Jamie Penketh spent a month working in a Malaysian hospital and talks about how much it taught him about the culture and the people

           Many people may not realise but medicine is one of a number of professions which truly allows you to travel the world. Most UK medical schools set time aside in the final year of training for students to undertake an elective. During this time students can study in an area of interest anywhere in the world. I was lucky to spend part of my elective in Kuala Lumpur (KL), Malaysia. I spent 4 weeks working at the University Malaya Medical Centre in Pataling Jaya, or PJ to the locals, a district to the south west of KL. The area is bustling, non-touristy and for me a great way to experience local life. My elective trip was the first time I had truly travelled alone. This was initially daunting but I soon realised if I embraced the experience my memories would become all the more special, perfectly exemplified by my first day trip to the centre of KL. During that day I was offered and ate lunch with strangers beneath the Petronas Towers, was interviewed for a short film, posed for photos with strangers and then I ended the day with an interview on a local radio station. All this from what I thought may be a lonely day trip.

          My placement in the emergency department started soon after I arrived. I was staying a 10-minute sweaty walk from the department and wasn’t sure what to expect. I turned up a little flustered. I found myself arriving at a large busy hospital, but thankfully everyone was friendly and happy to show me the ropes. Being eager to learn, I attached myself to one of the ED doctors and helped out wherever I could. I spent most days assessing patients, helping with procedures. With limited ED experience there was much to learn, polytrauma, barong (machete) attacks, poisonings and Dengue fever were just some cases I learn a lot from. As with any ED in the UK, things became a lot more interesting at night, hence I worked a few night shifts. Studying and practicing medicine in a foreign country can be daunting. Medical school policy requires extensive risk assessments and pre-experience research but still you are never sure exactly what to expect when you arrive. I had definitely underestimated the risk of Dengue fever. A number of students from the nearby accommodation had been admitted to the department with Dengue fever. I soon learnt why there was daily smogging outside my room and perhaps became unnecessarily paranoid about mosquitos.

          Luckily medicine in Malaysia is practiced following the traditional English system. All of the doctors spoke English but I needed a translator to speak to many patients. Having spent most of med school training in Exeter, treating and experiencing patients from different cultures was both invaluable and an eye opener. I was at times the only white person in the hospital – altruistically this was something I quite enjoyed. Malaysia is the home of a rich mix of diversity and cultures as people mostly come from Malay, Chinese or Indian backgrounds. This was not only great from a medical point of view, but also for expanding my own horizons. Under the guidance of the doctors, students and a family friend living nearby, I tried to enjoy every local opportunity. Chinese markets, mamak shops and Durians. My first lunch soon made me realise my stomach wasn’t a strong as I thought. Toilet hoses and signs prohibiting squatting on the toilets took a little getting used to.

Petronas towers by day

Petronas towers by night

          The choice of food available was incredible and also ridiculously good value. From street sellers making fresh stir fry to curry or restaurants selling traditional curries on banana leaves to high end restaurants and fast food outlets. One strange observation I made was the lack of knives at the dinner table, the usual choices being chopsticks, hands or fork and spoon. PJ was in easy reach of KL city centre either by train and monorail or affordable taxi. Travel is easy through the city via the rail network and gives access to a vast metropolitan city with some excellent sightseeing, shopping and nightlife.

          Weekends away from the hospital allowed me to experience the other areas of the country. In the north the beautiful island of Penang gave me some more memorable experiences: visits to colonial houses and an off-road trip up Penang hill with some Australians. In the south I visited the city of Malacca. This historic Portuguese settlement is rich in history and architecture and well worth a visit.

          Back in the hospital, ambulances continued to pile up at the ED entrance. One opportunity I did pass on was a ride in an ambulance. Retrospectively this wasn’t a bad thing as I was told there had been accidents in the past because of the busy traffic. There is no NHS in Malaysia. Patients have to pay towards their investigations and care at the point of delivery. Resources aren’t as vast as in the UK and patients tend to present later in the disease process. This can make treatment challenging but everyone appeared to get the best care that was available.

          Healthcare professionals get privileged insights into people’s lives often from meeting them only briefly. We encounter people at their most vulnerable, in times of sadness and in times of happiness. Getting these insights abroad enabled me to get a unique perspective on Malaysia, whilst also learning about medicine. I met some amazing people and learnt a lot. This was just the first leg of my elective; with four more countries to visit, Malaysia had got me off to a fantastic start.