Hidden jewel swallows medical students

The LiU medical programme will grow as of the start of the autumn 2013 term. Admissions will increase in two stages, with a total of 40 new yearly slots. Measures for managing the expansion are now being prepared by the Faculty of Health Sciences in collaboration with the county council.

A big, important piece of the puzzle is an expansion of education activities at Vrinnevi Hospital in Norrköping.

“Vrinnevi is a hidden jewel,” says Johan D Söderholm, dean of the Faculty of Health Sciences.

The hospital, which only a few years ago was threatened with major cutbacks –including shutting down the casualty department –, is now facing expansion and renovation, including an upgrade of its academic status.

When the medical programme is filled with 118 new students every spring and autumn starting in 2014, a proper contribution of resources will be required, chiefly intern positions (VFU) for terms 7 through 10. A large part of that – 1,300 student weeks per term – will be swallowed up by Vrinnevi Hospital.

When news of the government’s decision to expand was only a few days old, medical students Janni Andersson and Magnus Persson started Term 8’s first intern blocks, with placements at the hospital surgery clinic a short distance away from downtown Norrköping and with nature just around the corner. Before them lay a total of twelve weeks with stops in the surgery clinic, the casualty department, the operating theatre, the nursing ward, and the outpatient surgery in Finspång.

In the surgery clinic, Janni will get mentoring from chief physician Kalev Teder.

When a new patient comes in Janni can take them on, listen to their medical history and current status, and perform a preliminary examination. Today she’s met a man who will undergo a gastric bypass to lose weight. Afterwards, she discussed the case with the doctor.

“I can get another view of the problem from the students; it’s fun and stimulating,” says Teder, who is responsible for upper abdominal surgery at the hospital.

When you see things in an internship, you discover what gaps you have in your knowledge, Janni believes.

“For the most part it feels like the doctors have time for questions and discussion. But when something comes up – in the casualty department, for example – you may need to stay in the background.”

This morning, Janni was in the oesophageal lab, where a patient with an oesophageal orifice hernia was having a gastroscopic examination.

“The best part is when you get to do something instead of just watching. That’s why longer placements are good; you get to know the staff. You want to be really good at this.”

To make the VFU even more worthwhile, she’d like to have closer contact with her supervisor. Persson agrees:

“With more and more students in a department, there is a certain risk that the quality of the mentoring can’t be maintained,” says Magnus, who spent the day at the vascular clinic.

When LiU's news team visited, there were five students getting on well in the surgery where Henrik Blomqvist, specialist medical trainer in surgery, is one of three doctors responsible for the students. But all doctors should count on functioning as supervisors.

“It’s great to teach people what you yourself can do. But there’s a limit to how many students you can take on and provide good mentoring at the same time.”

Vrinnevi’s increased responsibility for medical training also entails “academisation” – an increased strain of research staff. To start with, recruitment to four academic combination positions, and the same number of university chief physicians, is under way. They are contemplating making a professor of obesity surgery the first professor at the hospital in a long time.

Teder, like many of his colleagues, does not himself conduct any research. But he welcomes the new effort.

“Research is a source of inspiration for us clinicians. Over the long term, health care will benefit from it in the form of increased safety and quality”.

Blomqvist, who himself participated in several different research project, views connecting specialists with research positions at Vrinnevi positively.

“It strengthens competence at the hospital, as well as the quality of training for the students,” he says.

Internship placements (VFU) are today spread across seven hospitals within a 250-km radius around Linköping. One of them, the University Hospital in Örebro, is being phased out in a couple of years when their own students have come this far in their training. Besides Vrinnevi, Ryhov in Jönköping will get a stronger role; even Västervik has shown interest in offering more places.

In addition to the VFU slots, the need for lecture halls and breakout rooms will increase, chiefly in Linköping where the nursing programme has become overcrowded. Since the government decision means a quicker expansion of medical training than the HU leadership had planned, there will be a gap before the offices in the giant University Hospital construction project is ready. During the wait interest has been expressed in finding space at the Kunskapsgallerian (the former Birgittaskolan).

Text: Åke Hjelm
Photo: Göran Billeson
16-10-2012