This is a question that many foreign medical students including myself and my friends, asked ourselves when we were scheduling our electives rotations in US last year. Everyone had different opinions, especially depending upon their specialty of choice, but then we used to think ‘is there any electives rotation which can be declared the “best” and “must” for all the specialties?‘. I found the answer to my question this March when I came to UCSF for my radiology rotation. It was one of the best experiences of my life; I don’t think it could have been better.
First let me tell you about the UCSF Medical Centre, Parnassus Centre. It is a 600 bed tertiary care teaching hospital affiliated with University of California, San Francisco (UCSF), has almost all the specialties of medicine and was declared as 7th best US hospital of 2007 by the US News & World report and the best hospital in bay area. UCSF Medical Centre has been in the top 10 rankings consecutively for the past 8 years. Moreover out of 16 various specialties, UCSF ranked in the top 10 position of the 8 various specialties including endocrinology, neurology and neurosurgery, gynecology, urology, cancer, respiratory disorders, rheumatology and ophthalmology in 2007.
UCSF Medical Center is recognized throughout the world as a leading academic hospital that provides innovative treatments, uses advanced technology, fosters collaboration among clinicians and scientists, and employs a highly compassionate team of doctors, nurses and staff. As far as UCSF medical school is concerned, it is the only US medical school to be ranked in the top 5 positions in both research and primary care rankings in 2008 among all the other US medical schools. According to the official NIH Rankings of 2005, it is the 3rd best medical school in US.
I worked in the Radiology Department of UCSF Medical School which ranked as one of the top 10 US Radiology Departments according to NIH Awards of 2005. I had the 140.03 Diagnostic Radiology Elective; most of our teaching was done in The Henry I. Goldberg Radiology Learning Center for Advanced Imaging Education in UCSF.
Each morning by around 9 am, we had small group lectures, seminars and case demonstrations by the radiology faculty. Over the 4 weeks, we covered the full spectrum of diagnostic radiology, including sessions on nuclear medicine, neuro-radiology, interventional radiology, introduction to body imaging, chest and musculoskeletal radiology and true hands-on ultrasound demonstrations.
This exposure to basic and advanced imaging and image interpretation is supplemented by some wonderful self-instructional cases especially by Dr. McCowin in all the major areas of imaging. These teaching case files are available all days, evenings, and weekends. Radiographs from the PACS are used to practice skills in acute care imaging. Moreover each student rotates on evening “night-call” with radiology residents; I had a wonderful experience on these calls and it is a great experience of learning the true practical aspect of not only imaging and radiology but also many related specialties. Moreover it provides us with a chance to share the responsibilities of residents and then in the morning, we share our call experiences under the supervision of a resident, with the other students using the PACS.
We had small group lectures, seminars and case demonstrations daily by the UCSF radiology faculty on various sections of diagnostic radiology like nuclear medicine, neuron-radiology, interventional radiology, chest and musculoskeletal radiology. Most of them were exceptionally well-oriented lectures and interesting case demonstrations especially those by Dr. Breiman, the course director. The 3D Stereoscopic Imaging demonstration by Dr. Breiman will make you apreciate how far UCSF radiology department has progressed.
There is a also a true hands-on ultrasound and Doppler demonstration where you yourself perform the ultrasounds of other students. Then the self-instructional cases and presentations by Dr. McCowin is a wonderful learning experience. She is the best and most dedicated teacher one could ever come across; she would make you see hundreds of things in the X-Rays, CT- Scans, MRIs and Ultrasounds without even giving any formal lecture. Actually, the interactive and self-instructional modules are so beautifully designed by Dr. McCowin that you don’t even feel like you are learning and she is teaching, but you remember everything. Moreover, handouts are given out as the study material in addition to the extensive online material. In short, the resources and staff create an intense, productive learning environment and the phenomenal lecturers make learning interactive and memorable.
Each student is assigned to make a Powerpoint presentation on the last day of the elective regarding any medical topic of their choice with some interesting pictures of themselves and their area. It is indeed a very pleasant experience. At the end, the students are given a Pass/Fail according to their presentations and their learning experience in the past 4 weeks. There is also a small celebration: a pizza party over lunch on the last day of elective to provide a memorable ending to a beautiful learning experience.
I would give special credit to the course director Dr. Breiman on designing such a wonderful elective course for all the UCSF and visiting medical students. I would call it a “learning treat” as it does not feel like learning; by the end of the electives, you would realize that you had great fun and you also learned a lot. I consider myself incredibly lucky to have been taught by these radiology professors as they have been the finest and most dedicated group I have ever encountered.
As this is a clinical elective in Radiology, there was not much patient interaction. As far as any language difficulties are concerned, if you know English well, you would not have any problem interacting with staff and other students. However, even if you don’t know how to speak good English, you need not worry. I would recommend interacting more and more with the staff and other students, they all are very helpful, co-operative and understanding, you would not feel like being a visiting medical student.
I very strongly believe that you learn a lot during these few weeks in the very intelligently designed 140.03 elective by Dr. Breiman in UCSF/Henry Goldberg Center for Advanced Imaging Education. Irrespective of whatever field you plan to go in, the UCSF people teach you in such a great manner that you acquire a vast knowledge of your specialty, whether it it be medicine, surgery, pediatrics, orthopedics or even anesthesia. It seems that they have something for everyone. The best part is most of the instructors would ask your specialty of choice before your lectures and note it down and then teach and question you accordingly. So at the end, you don’t feel like you have studied only radiology but you feel like you have acquired an immense amount of knowledge in the field of your choice probably because they discuss in detail every aspect of the radiological findings including anatomy, physiology, pharmacology, pathology, medicine and surgery; this way everything is revised in a very systematic manner and much of it is retained, with reference to the radiological image you see. I wish I could have learned what I did here before. I am jealous of the UCSF medical students, because they have always had this quality of instruction.
UCSF staff and students are very nice, helpful, understanding and co-operative; they would do whatever they can to make your stay a memorable experience. So you have a great time in UCSF. Moreover you find a chance to meet new people from various parts of the world, so it’s a rich and interesting cultural exchange program.
The same holds true for San Francisco; you would find people from every part of the world, along with food and grocery stores from all ethnic groups. You would meet many new people and learn many new interesting things. In general, people in San Francisco are very co-operative, helpful and easy-going. Moreover, San Francisco is well known for its awesome weather, beautiful scenery and bay area; it’s a hilly area with steep roads and a beautiful ocean, it’s a great place to be and one of the biggest tourist spots in the world! You would definitely have a great time here! However, as UCSF does not provide any accommodation to visiting medical students itself and San Francisco is somewhat more expensive as compared to other US cities, so you might face some problems in finding accommodation. Traveling is much cheaper in San Francisco than most of the other US cities as they have a really nice public transport system e.g. Judah, MUNI, BART etc.
If you are interested in getting radiology elective in UCSF, then it has the most convenient application process among all the US medical schools. They reserve a spot for you on your request via email and then you have to send the fees with the application form but keep in mind UCSF accepts foreign medical students only in Radiology and Anesthesia departments so you cannot apply for elective in any other UCSF department.
Before starting the elective it is better if you revise some of the basic anatomy, specially the relations of structures in mediastinum and abdomen. Moreover, try to go through the Rad100 Syllabus (accessible on the UCSF Radiology department website after acceptance) before the start of your elective.
UCSF is one of the best medical schools in the US and the Henry I. Goldberg Radiology Learning Center is the best learning center for radiology in the whole world according to me. I would very strongly recommend this elective to everyone irrespective of whatever specialty you plan to go in; you would definitely learn a lot related to your specialty. I had a wonderful experience in UCSF and found an answer for my question, “Which is the best place for electives in US!”… it could not have been better in any way….it was simply the best experience and I very strongly recommend it to everyone.
Umar Tariq is a final year medical student at King Edward Medical University, Lahore, Pakistan.
umartariq58@yahoo.com