Pictures

Here are some random photos I have taken. Definitely get the 2 GB SD card for your camera.

Food and Sites

What to eat: It all is really good. You will find great coffee(espresso here in the states) everywhere, so it is difficult to actually not find a shop that sells coffee. When you go to a restaurant order a francesinha (steak/sausage sandwich covered in a spicy sauce); other things to ask about while you are here should include bolo de carne, chest nuts, roasted sardines, rissol. It is all good. And for your losers out there McDonald's is also here and was quite popular with the students. As for the wine, try it all; this place is a wine lover’s paradise. Dr. Basto, one of your attendings at the hospital will be more than happy to assist you in this as well as any other. Also I have informed by my residents to let everyone know that Sangrias are from Portugal and not from Spain. And the ones that I have tasted here in red and white wine are ridiculously good.

Where to go: Even with a month in Porto, there are too many things to see. But there are some things I feel you have to see before you leave. Here are a few places you have to see in my opinion

Ribeira (River): Lots a restaurants, coffee-shops wine, and great views by the river, depending on when you come, you may be able to rent a bike during the summer

Palácio Cristal/ Jardins do Palácio Cristal

Fundação Serralves : Contemporary art museum and garden, with lakes, aromatic garden, sheep, horses. It is also free with your Student ID card.

Casa de Musica: A stunning architectural fate inside and outside, with a concert style stadium inside, with an assortment of bands of different genres, from the national orchestra, the Gotan Project, to Gil Scott Heron . In hindsight, I would ask Dr. Basto about the schedule for the month you are coming. I am sure it would have been amazing to see a concert here and is one of the things I wish I got a chance to do. Free to walk around as you please, and they have guided tours everyday with one of those tours done in English

Recommendations

With my last week coming up, I have had nothing short of a fantastic time here in Porto, and have learned a great deal not only about the amazing food, architect, culture, but how both the day to practice of medicine is practiced outside the US and in a “socialized” system.

Here are some things that will make your life easier.

1. If you are a very timid and shy person, this may not be the rotation for you. Partly because it is a completely different country and your attendings are very busy and won’t have time to always hold your hand. You definitely need to embrace a certain level of independence, and don’t mind struggling, or getting lost, and having conversations in three languages (as in my case)
2. When you talk to Dr. Felix about the trip, she will give you an application; make sure and fill that out and. Also be prompt in getting housing at World SPRU Porto as it can fill fast.
3. Even though I sent my application 6 months in advance to Porto, I did not get my welcome packet to Porto from the international office until 2 weeks into my stay. I think in hindsight I should have re-contacted the office by email closer to my arrival. The reason this is key is so that you can get your Student ID, tourism map and guide (probably the most useful of the information you get) as well as a free SIM card for your phone which will really get around the city
4. The student ID gets you into many museums for free, as well as allow you to get access to all the facilities connected to the University of Porto, which the international office will explain to you. Moreover, the SIM card is through the ERASMUS (international exchange program for European students); therefore if you meet other students you can talk to them for free through the Network. Dr. Basto can help you if you help putting money on the account.
7. Remember to bring a copy of your passport any two passport photos with you when you come. One will be for your University of Porto School of Medicine registration when you get here, as well as for your student ID.
8. Try to learn some European Portuguese; I think people actually appreciated it. And for as difficult a language to pick up in my opinion, having some familiarity in Spanish will be an advantage. Beside you will find more people wanting to talk with you because it gives people more opportunities to practice their English. In fact English is compulsory in most Portuguese schools.

On the Wards

Hospital São João is the largest teaching public hospital in Portugal. It also trains residents in all medical and surgical specialties, except for emergency medicine (emergency medicine is not yet a separate specialty) your day will begin in the medicine units. There are 8 units, and 200 dedicated beds solely for the medicine staff. 4 attendings are attached to each unit. The medical units unlike in the United States are separated by gender. your day will start at 8 am and your team will be composed of a Senior Attending, a 6th year medical student, an internal medicine resident and a common intern. Unlike the United States, all residents regardless of a surgical or medical career do a common internship and rotate through all the major specialties, similar to a Transitional year stateside. Don't worry, most of the residents and attendings speak English. The patients usually do not speak English, but when you get acclimated to the wards, you'll pick up a lot of information. I am always asking my colleagues how to ask something or what certain phrases patients are saying, and they have been more then happy to help. Diseases are varied, from patients with glomerulonephritis, heart failure, pneumonia, stroke, etc... There are many similarities and differences in the day to day ritual of managing patients when thinking back on the rotations I did back in the States. In the mornings, our team collect vitals on each patient, discuss nursing notes from the night, perform arterial blood gases as needed, and complete a review of system and physical exam (called observation here). My job on the team was to do the physical exam, and report to the team my findings and whether they have changed since the last exam. I find that physical exam are relied on to a larger degree than stateside, and the residents here are really good at picking up subtle signs. After our morning physical exam and review, we head down to get a snack in the ground floor. There are several coffee/pastry shops in the Hospital with really good options. The coffee is really good, but there will be no Starbuck sizes. If you ask for coffee (café) you will get an espresso, you can also try a café pingado (coffee with a drop of milk), or Meia de leite (half coffee, half milk). The pastries and bread items are all good. I am attempting to try most of them. When you come definitely try the pastel de nata, a very typical Portuguese pastry, and the folhados (literally meaning leaves), which will be stuff with all kinds of goodness. After our break, we check the electronic system to get labs/ x-rays that were ordered on all patients. We also review the patients medicines and determine which ones to keep or to remove. You will usually leave the hospital at 2pm along with the medical students, which gives you plenty of time to travel and sightsee.

Getting Around: Metro

Getting from Porto Airport to WORLD SPRU

To get from the airport to your housing: Follow the signs to the Metro through the airport. You can take money out of the ATM as long as card has a visa logo. Purchase a Z4(1,45 euros) card.

Getting to the Hospital São João: When you are going to work head, towards the Campanha Station. Purchase a Z2 card (0,95 Euros each way), which you can refill. Hope of metro going away from Estádio Dragão. Get off at the Trindade Terminal Station and follow the signs saying Hospital São João. hop on the metro and it the Hospital stop will be you last stop. Make a left, and you will see the Hospital on your right.

Living in Portugal

I am living at the Sociedade Promotora de Residências Universitárias, located incredibly close to the Porto Campanha Interface train station, a major transportation hub in Porto. It a very modern dorm-like facility with 24 hour security guards, internet access built into your monthly rent, private bathroom, study areas, and two televisions in the lounge area. You room also comes with a desk with a lock cabinet, where you can place your valuables. There are also laundry machines on the ground floor (1,50 Euros a load) as well coffee (0,30 euros) by the cup. They also offer a weekly cleaning service to tidy up the bathroom.

Here are some tips before moving in:

Getting here: It is incredibly easy to get to the dorms by the metro. Take the metro from the Porto airport to the Campanha Terminal Station. When you get off make a right. You will see taxis directly in front of you waiting and buses to your right behind the glass. DO NOT take a taxi; walk along that sidewalk going up the hill where the buses are located. When you get to the top of the hill, you will see the residence. This walk is no more than 2-3 minutes.

You will have to pay 50 euros to reserve your month here. I recommend using XOOM (http://xoom.com), since it was cheaper than asking my bank to do an international transfer. I paid 9 bucks, the bank wanted 30 bucks. The director of the campus will email you with the particulars about where to send the money and the codes needed to make sure it gets to the right account. It is a very easy process. When you arrive you will pay for the month upfront, either by cash or bank transfer, since they only use Portuguese debit cards. At the end of your stay, they will check the room, check how much water and electricity you used that month and give you a final bill.

The dorm will provide you with towels, sheets, pillows and blankets during you stay. Feel free to bring your own. You will also get cooking utensils, pots and pans, and have a small kitchenette.

If you want to go with another friend, they do offer dorms for two public, with some having public or private bathrooms.

Also, make sure to bring an international converter.

Why go overseas?

Before starting my journey into the abyss that can be residency, I wanted to get the chance to go abroad. I have always enjoyed traveling overseas, learning about the different cultures, and history. In medical school, we learn briefly about medical systems in other countries, and I wanted to get a more practical grasp on health-care delivery outside of the United States. I have the fortunate opportunity to complete both of my goals before graduation, and complete a month-long medical clerkship rotation in Porto, Portugal at Hospital São João I, the largest teaching hospital in Portugal. This blog will give me a chance to tell you about my travels, post some photos, as well give future medical students tip to make their travels easier.