I spent from the beginning of January
to the end of March in Madurai, southern India, pursuing my interest in medicine
by doing work experience in a hospital there. I went with a company called Travellers
Worldwide, which I found on the Internet while looking for medical work experience
abroad. It had a variety of projects located in Madurai. When I arrived I was given
the choice to stay in the same hospital for the whole three months or to move around.
I chose to stay in one hospital for all three months, which I’m glad I did since
the longer I was there the more interesting were the activities that I was allowed
The Hospitals: Health care in India is predominantly privately run
so, apart from the few government hospitals, all the ‘hospitals’ in Madurai were
more like clinics with just a few specialist doctors working in each. The government
hospitals are more similar to our picture of a hospital, with many specialities
under one roof. The services here are much cheaper than elsewhere, but the conditions
and hygiene of the hospital are very poor.
The hospital that I was placed in was run by two doctors who were husband and wife,
an Urologist and a Gynaecologist. The doctor that I shadowed for the three months,
owned the hospital and specialised in Urology, but he also did general practice.
His wife took paediatric cases as well as the gynaecological cases. This was one
of the bigger privately owned hospitals in Madurai and had about fifty beds for
in-patients, a laboratory, x-ray and ultrasound scan rooms, an operating theatre
and a labour room. The hospital was also in the process of building a large new
My Work: My schedule consisted of going into the hospital for about
two and a half hours in the morning where I would sit in on patient consultations.
All these consultations were in Tamil, the state language, but the doctor spoke
excellent English and he always explained what had been going on afterwards. If
there was a particularly interesting case I would be asked to come and observe or
feel the problem. The doctor would describe what I was looking at or feeling and
he would also direct me what to feel for in relevant cases. This way I became familiar
with recognising hernias and swollen abdominal organs.
From the beginning I was taught how to take a blood pressure manually and in consultations
it became normal practice for me to take the patients’ blood pressure. In the afternoon
there would often be surgery of various kinds occurring and if so I would go into
the hospital around 3:30pm until 7pm. The exact times used to vary depending on
how many surgeries where going on that day or if a visiting surgeon wanted to do
the surgery earlier in the afternoon.
Many of the patients attending the consultations came regularly every day to have
the dressings on their diabetic ulcers changed. The majority of the population have
diabetes in India since they are genetically more at risk, eat a great deal of sweet
food and have a high carbohydrate diet. A high proportion of patients came in with
ulcers on their feet since most people seemed to walk everywhere bare foot. With
all ailments, but especially these ulcers, patients didn’t come to the doctor until
they absolutely had to, so their symptoms were almost always acute. This was particularly
instructive for me, however, as the worse the case the more interesting the diagnostic
and treatment processes.
I particularly liked to see patients during consultations and then see them a few
days later in surgery, as I then knew exactly what was wrong with them and what
was being done to correct the problem.
I enjoyed watching the surgery more than observing consultations as I found seeing
the many structures and organs in their proper places within the body fascinating.
Although I am not very keen on dissecting dead organs, surgery on live bodies is
completely different, with all the tissues such a healthy colour and none of the
off-putting smell experienced with dissection. At first I was only allowed to watch
from the side-lines, but I was in the operating theatre and could see well since
I could move to any position around the table and come as close as I wanted, providing
I didn’t get in the way or touch the sterile area of the table. This was perfect
at the beginning since I had never seen human surgery and didn’t know how I would
react to it the first few times.
After a month or so I was allowed to scrub up occasionally and helped the surgeon
by holding instruments and grips and passing items to the operating staff. I loved
this as I was as close as possible to the action and could see exactly what was
On these occasions I was also allowed to gently probe inside and actually feel what
the various tissues were like. Most of them felt much tougher than I expected. The
doctor and his anaesthetist always explained to me what was going on, as did his
wife whenever I watched one of her surgeries, and I was encouraged to ask questions.
Towards the end of the three months I was scrubbing up for almost every surgery
and on one occasion I was allowed to do a few stitches.
I was so lucky to be able to experience a range of surgical techniques as the Indian
medical profession are in no way behind the West in this respect. I saw key hole
surgery since, unless there was a complication, the doctor always removed the Gall
Bladder in this way from patients with gall stones. I saw many laposcopic and siscopic
surgeries for bladder stones and reduction of the prostate.
All kinds of stones were a common complaint of patients coming into the hospital.
The local water contains a high percentage of calcium and so the calcium deposits
in the bladder and gall bladder where larger than would be found in England. I also
saw open surgery in many areas of the body.
Since the operating theatre was so good the doctor would often get visiting surgeons
in to perform surgeries that were not his speciality or that he could not perform
himself. I also saw all his wife’s surgeries that included hysterectomies, terminations
and caesareans and witnessed orthopaedic surgery and a few different kinds of plastic
surgeries. Since the doctor was an urologist I saw a great deal of abdominal surgery
such as hernia reparations. I really enjoyed watching an appendix removal as that
is the only major surgery that I’ve experienced and seeing what it entailed was
Accommodation and Travel:When I first arrived one girl had been
working in the orphanage for six months, but the majority of the volunteers stayed
anywhere between one and two months with a few staying just two weeks and a few
others doing three months like me. I really enjoyed living with other westerners
as I think I would have been lonelier with a host family. The locals were all friendly
and accommodating, but their culture is so different from our own that they find
it difficult to understand concepts we would think normal. In the house we had a
lady who cooked for us and was always in the house. She was called Jeya and acted
a little like a mother, cooking our favourite meals and so on. We also had a cleaner
who came in every day to clean both houses and a rotation of security guards outside
both houses day and night. The houses were comfortable and really quite Western.
My travelling to and from work was almost always done in “autos”. These were small,
three wheeled motor vehicles, which were driven within an inch of all other obstacles,
animals, people or other vehicles, but never exceeded about 15 mph. The roads were
fun since they were packed with other vehicles and few rules of the roads, except
not to hit the cows, which were left free to wander wherever they pleased including
across the main roads! We had regular drivers, organised and paid for by Travellers.
During the three months I was in Madurai I took the opportunities provided at weekends
to travel around the south of India a little bit. I managed to get away four times.
Two of the places I visited where close by, by which I mean just four hours drive
on a crowed government bus, while the other two were at least ten-hour overnight
journeys. For the longer weekends I took the Friday off work.
Safety: While I was preparing to go to India over Christmas, I made
a decision not to take anything of value with me. I had heard many tales of possessions
being stolen from one’s room, one’s bag and just about everywhere else. I think
I was luckier than most since I lived in a fixed home and knew from the beginning
that anything I left in the house would be safe since Jeya was nearly always in
the house. There was always a security man on duty and everyone who worked in the
house, like the cleaner, knew it was more than their job was worth to steal anything.
I always kept my bag close to me when I was out and about and I never experienced
any attempts to grab it. Once, when on a train, I saw a fellow traveller drop a
purse on the ground and an Indian man picked it up and gave it back. The only other
place I left my bag unattended was at my hospital and in the last few weeks of my
stay I had 1000 rupees stolen. The doctor however, refunded me on my last day, which
I hadn’t expected at all and felt it was very kind of him. My advice would be never
to carry large sums around, unless of course essential for travelling. I usually
carried a maximum of 500 rupees, but on that occasion I had been planning to pay
the local tailor who had made up some dresses and trousers for me.
Conclusion: I strongly feel that my time in India was everything
I hoped it would be. I managed to see and experience so many medical and surgical
procedures and cases that would never have been possible in the UK and I had a fantastic
time as well.
I’ve stayed in touch with many of the people I met in the house and I hope to remain
in touch with the doctor and the hospital. I would certainly like to re-visit and
explore more of southern India as I didn’t do much travelling and I would also love
to go back to the hospital in the future, perhaps on my elective period during medical
I am certain that this unusual experience helped me to obtain the three offers
that I have received following interviews at my chosen universities.
I am grateful to all the sponsors who have shown interest and provided financial
support to allow me to complete this very worthwhile and unforgettable project.