others you should know something about
     Acute coronary syndromes
     Syncope
     Pericardial disease
     Cardiomyopathies
     Cardiac infections and prevention
     Congenital heart disease
     Wolf-Parkinson-White syndrome
     Atrial flutter


Skills
        Take a complete history of all common symptoms of cardiovascular disease e.g. chest
         pain, breathlessness, palpitations, dizziness/blackouts
        Perform a cardiovascular examination, including examination of pulse, blood pressure,
         JVP, murmurs, lung fields and oedema
        Interpret a chest radiograph including cardiothoracic ratio
        Be aware of use of CT and MRI in diagnosis of cardiovascular pathology


                                                                                                47
        Perform and interpret a 12-lead ECG (normal ECG, AF and ectopic beats, MI)
        Understand and describe use of GTN spray


Procedures to observe or be aware of-
    Cardiac pacing
    Cardiac catheterisation and/or angioplasty
    Electrophysiology studies
    Exercise testing
    Echocardiography



Vascular surgery
Knowledge
   Key points
     Risk factors for vascular disease
     The diabetic foot
     Abdominal aortic aneurysm
     Claudication and rest pain
     Varicose veins
     Acutely ischaemic limb

   Other topics to know about
     Lymphoedema
     Amputations
     Raynaud‟s syndrome/disease
     Arteriovenous malformations (congenital or acquired)
     Popliteal artery aneurysms
     Cervical rib


Skills
        Take a complete vascular history of any common symptoms, including claudication pain,
         ischaemic rest pain, acutely ischaemic limb, symptoms of leaking/ruptured AAA, varicose
         veins, amaurosis fugax, TIA
        Perform a vascular examination, including examination of upper and lower limb pulses,
         carotid bruit, aortic aneurysm, peripheral skin/nail/hair changes, capillary refill, Bürgher‟s
         Test, assessment of feet and ulcers, gangrene and the vasospastic hand/foot (Raynaud‟s).
        Interpret plasma glucose results to correctly diagnose diabetes mellitus
        Interpret a plain abdominal radiograph and understand limitations for vascular assessment
        Be aware of the use of CT/MRI in diagnosis of vascular disease

Procedures/tests to be aware of and observe-
    ABPI
    Duplex ultrasonography
    Arteriography
    Treadmill testing




                                                                                                     48
Respiratory system
Knowledge
   Key points
     Asthma
     Bronchial carcinoma
     Chronic obstructive pulmonary disease (COPD)
     Pulmonary oedema
     Pneumonia (community acquires and atypical)

   Other topics to know about
     Bronchiectasis
     Lung function tests
     Cystic fibrosis
     Respiratory failure
     Sleep apnoea
     Sarcoidosis and related conditions
     Fungal infections of the lung
     Acute respiratory distress syndrome (ARDS)
     Industrial lung diseases
     Extrinsic allergic alveolitis
     Cryptogenic fibrosing alveolitis


Skills
        Take a complete history and be able to assess common respiratory symptoms e.g.
         breathlessness, chest pain, cough, sputum, haemoptysis, wheeze, stridor
        Perform a detailed examination of the respiratory system, to include the shape of the
         chest wall, respiratory movements, percussion and auscultation of the lung fields (breath
         and voice sounds)
        Interpret a chest radiograph, including cases of pneumonia, pneumothorax, pleural
         effusion, masses, and fractured ribs
        Be aware of the use of CT/MRI in respiratory medicine
        Demonstrate use of a metered dose inhaler and spacer device
        Demonstrate use of a peak flow meter
        Interpret respiratory function tests

Procedures to observe-
    Lung function testing



ENT and Maxillofacial surgery
Knowledge
   Key points
     Glue ear
     Deafness

   Other topics to know about
     Tinnitus



                                                                                                49
        Vertigo
        Epistaxis
        Otitis externa
        Tonsillitis
        Quinsy
        Salivary gland stones
        Salivary gland (parotid) tumours
        Facial palsy
        Mastoiditis


Skills
        Take a history and evaluate common symptoms e.g. deafness, dizziness, ringing in ears,
         hoarseness, difficulty swallowing, neck lump, blocked nose, mouth ulcer, odontalgia,
         temperomandibular pain, facial deformity, facial fracture
        Perform a detailed examination of the ear, nose and throat including Weber‟s and Rinne‟s
         Tests, inspection of outer ear, otoscopic examination of ear, inspection of external nose
         and nares, assessment of dysphonia/stridor, inspection of oral cavity and oropharynx
         (mouth ulcer, erythroplakia, leukoplakia, stomatitis, glossitis), inspection and palpation of
         neck and neck lumps (size, mobility position, consistency), transillumination of lumps,
         presence of bruit
        Interpret findings of pure tone audiometry in common causes of deafness
        Interpret plain radiographs and be aware of uses of other imaging techniques in MaxFax
        Be aware of the relationship of anaemia and other systemic diseases to oral ulceration,
         stomatitis and glossitis

Procedure and tests to be aware of and observe-
    Examination of nasal cavity and post-nasal space (anterior rhinoscopy,                      rigid
      nasendoscopy)
    Examination of larynx and hypopharynx (indirect and flexible laryngoscopy)
    Pure tone audiometry
    Tympanometry
    Fine needle aspiration of neck lumps




                                                                                                    50
Language tips
This section contains some useful medical vocabulary in French, German and Spanish which
applies to the units you will be covering abroad. Obviously the list is not exhaustive, but it will
hopefully give you a head-start on what you need to know. A medical dictionary will also be
invaluable, but you may find that in fact many of the diseases are called similar things, especially
those with names derived from the Latin or Greek (they may sound a bit strange when
pronounced in a foreign accent however!) There are also other guides to European languages for
medical students produced by students who have been on an exchange from Bristol- check out
the Galenicals‟ pages for more information.

There are also some good online dictionaries, these are examples:
French - http://www.wordreference.com/enfr/
German – http://dict.leo.org/
Spanish - http://www.wordreference.com/es/translation.asp?tranword




General

ENGLISH                  FRANÇAIS                 DEUTSCH                   ESPAÑOL
absolute(ly)             absolue                  unbedingt                 completamente,
                                                                            totalmente
aetiology                                         die Aetiologie            etiología (f)
anaesthetic              la narcotique            die (das)                 anestesia
                                                  Narkose(mittel)
antiobiotic              antibiotique (m)         das Antibiotikum          antibiótico (m)
appendicitis             appendicite (m)          die                       appendicitis
                                                  Blinddarmentzündung
appointment              le rendez-vous           der Termin                cita (f)
blanket                  la couverture            die Decke                 manta (f)
blood                    la sang                  das Blut                  sangre (f)
blood count (FBC)        Numération Formule       das (komplette)           análisis de sangre
                         Sanguine (NFS)           Blutbild
blood donor              donneur(euse) de         der/die                   donante de sangre
                         sang                     Blutspender(in)
brain                    le cerveau               das Gehirn                cerebro (m)
cause (the)              la cause/la raison       die Ursache               causa (f)
chronic                  chronique                chronisch                 crónico
clinical                 clinique                 klinisch                  clínico
clinical medical         interne                  der Medizinstudent
student                                           (Famulant)
clotting                 la coagulation           die Gerinnung             coagulación (f)



                                                                                                  51
cogwheel rigidity   la rigiditéde roue     das Zahnradphänomen
                    dentée
cold (I have a)     (je suis) enrhumée     die Erkältung             resfriado (m)
dehydrated          déshydraté(e)          dehydriert                deshidratado
diarrhoea           la diarhée/échec (m)   der Durchfall             diarrea (f)
disease             la maladie             die Krankheit             enfermedad (f)
dose                la posologie           die Dosierung             dosis (f)
face                le visage              das Gesicht               cara (f)
flu                 la grippe              die Grippe                gripe (f)
forehead            le front               die Stirn                 frente (f)
frail               frêle                  schwach                   frágil
frusemide           le furosémide          Lasix™
gall bladder        la vésicule biliaire   die Gallenblase           vesícula biliar (f)
gut                 intestine (m)          der Darm                  tripas (f) intestinos
                                                                     (m)
haemorrhage         hémorragie (f), le     die Blutung               derrame (m),
                    saignement                                       hemorragia (f)
headache            la céphalée, mal de    Kopfschmerzen (pl),       dolor (m) de cabeza
                    tête                   das Kopfweh
immediate           immédiatement,         Unmittelbar, sofort       inmediato
                    directement
infection           infection (f)          die Infektion             infección (f)
inflammation        inflammation (f)       die Entzündung            inflamación (f)
infusion/drip       la perfusion           die Infusion, der Tropf   infusion (f)
injection           la piqûre              die Spritze               inyección (f)
junior doctor       externe                der Assistenarzt          residente (m)
kidney              le rein (le rognon)    die Niere                 riñón (m)
management,         le traitement          die Behandlung            manejo (m),
treatment                                                            tratamiento (m)
nail                ongle (m)              der Nagel                 uña (f)
needle              aiguille (f)           die Nadel                 aguja (f)
nerve fibres        la fibre nerveuse      die Nervenfasern          fibra (f) nerviosa
nerve root          la racine              die Nervenwurzel          raíz (f) nervosia
nil by mouth        rien per oral          nüchtern                  nada por la boca
numb                insensible             taub, gefühllos           entumecido, dormido
obesity             obésité (f)            die Adipositas/die        obesidad (f)
                                           Fettleibigkeit/die
                                           Fettsucht



                                                                                             52
pain                 la douleur            der Schmerz                 dolor (m)
painful              douloureux(euse)      schmerzhaft                 doloroso
palpable             evident(e)            palpierbar                  palpable
pins and needles     sensations de         das Kribbeln                hormigueo (m)
(paraesthesia)       fourmillements
pregnant             enceinte              schwanger                   embarazada
scar                 la cicatrice          die Narbe                   cicatriz (f)
soft                 mou, molle            weich                       blando
spinal cord          la moelle             das Rückenmark              columna (f) vertebral
sterile              sterile               steril                      estéril
stomach              estomac (m)           der Magen                   estómago
sudden(ly)           soudain(e)            plötzlich                   súbito
swelling             le gonflement         die Schwellung              tumefacción
swollen              gonflé(e)             geschwollen                 hinchado
temperature (high)   la fièvre             das Fieber                  fiebre (f)
(to be) dizzy        d‟avoir la tête qui   schwindlig (zu sein)        vertiginoso
                     tourne
to bleed             saigner               bluten                      sangrar
to burn (oneself)    (se) brûler           (sich) verbrennen           quemarse
to deteriorate       détériorer            sich verschlechtern         empeorarse
to fall over         tomber                hinfallen                   caerse
to get better        s‟améliorer           sich (ver)bessern           mejorarse
to heal              cicatriser            verheilen                   cicatrizar, curar, sanar
to inject            injecter              (ein)spritzen, injizieren   inyectar
to measure           mesurer               messen                      medir
to prescribe         prescrirer            verschreiben                recetar
to recuperate        récupérer             sich erholen                reponerse,
                                                                       recuperararse
to relax             relaxer               sich entspannen             relajarse
to rest              se reposer, se        sich ausruhen               descansar
                     détendre
to shiver            trembler              zittern                     tiritar, temblar
to smoke, smoking    fumer, tabagisme      rauchen                     fumar
to sterilize         stériliser            sterilisieren               esterilizar
to suture            suturer               nähen                       suturar
to vomit             vomir, décacheter     (sich) erbrechen            vomitar
tumour               la tumeur             der Tumor                   tumor (m)



                                                                                               53
tweezers     la pincette    die Pinzette      pinzas (fpl)
ultrasound   ultrason (m)   der Ultraschall   ecografía (f),
                                              ultrasonido
unexpected   inattendu(e)   unerwartet        inesperado
urea         urée (f)       der Harnstoff     urea (f)
urge         le besoin      der Drang         urgir
ward         la salle       die Station       planta (f), sala (f)
ward round   le visite      die Visite        visitas
warfarin                    Markumar™




                                                                     54
On Admission – L’admission – Die Aufnahme – Ingreso

admission               admission (f), accueil    die Aufnahme             ingreso (m)
                        (m)
allergy                 allergie (f)              die Allergie             alergia
appendix                appendice (m)             der Blinddarm            apéndice (m)
appetite                appétit (m)               der Appetit              apetito (m)
blood pressure          TA (tension arterielle)   der Blutdruck            presión arterial
blood relative          consanguine(e)            der Blutsverwandte       relación consanguínea
cancer                  le cancer                 das Karzinom/der         cancer (m)
                                                  Krebs
cardiac risk factors    facteurs de risque        die kardialen            factor de riesgo
                        cardiaque                 Risikofaktoren           cardiaco
cholesterol             le cholestérol            das Cholesterin          colesterol (m)
clinic (outpatients)    la clinique               die Ambulanz             clínica (f) ambulatoria
complaint               la doléance               die Beschwerde           dolencia (f)
current medical         la description de la      die jetzige Erkrankung   historia (f) médica
history/presenting      maladie                                            corriente
complaint
diabetes                le diabète sucré          der Diabetes/die         diabetes (f)
                                                  Blutzuckerkrankheit

diagnosis               la diagnose               die Diagnose             diagnóstico (m)
drug                    le médicament             das Medikament           droga (f),
                                                                           medicamento (m)
event                   événement (m)             das Ereignis             acontecimiento (m)
family history          l‟anamnèse (f)            die Familienanamnese     historia (f) familia
                        familiale
hepatitis               hépatite (f)              die Hepatitis            hepatitis (f)
history                 anamnèse (f)              die Anamnese             historia (f) médica
hypercholesterolaemia   hypercholestérolémie      die erhöhte Blutfette    nivel (m) alto de
                                                                           cholesterol
                        (f)
hypertension            HTA, l‟hypertension (f)   der Bluthochdruck/die    hipertensión arterial
                                                  Hypertonie
jaundice                ictère (m), la jaunisse   die                      ictericia (f)
                                                  Gelbsucht/derIkterus
mood                    humeur (f)                die Laune/die            humor (m)
                                                  Stimmung
notes (folder)          le dossier                die Mappe                apuntes (pl) médicos




                                                                                                   55
operation              operation (f)           die Operation           operación (f)
past medical history   la préhistoire,         die Vorgeschichte       historia (f) médica
                       antecedent (m)                                  pasada/previa
piece of paper         bout de papier          der Zettel              una hoja de papel
prescription           ordonnance              das Rezept              receta (f)
proof                  la preuve               der Nachweis            prueba (f)
reason for admission                           der Grund für die       razón para ingreso
                                               Einweisung
referral letter                                der Überweisungsbrief   letra (f), volante (m)
relax                  relaxer                 locker lassen,          relajar
                                               entspannen
result                 le résultat             der Befund              resultado (m)
stroke (CVA)           AVC (accident           der Gehirnschlag        accidente-vascular-
                       vasculaire cérébrale)                           cerebral (AVC),
                                                                       apoplejía (f)
thyroid                la thyroïde             die Schilddrüse         tiroideo (m)
to complain of         plaindre                klagen über             quejarse
to examine             examiner                untersuchen             examiner
to lead                guider, diriger         führen                  guiar, llevar
to refer               assigner                überweisen              referir
to relieve (e.g. of    atténuer                lindern                 aliviar, mitigar
pain)
to sweat               suer, suinter,          schwitzen               sudar
                       transpirer
to vaccinate           innoculer, vacciner     impfen                  vacunar
tonsils                amygdale                die Mandeln             amígdala (f)
transient ischaemic    accident ischémique     transitorische          ataque isquémica
attack (TIA)           transitoire (AIT)       ischämische Attacke     transitorio
                                               (TIA)
ulceration,            purulence,              die Ulceration, die     ulceración (f)
suppuration            suppuration             Eiterung




                                                                                                56
Cardiology – Cardiologie – Kardiologie – Cardiología

aneurysm                   anévrisme (m)             das Aneurysma            aneurisma (f)
angina pectoris            angine (f) de poitrine    die Angina Pectoris      angina de pecho
ankle oedema               des oedèmes des           das Ödem in der
                           chevilles, oedème du      Knöchelregion
                           membre inferieur
                           (OMI)
aorta                      aorte (f)                 die Aorta
arch of the aorta          la crosse de l‟aorte      der Aortenbogen
artery                     artère (f)                die Arterie/die          arteria (f)
                                                     Pulsader
atherosclerosis            atherosclerose            die Atherosklerose       arteriosclerótica
atrial fibrillation (AF)   la fibrillation           das Vorhofflimmern       fibrilación atrial
                           auriculaire
atrium                     auricule (la)             der Vorhof, der Atrium   atrio (m)
blood vessel               le vaisseau sanguin       das Blutgefäβ            vaso (m) sanguineo
breathlessness             éssoufflé                 die Atemnot              sin aliento
burning                    brûlant(e)                brennend                 candente
calf (lower leg)           le mollet                 die Wade                 pantorilla (f)
coronary heart disease                               koronare                 cardiopatía isquémica/
(CHD)                                                Herzkrankheit (KHK)      arteriosclerótica
deep vein thrombosis                                 die tiefe (Bein)         trombosis venosa
(DVT)                                                Venenthrombose           profunda (TVP)
                                                     (TVT)
ECG                        ECG                       das EKG                  ECG
heart                      le coeur                  das Herz                 corazón (m)
heart attack (MI)          IM, la crise cardiaque    der Herzanfall/der       ataque cardíaco,
                                                     Herzinfarkt/das          infarto
                                                     Herzkasperl (lay term)
heart block                le bloc du coeur          der Herzblock            bloqueo aurículo-
                                                                              ventricular
heart bypass               le pontage                der Herzbypass
heart catheter             le cathéter cardiaque     der Herzkatheter
heart defect               la déficience cardiaque   der Herzfehler           defecto de corazón
heart disease              la maladie du coeur       die Herzkrankung         cardiopatía (f)
heart failure              insufficance cardiaque    die Herzinsuffizienz     insuficiencia cardíaca
                           (f)




                                                                                                       57
heart rate           fréquence cardiaque     die Herzfrequenz       ritmo de pulsación
                     (FC)
heart sound          bruit du coeur (BDC)    der Herzton            sonda de corazón
heart transplant     la transplantation      die                    transplante de corazón
                     cardiaque               Herztransplantation
heart valve          la valvule              die Herzklappe         válvula (f)
heartbeat            la pulsation du coeur   der Herzschlag,        latido del corazón
                                             Pulsschlag
ischaemia            ischémie (f)            die Ischämie           isquémia
murmur               le souffle              das Herzgeräusch       soplo en el corazón
oedema               oedème (m)              das Ödem
orthopnoea           orthopnée (f)           die Orthopnoe
pacemaker            le stimulateur          der Schrittmacher      marcapasos (m)
                     cardiaque
pulse                le pouls                der Puls               pulso (m)
radiate (pain) to    émettre, rayonner       ausstrahlen von … zu   irradiar
septum               le septum               das Septum             tabique (m)
syncope              la syncope              die Synkope            síncopa (f)
vein                 la veine                die Ader/die Vene      vena (f)
ventricle            le ventricule           die (Herz)kammer       ventrículo (m)
wave (e.g. on ECG)   onde (f)                die Welle              onda (f)




                                                                                          58
Respiratory – Pneumologie - Pulmologie – Respiratoria

alveolus                 alvéole (f)             die Lungenalveolen      alveola (f)
asthma                   asthma (m)              das Asthma              asma (f)
asthmatic                asthmatique             asthmatisch             asmática
blood gases (ABGs)       gaz du sang (GDS), la   die Blutgasanalyse
                         gazométrie arterielle   (BGA)
breath                   le souffle              der Atem, das           aliento (m)
                                                 Atemgeräusch
breathe deeply in and    inspirer profondément   tief ein und ausatmen   respirar hondo
out (with your mouth     puis expirer            (durch den offenen
open)                                            Mund)
bronchiectasis           bronchiectasie          die Bronchiektasie
bronchitis               la bronchite            die Bronchitis          bronquitis (f)
bronchoscopy             la fibroscopie,         die Bronchoskopie
                         bronchoscopie
bronchus                 la bronche              die Bronchie, der
                                                 Bronchus
carbon dioxide           carbon dioxide          das Kohlendioxid, CO2   dióxido de carbono
COPD                     BPCO                    chronisches             enfermedad de
                                                 unspezifisches          obstrucción pulmonar
                                                 respiratorisches        crónica (EOPC)
                                                 Syndrom (CURS)
cough                    la toux                 der Husten              tos (f)
crepitations, crackles   crepitations            das Geknister           crepito
cyanosis                 cyanose                 die Zyanose
exhale                   exhaler, expirer        ausatmen                espirar
gas exchange             échange du gaz (m)      der Gas austausch       intercambio de gas
hypoxia                  hypoxie (f)             die Hypoxie
inhale                   inspirer, humer         einatmen                aspirar
lung                     le poumon               die Lunge               pulmón (m)
lung cancer              le cancer du poumon     der Lungenkrebs         cáncer de pulmón
lung disease             la maladie du poumon    die Lungenkrankheit     enfermedad pulmonar
lung function tests                              die
                                                 Lungenfunktionsdiagn
                                                 ostik
obstructive lung         syndrome obstructif     obstruktive             enfermedad pulmonar
disease                                          Lungenkrankheit         obstructiva




                                                                                              59
obstructive sleep          apnée                    die Apnoe, der
apnoea                                              Atemstillstand
oxygen                     oxygène                  der Sauerstoff         oxígeno (m)
PE                         EP (embolie (f)          die Pulmonalembolien
                           pulmonaire)
pulmonary oedema           l‟oedème pulmonaire      das Lungenödem
                           aigu (OAP)
restrictive lung disease   syndrome restrictif      restriktive            enfermedad pulmonar
                                                    Lungenkrankheit        restrictiva
short of breath,           éssoufflé, dyspnée       das Atemnot, die       jadeante, sin aliento
breathless, dyspnoea                                Dyspnoe
sputum                     le crachat               der Auswurf, das       esputo (m)
                                                    Sputum
TB                         tuberculose              die Tuberkulose        tuberculosis (f)
to breathe                 respirer                 atmen                  respirar
to cough                   tousser                  husten                 toser
to spit                    cracher                  spucken                escupir
to whisper                 susurrer                 flüstern               susurrar
trachea                    la trachée               die Luftröhre          tráquea (f)
wheeze                     respiration haletante,   das Keuchen, das       resollar
                           le sifflement            pfeifendem
                                                    Atemgeräusch




                                                                                                   60
ENT - ORL - Hals, Nasen, Ohren (HNO) –
Otorrinolaringólogia

deaf             sourd(e)              gehörlos/taub        sordo
grommet          aerateur tympanique   das Paukenröhrchen   tubo transtimpánico
hearing          ouïe (f)              das Gehör            oído
otitis           otite (f)             die Otitis, die      otitis (f)
                                       Ohrentzündung
otosclerosis     otosclérose (f)       die Otosklerose
polyp            le polype             der Polyp(us)        pólipo (m)
sinusitis        la sinusite           die Sinusitis, die   sinusitis (f)
                                       (Nasen)nebenhöhl-
                                       enentzündung
tongue           la lange              die Zunge            lengua (f)
tonsils          amygdale              die Mandeln          amígdala (f)




                                                                                  61
Ophthalmology - Ophtalmologie – Augenheilkunde –
Oftalmólogia

age-related macular   la dégénérescence          die altersbedingte      degeneración macular
degeneration          maculaire                  Makuladegeneration      relacionada con la
                                                                         edad
blurred               fumeur, vague              verschwommen            borroso
cataract              la cataracte               der graue Star          catarata (f)
conjunctiva           la conjonctive             die Bindehaut           conjuntiva (f)
conjunctivitis        la conjonctivite           die                     conjunctivitis (f)
                                                 Bindehautentzündung,
                                                 die Konjunktivitis
contact lenses        les lentilles de contact   die Kontaktlinsen       lentes de contactos
cornea                la cornée                  die Hornhaut            cornea (f)
eye (ball)            oeil (m) (le globe         das Auge (der           ojo (m)
                      oculaire)                  Augapfel)
glaucoma              le glaucome                der grüne Star, das     glaucoma (m)
                                                 Glaukom
iris                  iris (m)                   die Regenbogenhaut,     iris (m)
                                                 die Iris
lachrymal gland       glande lacrymale           die Tränendrüse         glándula (f) lacrimal
macula                la macula                  der Hautfleck           macula (f)
pupil                 la pupille                 die Pupille             pupila (f)
retina                la rétine                  die innere Augenhaut/   retina (f)
                                                 die Netzhaut
retinal detachment    le décollement de la       die Netzhautabhebung    desprendimiento de
                      rétine                                             retina
sclera                la sclérotique             die Lederhaut, die
                                                 äuβere Augenhaut




                                                                                                 62
Accident & Emergency – Urgences – Unfall und Notfall –
Urgencias

accident                accident (m)              der Unfall                accidente (m)
acute                   aïgue                     akut                      agudo
ambulance               ambulance (f)             der Krankenwagen          ambulancia (f)
analgesic               analgésique (m)           das Schmerzmittel         analgésico (m)
asthenia, tiredness     asthénie                  die Kraftlosigkeit, die   astenia (f)
                                                  Schwäche
bandage                 le bandage                der Verband               venda (f)
chronic                 chronique                 chronisch                 crónico
effusion                épanchement (m)           der Erguss                derrame (m)
emergency               urgence (f)               der Notfall               emergencia, urgencia
general deterioration   altération d'état         die Verschlechtung des empeoramiento (m)
of health               générale (AEG)            Allgemeinzustands      de salud
poor state              le délabrement            schlechter Zustand        mala salud
repeated falls          chutes à répétition       mehrmaliges Hinfallen     caída repetidas veces
resuscitation           réanimation               die Reanimation           reanimación (f)
RTA                     accident voie publique    der Verkehrsunfall        accidente de carretera
                        (AVP)
state of shock          état de choc (m)          der Schock(zustand)       estado de shock
unconscious             inconscient(e)            bewusstlos/unbewusst      inconsciente
urgent                  urgent(e)                 dringend                  urgente
wound                   la plaie                  die Wunde                 herida (f)
x-ray                   la radiographie (radio)   das Röntgen(bild)         radiografía (f)




                                                                                                    63
Orthopaedics and Rheumatology – L’Orthopédie et
Rhumatologie - Orthopädie und Rheumatologie –
Ortopédia y Reumátologia

ankle                      la cheville             der Fuβknöchel, der      tobillo (m)
                                                   Knöchel
ankle joint                articulation du pied    das Sprunggelenk         articulación de tobillo
arthritis                  arthrite                die Arthritis            artritis (f)
avascular necrosis e.g.    nécrose de la tête      aseptische/spontane      necrosis avascular de
of femoral head            fémorale                Knochennekrose           cabeza de fémur
backache                   mal de dos, lombalgie   die Rückenschmerzen      dolor de espalda
                                                   (pl)
banisters                  la balustrade           das Geländer             pasamanos (m)
bone                       os (m)                  der Knochen              hueso (m)
bursitis                   la bursite              die Bursitis, die        bursitis (m)
                                                   Schleimbeutelentzündu
                                                   ng
buttocks                   les fesses (f)          das Gesäss               nalgas (fpl)
catching (articular)                               eingeklemmt              atrapar
cervical vertebra          vertèbre cervicale      der Halswirbel           vértebra (f) cervical
connective tissue          tissu conjonctif        das Bindegewebe          tejido conectivo
crushed/compound           le tassement            der komplizierte         fractura complicada
fracture                                           Knochenbruch
crutches                   les béquilles           die Krücken              muleta (f)
disc injury, discopathy,   discopathie, hernie     die Diskopathie, die     vértebra dislocada
slipped disc               discale                 Bandscheiben-
                                                   erkrankung, der
                                                   Bandscheibenprolaps
downwards                  en bas                  abwärts                  hacia abajo
elbow                      le coude                der Ellbogen             codo (m)
extension deficit          restriction des         das Streckdefizit        déficit de extensión
                           mouvements
                           d‟extension
flexion contraction                                die Flexionskontraktur
fracture                   effraction (f)          der Bruch                fractura (f)
frame (zimmer)             le déambulateur         das Gestell, die
                                                   Gehhilfe
gait                       la demarche             der Gang                 manera de andar
gout                       la goutte               die Gicht                artritis gotosa, gota (f)




                                                                                                    64
heel                     le talon                  die Ferse                 talon (m)
hip                      la hanche                 die Coxa/die Hüfte        cadera (f)
hip joint                articulation de hanche    das Hüftgelenk            cadera (f)
impaired                 gênant                    beeinträchtigt            dañado
incompetent              incapable                 unfähig                   incompetent
joint                    articulation (f)          das Gelenk                articulación (f)
knee                     le genou                  das Knie                  rodilla (f)
knee arthritis                                     die Gonarthrose
knee joint               articulation du genou     das Kniegelenk            ligamento de la rodilla
ligament                 le ligament               das Band                  ligamento (m)
locking                  immobilisation,           die Blockierung           atascar
                         encombrement
lumbar vertebra          vertèbre lombaire         der Lendenwirbel          vértebra lumbar
mobility                 la mobilité               die Gehleistung,          movilidad
                                                   Mobilität
osteoarthritis           arthrose (f)              die Osteoarthritis, die   osteoarthritis (f)
                                                   Arthrose
osteophytes              ostéophytes (pl)          der Osteophyt
osteoporosis             ostéoporose               die Osteoporose, der      osteoporosis
                                                   Knochenschwund
pain                     la douleur                der Schmerz               dolor (m)
-      climbing stairs   -    monter l‟escalier    -   beim                  -    subir las escaleras
                              (m)                      Stiegensteigen
                         -    parfois              -   gelegentlich
-      occasional                                                            -    esporádico
                         -    modéré(e)            -   mässig
-      moderate/modest                                                       -    módico
                         -    continuel(le)        -   ständig
-      always                                                                -    siempre
                         -    rien                 -   kein
-      none                                                                  -    nada
plaster                  le plâtre                 der Gips                  escayola (m)
psoriatic arthritis      arthrite psoriatique      Arthritis psoriatica      artritis de soriasis
reflex                   le reflet, réflexe        der Reflex                reflejo (m)
rheumatism               le rhumatisme             das Rheuma                reuma (m)
rheumatoid arthritis     arthrite rhumatisant      die rheumatoide           artritis reumatoide
                                                   Arthritis
rib                      la côte                   die Rippe                 costilla (f)
septic arthritis         arthrite septique         die Gelenkentzündung,     artritis séptico
                                                   die eitrige Arthritis
shoulder                 épaule (f)                die Schulter              hombro (m)
shoulder joint           articulation scapulaire   das Schultergelenk        articulación de hombro


                                                                                                    65
stability             stabilité             die Stabilität          estabilidad
strengthening         exercices fortement   die kräftigenden        ejercicios fortalecerse
exercises                                   Übungen
strong                fort(e)               stark                   fuerte
synovitis             synovite              die Synovitis           synovitis
systemic lupus        le lupus              der Lupus               lupus eritematoso
erythematosis (SLE)                                                 sistémico
systemic sclerosis    la sclérose           systemische Sklerose    esclerosis (f)
thigh                 la cuisse             der Oberschenkel        muslo (m)
thoracic vertebra     vertèbre thoracique   der Brustwirbel         vértebra torácica
to climb              monter                steigen (irreg. verb)   subir
to fracture           fracturer             brechen                 fracturarse
to limp               boiter                hinken                  cojear
to move               remuer                bewegen                 moverse
to stretch            étirer                strecken                estirarse
unrestricted          illimité(e)           unbeschränkt            ilimitada
upwards               en amont              aufwärts                hacia arriba
vertebra              la vertèbre           der Wirbel              vértebra (f)
weight bearing        port du poids         die Belastung
wrist                 le poignet            das Handgelenk/die      muñeca (f),
                                            Handwurzel              articulación de la
                                                                    muñeca




                                                                                         66
Thanks
I must extend my thanks to the many people who made the compilation of this booklet possible.

Firstly, for allowing me to participate in the Erasmus exchange, despite my initially terrible grasp
of German, to the medical faculty! Most especially within the faculty, the amazing Felicity Berry,
who has sadly left us for better places (Oxford apparently), without who I would have never been
able to organise the whole thing.

Secondly, to Helen Walters, who went to Vienna the year before me and wrote a fabulous guide
all about it, without which I would probably still be stuck in the Allgemeines Krankenhaus.

Thirdly, to the many lovely enthusiastic people who went on the Erasmus exchange in the 2005-
2006 academic year, who have been kind enough to pass on all the information and tips they
gleaned whilst away themselves. They are: Jienchi Dorward (Alicante), Elena Hazelgrove-Planel,
Louisa Daoud, Sarah Curtis, Sehr Bhatti and Sophie Epstein (Bordeaux), Ahna Allen, Faith Dyer,
Lauren McCluskey, Jess Parsons, Liam Ingram and Lucy Harten-Ash (Grenoble), Alison
Montgomery, Jess Green, Kate Myall, Laura Ilchyshyn and Noellie Ramsay (Paris) and Debbie
Linsky (Stasbourg).

Also to the very helpful Mr Matthew Ball, who has replaced Felicity in the office, and has
answered all my queries so promptly.

Finally to my supervisor Dr Clive Roberts, who has kept us all in wine and sandwiches during our
Erasmus feedback meetings. Cheers!




                                                                                                  67
References
Images
Flags – http://www.countryreports.org
Maps – Wikipedia - http://en.wikipedia.org/wiki



Information
Wikipedia
       http://en.wikipedia.org/wiki
Galenicals International Pages
       http://www.galenicals.org.uk/international/Erasmus/index.php
Medici Erasmus Pages
       http://www.medici.bris.ac.uk/student/exchange.html
Blackboard Online Learning Environment
       http://www.ole.bris.ac.uk


Online Dictionaries
Spanish and French - http://www.wordreference.com
German and French - http://dict.leo.org/




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