University of Crete School of Medicine - Cardiology Rotation

 During my cardiology rotation, there was a group of about 12 University of Crete medical students who were rotating in the department at the same time as me.  I enjoyed getting to know them and I had the opportunity to give a case presentation with 3 of the students.  One difference that I noticed is that medical school in Greece is a 6 year program that does not require a bachelor's degree.  In contrast, medical school in the U.S. requires a 4 year bachelor degree and 4 years of medical school.  I feel like this would make the decision to go into medicine more difficult if one has to choose it straight out of high school.  

 During my last week I was invited to spend some time with the rheumatology department for a couple days.  I was able to see many rare diseases and learn about important physical exam findings.  I also had the opportunity to observe a collaborative meeting where the radiology and rheumatology departments reviewed x-rays together in order to diagnose patients.  Rheumatologists commonly use expensive drugs known as biologics to treat disease.  It was interesting to see that they did not seem to have any issues with prescribing these drugs to patients.  In contrast, I have seen authorization from insurance companies act as a barrier to prescribing these drugs in the USA.

 During the rotation I had the opportunity to spend a couple day's in the electrophysiology unit of the hospital.  While I was there, I saw, ablation procedures, pacemaker implantation, and other electrophysiologic studies.  I have read about these procedure before and being able to see it in person has helped solidify my understanding of them. 

 I began this week in the catheter lab at the hospital.  I have never seen angiography and angioplasty before so it was great educational opportunity for me.  The interventional cardiologists were nice and kept offering me Greek pastries while I watched the procedures.  One thing I did notice is that in the cath lab and throughout the hospital, pictures of Jesus and other religious icons are present in the rooms.  Greek is predominantly Orthodox Christian, and it is a tradition to have these small paintings in homes and other buildings.  Here is one example of a painting.

 I have spent the past couple days in the hospital's cardiac ICU.  One thing I noticed is that there are no DNR, power of attorney, or other advanced directive documents that are used in Greece.  I asked the doctors how decisions are made in the ICU.  I was told that if they are doing something like intubation, they will notify the family first.  For other decisions, the doctors generally make them on their own.  It was interesting to see how different the medical decision making process was in Greece.  There does not seem to be much of a legal framework in Greece.  In America, much more decision power is given to families of the patients.  

I started out this week in the hospital's echocardiography lab.  One interesting thing I noted is that in Greece, the cardiologists perform the echocardiogram and then interpret the results.  In the U.S, they performed by an ultrasound technician and interpreted by the cardiologists.  I'm not sure if this makes a difference in the care that the patient receives.  I have observed that it can enhance the relationship that the cardiologists has with the patient.