The Little Differences

This summer I will participate in a tradition of Hopkins surgeons that dates all the way back to William Halsted by traveling to Europe for completion of a portion of my training. Starting on July 1, I will spend six months operating at the John Radcliffe Hospital in Oxford, England. I plan to spend the first three months working on the Upper Gastrointestinal (UGI) service with Professor Jonathan L. Meakins, Chairman of the Nuffield Department of Surgery, followed by three months of vascular surgery. From the stories told by many of my predecessors, life in the UK is radically different from what I’ve grown accustomed to over the past 3 years of general surgery training:

• OUT: struggling to defy the federally mandated 80-hour workweek without compromising your program’s accreditation. IN: complaining about how much harder it is working almost 40 hours/week compared to the French system.
• OUT: spending every third night draining pus from nearly every conceivable anatomic location. IN: operating independently during once-a-week call without having to carry a trauma pager.
• OUT: Unlimited laboratory and radiologic resources for the efficient diagnosis of routine pathology regardless of cost. IN: England’s National Health System.
• OUT: Friday night outdoor movies in Little Italy. IN: Spending the weekend in Venice, Italy.
• OUT: ABC’s. IN: BBC.

I guess I’d be a liar if I said I weren’t a little nervous about the changes that lie ahead. It will be a lot to adjust to, and in a way I can kind of understand why some residents elect to stay home. But all it takes is one whiff of the characteristic stench of the Johns Hopkins Department of Emergency Medicine, and I am quickly reminded of the immortal words of Samuel L. Jackson (minus the expletives): “I’m goin’, that’s all there is to it. I’m ….. goin’.”