The Outside Posting Experience Pt1: Within the Shores of Nigeria

You may have seen clips and images of senior colleagues, friends or social media mutuals with the caption “outside posting” at some point or the other. If you’re a medical student, these posts will typically leave you dreamy and make you imagine when you can also escape your school consultants for even a week or two😅.

Well, the good news is the outside posting phase will come sooner than you think. However in most schools the designated period is a month in your 600L or in Part 6 as we like to call it here in OAU.

Outside rotations, also known as ‘Elective’ or ‘Away’ rotations, give you the opportunity to experience the practice of medicine and surgery beyond the confines of your school borders. Here, medical students temporarily join a different hospital or healthcare institution, anywhere they choose, be it a different city or a whole new country!

It’s a chance to broaden your horizons plus, let’s not forget the added bonus of networking and making connections that could shape your future career!

If you are wondering what this world entails, buckle up because we’re about to spill the tea on this aspect of Med School. And it’s wrapped in the real-life stories of fellow medical students who recently returned from their outside rotations.

In IFUMSA, our Chiefs ventured off to different states in Nigeria and two countries overseas. We reached out to some of them for their adventures based on the following questions

  • What hospital did you venture off to for your outside posting?
  • What motivated you to choose that particular destination?
  • How did you navigate the treacherous path of applying for an externship spot?
  • What was your overall experience like? Share your one standout moment or a particular aspect of the posting you enjoyed most.

Their responses are revealed below. Today, we’ll be sharing the experience of those who did theirs within the country. And in the next episode, the adventures of those who travelled abroad. Enjoy!

Teniola Tope-Ojo [Federal Neuropsychiatric Hospital, Lagos]

“It really solidified my decision to build a career in Psychiatry “

I went to the Federal Neuropsychiatric Hospital at Yaba, Lagos. The motivation was that I have a lot of interest in psychiatry and actually plan to specialize there so I wanted to be at a location where I would get a sort of preview of what my experience will be building a career in psychiatry.

‘I think the treacherous path’ applies to international postings. There’s hardly one if you choose a location in Nigeria. Most places are welcoming of other medical students and eager to help you.

The overall experience was really fulfilling. I honestly didn’t want the time to end because I enjoyed remembering the concepts we learned back in part five and applying them. Also, the work environment was lovely and the residents there were honestly the nicest group I’ve ever met. It really solidified my decision to build a career in that area and I’m glad for the opportunity.

Adesua [LASUTH, Lagos]

I went to Lagos, specifically the catheterization lab at Lagos state university teaching hospital Ikeja. I’ve always been interested in cardiology, and being able to watch live interventional cardiology procedures, learn of their indications and see them in real-time made if an exciting prospect for me.

Well for this specific trip, I asked an OAU alumnus working in the institution, then I applied and learnt late that I had to pay and it even took them a long time to confirm my payment but all is well that ends well.

My overall experience was fair, I was only able to spend two weeks, I would have preferred to have spent more time but the red tape I had to maneuver made that impossible.

But I was able to see interventional procedures in real-time, learn and practice Advance trauma life support and improve generally.

My Standout moment, I met Dr. Oladimeji, one of the very few interventional cardiologists working in the country (he was in the news recently); he’s nice, welcoming, and always willing to teach.

Ileri [OAUTHC, Ife]

The time went by so fast!

I eagerly looked forward to my elective/outside posting period. Initially, I planned to do it at the ABUAD Multisystems Hospital in Ado-Ekiti for 2 weeks and spend the remaining 2 weeks here in OAUTHC, but procrastination, laziness and the fact that we were going to be resuming to write the end of posting exam for the posting we were in at that time made me do away with going to ABUAD.

I eventually spent some part of the elective shadowing Prof Ajenifuja, in Obstetrics and Gynaecology, but specifically Gyne-Oncology. I chose to do so because of the interest I have in that area of ObGyn, and Prof is a foremost consultant in that area.
It was a great experience, as I got to work closely with Prof and learn from him. I also had the opportunity of administering chemotherapy, participating in colposcopy and practiced thermal ablation as well.
Asides that, I also had time to relax and watch (more) movies😂 and prepared for my end-of-posting exam. It seemed like the time went by so fast, because tell me why when it was time to resume, I was asking myself how it was 4 weeks was already gone?!

Anyways, I must say that I enjoyed the outside posting period and I can only look forward to the final days in med school!

Misbahudeen Abdulkareem [UITH, Ilorin]

Every tertiary hospital in the country sort of have similar styles with some peculiarities

Being a familiar federal teaching hospital close to my house, it was the best option I had (With a good cardio unit😁) As to how I got the externship, I know people that know people. It’s Ilorin, all that was left to do was resume.

It was a really good thing to feel a different TH. I narrowed my rotation down to medicine. Cardiology to be specific. I particularly enjoyed my rotation through their cardiac center where they do regular echocardiography and electrocardiography giving me ample exposure to the procedures. I as well saw a patient with PPCM having a preexcitation syndrome. The environment was as well friendly so it was a good experience overall.

Every tertiary hospital in the country sort of have similar styles with some peculiarities. Expectation kills the fun.

Seyi [FMC, Lagos]

“I realized Healthcare in Nigeria is not so terrible in some places”

I chose Federal Medical Center Ebute-metta, Lagos because I wanted to change my environment. It was pretty easy. I wrote a letter to the chief medical director of the hospital, and the administrative staff reached out to me to confirm my details, they also asked me about my preferred specialty .

I really had a great time. First of all, i was able to learn medical stuff without the impending knowledge of forthcoming exams. I rotated through nephrology, endocrinology and neurology units and I was able to learn from the consultants. The center being a federal medical center doesn’t run a residency program in internal medicine, and there were no medical students, so it kind of made me have a one-on-one relationship with my consultants.

I was exposed to the use of electronic medical records, this was something I was not familiar with. I also joined in clinics and ward rounds, and what I found intriguing is how organized things were they had a schedule for scheduled clinic visits, such that it makes it easy to know the number of patients you are seeing next clinic day and it also reduces patient load on each day. I was also able to assist in minor tasks like taking blood samples, setting line and measuring vital signs.

I was also exposed to proper interpretation of imaging result like CT scan and MRI , which prior to the outside posting I wasn’t very vast in. I was able to see medications that would have been seen as expensive for patients down here in use , which might have been unaffordable due to the purchasing power of people here in ife.
All in all, I had a blast during the outside posting and it was an enlightening experience, I also realized that maybe healthcare in Nigeria is not so terrible in some places, might not be up to international standards but at least efforts are being made.

Paul Oloruntobi [UniMedTHC, Ondo]

The period of interaction with the medical students who were rotating the posting at the time was also memorable.

I did my outside posting in University of medical sciences teaching hospital complex (UniMedthc), Akure, Ondo state. I was initially planning to travel to a teaching hospital in Ghana with my acceptance letter and Ecowas passport already in the bag. However, I took a step backward and opted for Unimedthc after considering various things, including finance. Moreover, choosing Unimed would afford me proximity to my home, lesser cost, and time for self-study with good medical exposure too.

I was accepted for the outside posting program in Unimed after submitting my letter of application (with the acceptance letter I received from the teaching hospital in Ghana affixed to it) to the hospital’s medical director.

I had a great time learning from Dr. Akinfaderin, a consultant cardiologist, who I consider to be a really great teacher. Of course, there were moments of high velocity percussion but we remain solid and resonant. The period of interaction with the medical students who were rotating the posting at the time was also memorable.
In all, the practice of medicine is grossly the same in most places but your skill, attention to details and wealth of medical experience can make all the difference.

Fatima [UNIOSUNTH, Osogbo]

All eyes were on me as the “external student from OAU”.

I did my outside posting at UNIOSUN Teaching Hospital, Osogbo and picked that particular place because I honestly wanted to go home and be my mommy’s baby and still do my outside posting. So why not UTH?

Applying wasn’t hard. I got an introductory letter from the Dean to the hospital. The problem was submitting and getting approval for the posting. Spent days doing this. At a point I was going between HOD of internal medicine and the CMD’s office. I was very frustrated. I almost gave up if not for my mom.

So I finally got the approval, and started the next Monday i.e. week two. I reported to the Chief Registrar, who started asking me plenty questions, curious as to why I am outside my school during my final year. I told them I am spending two more weeks as they already took one week for the approval.

The hospital is small, just a bit bigger than Wesley but they have functioning laboratories. They are a bit short on staff though; nurses, doctors and even medical laboratory scientists are overworked. The school does not have part 6; their highest class is part 4. Wow, just wow. So yeah, they had to make a special schedule for me…yay!

I got my schedule, which includes going to all the clinics, everyday and ward rounds whenever I can. My God they even gave me call roaster and a topic to present. I sha resumed. Most clinics are in the afternoon, by 12 so I attend ward rounds in the morning when I can and clinic in the afternoon. It was really strenuous.

Morning review, all eyes were always on me as the “external student from OAU”. I sha did not disappoint sha. Asking questions in morning review, pointing out loopholes; let me show them all Prof Komolafe has been imbibing in us.
I clerked, presented patients, did minor procedures etc. The doctors there were pretty impressed. I mean, for a part 6 student I do pretty well during morning review, when I present patients, and during examinations.

I did call for one day and… Never again pleaseeee. I never presented that topic too. I met OAU alumni, about 4 of them in the department and it was a great time. I met snobby house officers too…yeah you guessed right, the females. The males were so receptive and always wanted me to follow them everywhere…don’t kill me please, I am not collecting salary.

When my two weeks ended, the doctors hoped (in vain, I should say) that I’ll come to UTH for my house job and I promised them to think about it. Overall, it was a very nice experience and I made new friends and acquaintances.

Asaolu Peace [Lagos]

I got to experience the Private health sector firsthand.

I had my outside posting experience at two private hospitals in the Ikorodu axis of Lagos state. Trust me, I was very happy I did go. I had no specific motivation ooo. It was because my plan for Ghana posting was truncated because of the unwillingness of my sponsors. However, I chose those hospitals based on referrals from family members.

I went to a private facility so the logistics of getting a slot for outside posting was relatively easy, I just needed to contact the Medical Director of the hospital and because it was based on referral, access was quite easy.

My experience, I will say was a beautiful one, hospital staffs were very accommodating and the doctors in charge were very receptive. The highlight was that I got to experience the Private health sector firsthand, their modus operandi, management of human and physical resources, and protocols for dealing with patients. These things are quite different from the usual tertiary hospital setting.
My activities included managing patients alongside the doctor in charge (consulted alone a few times;) running different tests like rapid pregnancy, malaria, hepatitis B and PCV tests, grouping and cross-matching of blood; observing some manual vacuum aspiration, performing vagina examination, assisting in vaginal deliveries, assisted in emergency cesarean sections, hysterotomy.
A few cases I saw included: Twin pregnancy with severe birth asphyxia, neonatal seizures, adherent placenta, IUFD, Epididymo-orchitis with hydrocele, infected ovarian cysts, anemic heart failure in shock, surgical site infection with wound dehiscence, amongst other cases.

Memorable moment: There was this day that I was on call around 11.30 pm when I was called that one of the patients was already feeling funny and wasn’t breathing well. Upon examination, she had features of anemic heart failure. Two major probs: first, she’s very thick so her veins/lines were very hard to find and the current line was swollen up (I and the nurses even had to use palpation to locate peripheral veins, it was that bad). We eventually got to the right elbow sha😩. Secondly, she needed an urgent blood transfusion and was A negative. Her family members were ineligible to donate and it was already midnight, so our options were limited. The blood banks we contacted didn’t have any O neg remaining.

Eventually, we got the last pint of O neg blood at a blood bank 1 hour away from the hospital and transfused her at around 3:30 am that midnight. Seriously I was anxious😅 and had to be on constant calls with the MD especially at the point when the O-negative blood was not available nearby.
It was a very exciting and memorable learning experience for me. And all thanks to God that everyone was smiling in the end. I couldn’t be more proud of myself that I saved a patient who was at the point of dying. Most thankful to my teachers for the constant teaching on how to deal with patients in emergency cases, because following principles of resuscitation made things a lot easy in the highly tense situation.
My family and friends, I just want you to know that you’ve got a soon-to-be doctor who is competent of saving lives, especially with his hands. 🥰💖
Thank you for having me Medivoice.

So, which of these adventures struck you the most? Temporarily escaping your school consultants and becoming a special student in a new place seems like a fair deal to me😅.

However, the enlightenment that comes with seeing Medicine & Surgery beyond the lens of OAUTHC (teaching hospital complex) is definitely the best part of the bargain.

Watch out for Part 2, The Overseas Elective Posting Adventure. If you’re wondering what it’s like to Japa before the actual Japa😂, well, we can’t wait to share too. Stay tuned!

Click here for past Med school lifestyle episodes.

1 reply on “The Outside Posting Experience Pt1: Within the Shores of Nigeria”

Leave a Reply

Your email address will not be published. Required fields are marked *