International students get a taste of Czech medicine

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At a time when many Czech doctors are leaving underpaid jobs to pursue better wages elsewhere, it may seem surprising that a growing number of medical students from the United States and other countries come to Prague every summer to attend a broad study programme in Czech hospitals.

The man behind the project is Dr. Martin Stransky, who teaches medicine at Yale University several months every year. However, Dr Stransky, who is of Czech origin, is now based in Prague, where he runs a successful health care clinic on Narodni Street.

"About ten years ago I had a few students who I happened to be teaching in the US visit me here in Prague and they shadow me and then they said it would be a great idea if some more of us could come and see you next vacation and next year about six showed up and then about twenty showed up so I had to do something with it essentially turned it into a course."

The Prague Selective course lasts for three weeks. In the morning students visit different hospitals and different departments within hospitals to see how Czech medicine is practiced in various institutions by various people. In the afternoon they attend seminars where they discuss the thinking process of a physician and the difference between various health care systems. Stránský believes that Czech health care system offers loads of study material:

"We talk about different health care systems and for this the Czech Republic is perfect because it essentially has no health care system but sort of various aspects of health care all of which run along merrily at their own pace. It is of course going through tremendous transition right now so things are sort of opened up for the students to see and it gives them the opportunity to compare and contrast."

Is three weeks long enough for the students to get acquainted with Czech health care system and to spot some differences?

"I think its just right. On the one hand their vacations aren't too long so we can't get much longer and they do get to see many difaferent hospitals and departments within hospitals in that time period, it is fairly intensive. And they do get let into discussions just to right amount. They are in their early phases of training so we do not want to overwhelm them and we do want to leave them with enough time to enjoy the country and the culture."

"Many of them are in Europe for the first time and they do all have a sense of adventure, which is why they did come here. So they do also travel around Europe. They are away on all weekends: they are either out of town or out of the country. So I think it's a very good experience for them and they do rate the course extremely favourably and they do come back here year after year."

So what do the young medics notice first of all upon their visit of Czech hospitals? Do they notice only negative things or do they think that some aspects of Czech health care system are perhaps better than elsewhere?

"Well on the one hand after they come to know it a little bit they are very impressed by the fact that for the dollar Czech health care is extremely effective. It's in fact probably ten cents on the American dollar with only a slight fall in life expectancy."

"On the other hand I think most of them comment both the differences in the dress code because the doctors here don't wear their jackets and ties as they do in the US and other countries and on the very wide differences in technological aspects as well as interpersonal aspects of health care."

"In some cases there are doctors and institutions who really do go all out for their patients and who are well equipped and in another instances the doctor - patient contact leaves much to be desired especially from the part of the physician. And the institution can sometimes be very old and run down due to various reasons and that they do notice as well and that is one of the stated aims of the programme is for them to see the differences here."

I talked to some of the students when their afternoon seminars ended to ask them about the impressions they have so far from visiting Czech hospitals and about the differences they find most striking:

"The main difference is that everybody is covered here versus the US. In US you pay for health care; it is not universal. That's the main difference."

"Because I guess of the historical background of this country and the money that is allocated to the health system is limited, some of the procedures, such as sterilization techniques, are a little bit more basic compared to the US. To us it seems like cutting corners but I think if you look from a more general picture, it is functioning. So from their perspective we kind of wonder: Are we in the US overly sensitive towards some aspects of medicine or is it just something that we just grew up to? So I thought that was very interesting."

To date, over a thousand medical students from more than twenty-five medical schools have attended the course. For the first time this year, the programme has expanded out of Prague, to the teaching hospital in Pilsen. I was curious whether it was difficult to get Czech doctors involved in the project.

"Actually it wasn't. Within the realm of the Czech summer where many people are gone it was fairly easy to find people. It was a little bit harder to find good people but the students do fill out a questionnaire at the end of the rotation and they rate the doctors and only the good ones are asked back."

"The physicians do get paid and quite well for their work which is an incentive for them and I think the Czech physician are very pleased to be able to say they have students from all over the world coming here to observe them and I do know that they put their best foot forward so it is self-perpetuating now in a very good sense of the word."

Talking to the students, I got the impression that they are really enjoying the course, as well as their stay in Prague. I just wondered if a majority of Czech doctors would share their enthusiasm about the Czech health care system:

"I didn't have much chance to speak with patients but we did have a discussion with Czech doctors and I think they are very satisfied. Of course in any country there is always some dissatisfaction but overall I think the health care system is working very well."