The resident of the Department of Tocogynecology at the Faculty of Medical Sciences (FCM) Helena Slongo recently returned from an optional internship in Gynecology and Obstetrics abroad. She has just arrived from the University of South Florida College of Medicine, in the United States, where she worked at Tampa General Hospital in the area of Urogynecology, for a period of one month. The experience was enriching, according to her, and helped her design Unicamp, as she is studying the last year of her medical residency at Hospital da Mulher-Caism.
Helena chose Tampa General Hospital because her brother, Julio, is a Urology resident at the institution and, because of this proximity, ended up staying at her home. Julio and his boss at Caism, gynecologist Luiz Gustavo Oliveira Brito, indicated important contacts at Tampa Hospital. As a result, the doctor received a return confirming the internship. She went there like observership and was very well received by the medical team.
He was amazed at the attention that Americans gave to their patients. They explained in detail the pathophysiology of the disease and all treatment options. She was impressed by the interest they expressed in health in Brazil: how the public health system worked, the surgical techniques used in the country and what she thought of their hospital? She learned about different surgical techniques than those performed at Caism and new outpatient and surgical equipment that helped with surgeries.
“There, in Urogynecology, they do not perform open abdominal surgeries, only robotic and laparoscopic surgeries”, she reveals. Residents and fellows (doctors who have completed their residency) at the hospital have access to a Da Vinci robot simulator, which is available for training. “Every day I trained in a robot simulator, had to complete skill missions and received a score. I became agile. The experience was spectacular.”
During the internship, your task was to monitor the fellows of Urogynecology, especially in outpatient clinics and the surgical center. The group also met once a week to carry out scientific research together and participate in departmental meetings. Helena comments that the surgical center operates more than 12 elective hours a day, with a large flow of surgeries.
At the outpatient clinic, she reports that the patient fills out a basic anamnesis, which is given to the doctor before starting the consultation. This way, it is possible to have an idea of the main complaints before the consultation even begins.
The surgical instruments and those in the examination room at the Urogynecology Outpatient Clinic are very different from those Helena was used to seeing. The examination table is automatic and has compartments to store materials, such as the examination kit, which is replaced by assistants at each new appointment. The speculum has its own lighting. Care is provided by the resident or fellow and, at the end of the consultation, the teacher also examines the patients.
Each outpatient clinic is supervised every day by the same responsible manager, which means that patients get to know them more closely, creating a beneficial relationship, in addition to more easily maintaining the same medical reasoning.
According to the resident, Tampa General Hospital mainly serves medical insurance, since, in the region, economically disadvantaged people also have this right. It is a large hospital. There, secretaries can schedule appointments or advance them, send requests for exams and even prescriptions under medical authorization, as necessary, maintaining an open channel via computer.
One of the biggest lessons for Helena was understanding that learning is always multiple. “When we change our frame of reference, we change our vision. Another thing: all institutions have positive and negative points. Despite this, each one contributes to new learning and helps to design our future”, she believes. “I’m not the same person anymore. I feel like I've evolved, and the team there was an inspiration to me. We still keep in touch today.”
The doctor now intends to do a residency in Urogynecology and a master's degree at Unicamp. Afterwards, she must return to Curitiba to work in a private clinic and look for a university connection, to update and improve herself. She also intends to specialize in videolaparoscopy and return to the USA at other times. “North Americans always seek to discover less invasive and high-tech methods, which for me is fundamental”, highlights the doctor, who studied medicine at Hospital Evangélico do Paraná, in Curitiba.
