Universidad de Azuay - del Rio

For some time I have considered my Spanish ability as passing. After we met the chief of surgery, the director of medical education and the chief medical officer of the hospital on our way to dividing into groups for the week, it was clear that getting by should be a temporary solution. I fell in with the surgery students, 5th years mostly, and we began with a tour of the OR and then the surgical floor. This is a very new hospital, two years old, and is not yet full of patients. The new operating rooms are well equipped and spotless, the floor staffed with attendant nursing staff and numerous residents populate the nursing stations.
There were some obvious differences from the U.S. becoming apparent already. Students and residents answered nursing calls from the rooms, and performed many of the tasks we reserve for nurses here. I had heard about the unusual structure of medical education but hadn't understood it before. They spend 6 years in medical school immediately following high school, and residencies are shorter. Fifth years are externs and sixth years are interns. However, there are more similarities than differences. There wasn't much on the board for today, so the students made a copy of some 60 questions they were given to answer, all in English, reading suspiciously like ABSITE (U.S. residency board questions) material, and we retreated to the library to search for the answers. On the way there we stopped in the cafe for coffee and saw this doctor enjoying his morning puff and sip, which made me think of Camel ads from the 50s:

Since the questions were in my language, and this was my field of choice there was some expectation that I would naturally know all of the answers, which I quickly dispelled. I did help them with the English. 
The days went quickly here - brief rounds, morning report/lecture, occasional actual case to scrub, small group surgery lecture with the chief, question sets and Spanish classes in the evening. It felt almost like a regular U.S. surgery rotation with the twist of a foreign language instead of pimping, although pimping in a foreign language was bonus-bonus . The first case I scrubbed was a thoracotomy for removal of a mass, pleural adhesions and drainage. The surgeon was French, who told me that his Spanish was not that good, and his English worse, so if we had trouble he would just hand sign me. This actually works best for me when everybody does speak English, so I felt quite at home. Notably, the fifth year scrubbed in as the nurse tech and the surgeon attended to a lot of details that ancillary staff would perform here, regarding the equipment and patient handling, which made it seem more like a team performance.
I actually felt like my comprehension was coming along. It helps that the morning reports had powerpoints and medical language is very similar everywhere, so that when I was asked if I understood I could honestly answer: more or less.
In the evenings I would leave Spanish class, which was taught at a church on the southwest side of town, and start walking home. I'd try to catch a bus if one actually came down the street, or if it was raining, but often they didn't come that way, despite numerous stops. So, mostly I walked the 45 min home.
I usually got off the bus at the center anyway, about half-way home, so I didn't mind.

catedral vieja

catedral vieja

catedral nueva

 

municipal bank