Newsletter March 2023: TEP experience report

Inês Ferreira Vieira

picture1Since the very beginning of my residency in Anaesthesiology, I knew I wanted to do an internship abroad. What better way to get out of your comfort zone and meet a different reality? The idea of applying for the Trainee Exchange Program followed naturally. I was thrilled when the response came to say I was accepted into the Program!

Given my interest in both cardiac and paediatric anaesthesia, I wanted to deepen my knowledge of cardiac anaesthesia and see congenital cardiac surgery. And so I headed to Cologne in Germany, particularly to the Heart Centre of the Uniklinik Koln. I arrived there at the end of October for a two-month internship beginning in November. Dr Nicolas Leister provided a warm welcome and immediately made me feel at home.

The cardiac operating theatre in the Heart Centre has 4 operating rooms, with one of them usually reserved for transcatheter aortic valve implantation procedures. During my internship, I was able to see both adult and paediatric cardiac surgery, with some challenging cases and emergencies. I also had the opportunity to perform several transoesophageal echocardiography (TEE) evaluations. This is a skill that is critical for cardiac anaesthesia. In fact, TEE findings can influence or even change the surgical plan.

Although there were several resemblances with anaesthesia practice in Portugal, there were also many differences. The efficiency of the workflow was something that really got my attention. The working day starts around 7h30, with the patient’s admission to the OR. In addition to the room’s anaesthesiologist, two senior anaesthesiologists always supervised the rooms and provided additional assistance if needed. When the end of the surgery was approaching, the next patient would be prepared and anaesthetised in the induction room and would be ready to enter the operating room as soon as the cleaning procedures were finished. I always felt that the workday moved smoothly and efficiently, even amid cardiac emergencies.picture2

I had the opportunity to see several congenital cardiac surgeries in new-borns and very small children, both with and without extracorporeal membrane oxygenation, as well as minimally invasive cardiac surgeries, management of patients with circulatory support (ECMO and Impella devices) and emergent procedures, namely due to aortic dissection.

Certainly, this was a very enriching experience, both professionally and personally. I met some amazing people who made me feel welcome and part of the team. Even though there were natural language barriers, I always felt I was being involved and cared for. I must thank Dr Mehler for all the support, guidance and learning during my internship. Also, I am very grateful for all the tireless help and care provided by Dr Nicolas Leister.

I would like to thank ESAIC and the TEP Committee for this amazing opportunity. I always felt totally supported, especially due to all the help provided by Els Sung, who was always available to assist in every doubt.

This is certainly a program I would recommend to anyone interested in having a life-changing experience! Living and working abroad, getting to know a different language, culture, and traditions is a wonderful growth experience and one that I certainly loved.

“A mind that is stretched by a new experience can never go back to its old dimensions.”

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